How big is too big?

rockychryslerb2010

I haven't posted here before, only because I didn't think I would need a c-section.  Now, it is looking more and more like I will be having a c-section for this baby.  DH and I were planning a natural childbirth, with use of a birthing tub, for labor & delivery.  At 38w5d, I had a growth ultrasound and the baby measured at 12lb 14oz.  I have always been of the mindset that my body won't make a baby that is too big and a big baby is not a good reason for a c-section.  This weight estimate is making me rethink all of that, because even with the standard margin of error, LO is probably over 11lbs.  We have a meeting with the OB later to discuss options, but based on my initial conversation with the midwife and OB last night, it sounds like they are going to recommend c-section, and not let me try to delivery vaginally.

My question is, has anyone been in a similar situation? How big is really too big to try for a vaginal birth?  I know we will do what is best for LO and me, but I'm struggling with electing a c-section without trying to labor vaginally first.  I know there is the possibility I could delivery vaginally, but I also know there could be risks and we'd end up with an emergency c-section anyway.  I'm curious to hear if anyone has had a similar experience and what helped you come to terms with it.

chicsub

Did you have a follow up u/s to make sure it wasn't fluid or baby's position that threw things off?  How is your fundal height measuring?  Any family history of bigger babies or GD?  Those are some things I would look at first before making any decisions.  I'm like you with the mindset that your body can handle it, but if multiple ultrasounds were estimating my baby to be almost 13 pounds I'm not sure.  However, late growth u/s are the least accurate too, which is why my midwives never did them.  Was there concern and that's why you had one done? 

katmacwv

That sounds like an unusually large baby.  I've heard of some u/s techs being off by more than 2 pounds, but my tech was only 3 oz under DD's real weight when she estimated 8 lbs, 9 oz.  At my initial appt with my OB, he told me that something in my pelvis was narrow (the appointment was almost 5 years ago so I can't recall specifically what was narrow) and that if I had a baby over 7 1/2 lbs, I probably could not deliver vaginally.  My OB isn't what I would call a "cut happy" doctor, so when the tech estimated more than a pound over what the doc said could fit out of me, I didn't even want to attempt a vaginal birth.  A number of my friends ended up with c-sections after laboring for hours, and I saw the writing on the wall that that was where I was headed.  When DD came out at 8 lbs, 12 oz, my OB said that we had done the right thing by doing the c-section.  I agreed with him, but I didn't have a difficult time coming to terms with anything, as I wasn't set on the idea of a vaginal birth.

nosoup4u

chicsub:

Did you have a follow up u/s to make sure it wasn't fluid or baby's position that threw things off?  How is your fundal height measuring?  Any family history of bigger babies or GD?  Those are some things I would look at first before making any decisions.  I'm like you with the mindset that your body can handle it, but if multiple ultrasounds were estimating my baby to be almost 13 pounds I'm not sure.  However, late growth u/s are the least accurate too, which is why my midwives never did them.  Was there concern and that's why you had one done? 

I agree with this.  Is it your first sizing u/s this late? Can you have another one done, ideally with a different tech?

ACOG recommends c-sections if the baby is estimated at being over 11 pounds (though macrosomia can only be *really* determined after the baby is born, unfortunately).

It's definitely a hard call! If it were me, I would probably attempt a vaginal birth, and wait to go into labor on my own (as opposed to being induced). A c-section after labor is hard, but there's always a chance of vaginal birth, which is a faster recovery. Another option would be to wait until you start labor, and then have the c-section. 

This is a good blog post about macrosomia: https://birthsen.tmdhosting930.com/?p=1531

Good luck deciding!!

shibby00

Yikes that is one big baby!  On here I see tales of late u/s being wrong all the time, but my u/s done 4 days before my DD was born was right on.  I think your doc would want another u/s done just to make sure that it was correct!  I would want no part of vaginally delivering a baby over 10 pounds.  Or over 9 pounds, but that is just me and a very UO on TB.  GL!

skio

chicsub:

Did you have a follow up u/s to make sure it wasn't fluid or baby's position that threw things off?  How is your fundal height measuring?  Any family history of bigger babies or GD?

Ditto all these questions. Also, has the baby been measuring large throughout the pregnancy or just this u/s? I mean, 12 pounds is a big baby, but I can't imagine that is correct unless you have GD.

It's your call, but if I were in your position, I'd hold firm on trying to labor and deliver on my own before going into a c/s. Sure, you may end up in an emergency section, you may end up in a non-emergency section, or you may push that baby out with no issues at all. No one can tell you that a baby is definitely too big for you to deliver naturally, and you won't know unless you try. DD wouldn't pass under my pelvic bone despite full dilation and three and a half hours of pushing, so she may not have fit, period. But I sure as hell tried my damnedest before giving in to major surgery.

kkfeb04

DS was 10 lbs and I had a c/s because I wasn't even prepared to labor at 39 weeks.  His head was 15", I don't care how much the head collapses, I highly doubt I could've pushed that head out.  I have absolutely no regrets not laboring at all.  I wasn't effaced, dilated, nor having contractions.  After I had my final u/s in the hospital, the midwife said to me, honestly I would have the c-section, you could be here for 36 hours and still end up with a c-section since my body wasn't prepared to labor.  I knew the possibility was high for a c-section at 32 weeks when he was measuring at 5 lbs 13 oz.  So it wasn't a shock or surprise, I never had a birth plan because you just can't always plan for things.  As for this LO, I still have no birth plan nor do I plan to make one.  If this one is smaller than DS, sure I'll have a VBAC if my body decides to go into labor.  If this one is the same size or bigger and my body isn't prepared to labor, I'll have a RCS, no big deal either way. 

As far as late u/s are off, I think it depends on the techs, if you have great techs, they aren't really off.  I had weekly u/s with DS starting at 30 weeks.  They were right on track.  My last one was 6 hours prior to the c-section and it was barely off, they stated he was about 10 lbs 1-2 oz and he was 10 lbs 0.5 oz (they rounded down to 10 lbs even). 

FusionLMT

kkfeb04:

DS was 10 lbs and I had a c/s because I wasn't even prepared to labor at 39 weeks.  His head was 15", I don't care how much the head collapses, I highly doubt I could've pushed that head out.  I have absolutely no regrets not laboring at all.  I wasn't effaced, dilated, nor having contractions.  After I had my final u/s in the hospital, the midwife said to me, honestly I would have the c-section, you could be here for 36 hours and still end up with a c-section since my body wasn't prepared to labor.  I knew the possibility was high for a c-section at 32 weeks when he was measuring at 5 lbs 13 oz.  So it wasn't a shock or surprise, I never had a birth plan because you just can't always plan for things.  As for this LO, I still have no birth plan nor do I plan to make one.  If this one is smaller than DS, sure I'll have a VBAC if my body decides to go into labor.  If this one is the same size or bigger and my body isn't prepared to labor, I'll have a RCS, no big deal either way. 

As far as late u/s are off, I think it depends on the techs, if you have great techs, they aren't really off.  I had weekly u/s with DS starting at 30 weeks.  They were right on track.  My last one was 6 hours prior to the c-section and it was barely off, they stated he was about 10 lbs 1-2 oz and he was 10 lbs 0.5 oz (they rounded down to 10 lbs even). 

My son was the same size w/ the same size head. I labored for 40 hours and then got the section. I wish I had been given the same advice you did! That labor was THE most painful thing I have ever been through.

alohasoprano

I had a similar birth plan. I went into labor at 41 weeks exactly, labored naturally for 30+ hours, transitioned and everything, but baby wouldn't drop. The length of my labor lead me to an infection, baby's heartrate skyrocketed, I had a terrible fever and I was rushed into an emergency c-section. Turns out he was stuck and couldn't pass my pubic bone. He was 9lbs 4oz, 22in long with a head circumference of 35 1/2 cms. He was literally stuck. 

 My c-section has been a very emotional thing, but I think it would have been easier if I had a planned c-section. My body was physically exhausted, my uterus was in shambles by the end, which has made my recovery even harder. Plus I went through over 30 hours of labor but didn't get the euphoric emotional closure that, they say, comes after labor when you push your baby out. 

Back when I was still pregnant it would have been very difficult for my doc to talk me into a c-section, but knowing what I know now, having been terrified and nervous about the well-being of my baby and myself, I am much more open to the idea of elective c-sections, when done due to possible risks of vaginal delivery. 

It took my experience to make me realize that there are many ways for babies to arrive, and arriving healthy and with a healthy mom is the most important thing.  

chicsub

I know this may be obvious, but the women on this board have all had c/s so you probably won't hear any positive vaginal birth stories here.  Not saying that's the way to go, but I also don't want you getting freaked out b/c you're just hearing bad stories. 

maddie80

Hard to say how big is too big, because so many factors play into the equation.

I will say this - my DS was a 9 lb, 15 oz baby.  Our us tech estimated him to be 8 lbs.  I labored for 27 hours, and pushed for 4.  I was not deadset on a vaginal birth, but it was my preference.  Only at the 4 hour mark, when I asked my midwife dead on if she thought we had a shot, did she tell me that she thought we should move on to a c-section.  I personally would have prefered to have some of that advice earlier.  My recovery was tough because I'd basically had the "Full service" birth experience, and I was very medicated the first few days.  I don't have a ton of memories of exactly how they went, and I wish I did.

 For these reasons, and because my DD is still breach, we will likely be scheduling a RCS.

caseywanner

My first baby was born at 10 lb 10 oz by vaginal delivery. My doc never did a growth ultrasound but suggested we induce at 41 weeks because she thought I was having a large baby. After cervadil I started contracting right away. I went from a 1 to an 10 in about 7 hours and pushed for another 3 hrs after that. I couldn't deliver my baby on my own. They had to pull her out with the vaccum extraction and I ended up with a 4th degree tear that didn't heal properly.

I don't want to scare you but had my doc bothered to do a growth ultrasound and to give me more information on what happens to your body if you have a 4th degree tear. I would've elected for C-section instead, without hesitation.  And I went into my delivery wanting it to be as natural as I could, I avoided epidural and everything to be able to have my baby and to avoid c-section as my ultimate goal.

I am now 14 weeks pregnant with my 2nd and have to choice but to have a c-section this time only to maintain what is left of the damaged tissue from the previous delivery. Best of luck and you can only make the choice that is right for you!

 

biblionerd

I don't think there's a single answer to "how big is too big". You'll hear ALL sorts of stories from 6 lb babies who wouldn't come out vaginally to 12 pounders delivered vaginally. My OB is a very med-free friendly Dr. and her patients are about 50/50 med-free with an extremely low c/s rate. So when she told me c/s was our best option I believed her. I'm only 4'11", but have a narrow pelvis. DS was measuring 9lb 5 oz (born 9lb 2 oz) with a 99th percentile head and shoulders nowhere near measurable. I was a firm believer of "your body won't grow a baby bigger than it can deliver except for GD, etc. " but I'm so glad I listened. When she was in there she said there was absolutely no way he was coming out vaginally. He would never drop and it took 3 people to get him unwedged from my pelvis, which she said was not only very narrow but funny shaped.