XP from 3rd Tri: Elective C-Section-Size

Lindsay112010

I'm wondering what you all think and/or if you have any experience with elective c-sections.  Baby boy has been measuring big since 8 weeks and at my growth scan last week at 37 weeks 2 days, I was told he was measuring at 9.5 lbs which could be off 1.5 lbs either way.  So he's either currently 8 lbs or 11 lbs.  Ultrasound tech said she hoped we didn?t by any newborn diapers lol.

Doc says their "eyebrows are raised" and that the biggest concern is shoulder dystocia.  She explained this can happen with a baby of any size and that it's not guaranteed to happen just because he's larger, but it is something to be aware of.  She explained that they don't really do elective c-sections unless you feel strongly about it (and even then, it sounded iffy).  They will basically just watch and see and do another growth scan on my due date "if I'm still pregnant".

I've done some research and have been thinking about it since then, and I know there's no guarantee he will be huge and no guarantee there will be any problems if I try to deliver vaginally, but I would feel more comfortable with a c-section.  I don't want to try to deliver vaginally and end up with them using forceps or laboring forever and stressing my baby only to end in an emergency c-section because he's stuck or something.  I'd just rather not take the chance.  I don't want the c-section early.  I'd go as close to his due date as possible.

What are your thought's/experiences with this? Also, my doc is very cut and dry, and sort of stuck in her ways I guess you could say.  What would you do if you wanted a c-section for the reasons I described above and they refuse? Can they do that?

Thanks!!!

lintscreen

I was in a very similar situation.  DS was measuring large during my entire pregnancy.  At one point, they projected his birthweight would be over 10 lbs.  My side of the family makes big babies and DH's side of the family makes big heads.  I kept resisting the idea of c-section w/my doctor, and he also was worried about shoulder dystocia.  After my 20 wk ultrasound, Dr. sheduled my c-section at the hospital "just in case" we needed it.    I was aginst the idea of the c-section the whole time as I wanted to feel labor and give birth the way I was made to.  When we came up on the c-section date and there were absolutely no signs of DS coming on his own, I decided to go ahead w/the scheduled section.  Also, as much as I didn't want to do it, DS's safety was my top priority, not my own wishes. 

In the end, DS was born at 8 lb 10 oz w/a head size in the 99th percentile.  They still had to use a vacuum to get him out.  In talking to my doc after, there is no way he would have come out vaginally, so we made the right decision. 

callalilly323

Having a c-section due to macrosomia should not be considered elective.

DS was measuring over 11lbs on my due date, and 3 different doctors recommended the section. He was 10lbs3oz 23in at birth and I do not regret my decision at all. If anything had happened to him I never would have forgiven myself.

I will say that I did not schedule the section until my due date because I held out hope I would go into labor.

The section itself was not bad. The worst part for me was getting the spinal because DH couldn't be in the room and I was a bundle of nerves. I wouldn't have been able to hold th baby much even if I had delivered naturally because they check the sugar in large babies (I did not have GD and DS had no issues but it's procedure).

 Like PP, my doc says I absolutely made the right decision.

LaRue86

Honestly if you want to deliver vaginally give it a shot. Worse case you end up with an emergency c-section. My doctor gave me the parameters I would have to meet and at which points I would be sent for a c-section.  I would have to advance at the clinical standard of 1cm/an hour, my doc said if I didnt, c-sec and that it had to be a full centimeter not 1/4cm or anything like that. If they began thinking they would need foreceps or vacuum that it would be a c-sec under general anesthisia. Finally, my Bishop score had to be favorable for induction.

I "chose" the c-section. My Bishop score was never favorable for induction and my doctor didnt want me going past 41wks. We scheduled the c-section for 41wks and would determine another course of action if I happened to go into labor.

I am glad that we scheduled it because I avoided the emergency c-section. DS was only 9lbs, but due to my body structure and surgeries I will never be able to deliver vaginally. His head was also a hair shy of 15inches. C-section for size is not elective.

Good luck with whatever you decide.

Five_letter

I opted for the c/s and my baby was only 6lbs 9oz.My doctor was against it, but I guess legally he had to offer it. I had a 1 in 1500 chance of her shoulders getting dislocated.

Still the best decision ever. 

ImThisBabysMom

My Dr was concerned that my pelvis could be too small to deliver but they weren't sure. They recommended trying vaginally and if it didn't work, we would have to do a c/s. I labored for 13 hours. Stuck at 8cm. Baby couldn't get any farther. She was high enough we could still do a c/s. Plus baby had made her bowel movement inside. So no more labor. I wasn't an emergency c/s where I was knocked out. But it wasn't planned. I would try vaginally if the Dr thought it could work. That's just me.

rockychryslerb2010

LaRue86:

Honestly if you want to deliver vaginally give it a shot. Worse case you end up with an emergency c-section.

I just want to point out that this is not the worst case scenario. If you get into trouble, best case is that the emergency csection happens in time. Worst case scenario is something happening to your LO and not being able to get him out in time.

I was in a similar situation, and really wanted a vaginal birth. We scheduled a csection at 39 weeks because he was measuring 12lbs 13oz. He was 11lbs 4oz at birth and his chest was thicker than his head so they said there was no way he was going to come vaginally.  Ultimately it if your decision, and no one can guarantee the measurements are correct.  I approached the decision as picking what was best for E. when you start looking at the risks it becomes and easy decision.

I think sometimes some of the bump boards are a little harsh on this topic, saying that a big baby is not a valid reason for a csection. You never know what you will do until you are faced with the decision. I had great csection experience and my LO is here save and sound, who cares if I didn't give birth vaginally. I'd rather have my baby than bragging rights about birthing a large baby vaginally. 

skio

rockychryslerb2010:

If you get into trouble, best case is that the emergency csection happens in time. Worst case scenario is something happening to your LO and not being able to get him out in time.

I had great csection experience and my LO is here save and sound, who cares if I didn't give birth vaginally. I'd rather have my baby than bragging rights about birthing a large baby vaginally. 

Something happening to the baby is the worst case scenario in ANY delivery and no one should be going into a birth thinking in terms about what the worst possible outcome could be. This isn't very encouraging logic.

And regarding the second bold part, that's a really narrow point of view to have about birth experiences. I don't think that women who do succeed in delivering vaginally, whether it's a large baby or not, are looking to brag about it. They're probably thrilled that their birth plan went according to plan. Do you think that they're any less happy that they have a healthy baby in their arms? Of course not. But the "at least you have a healthy baby" line can be hurtful to a woman whose birth plan failed. It's very dismissive of the feelings of failure many women experience after a birth plan ends in surgery and adds guilt to an already emotionally-charged situation. Of course every woman should be happy to have a healthy baby, but can a woman whose birth plan fell apart not also feel sad about it? It's great that you're happy with your c/s, but a lot of women are not. And FWIW, I agree that there are people out there who think negatively about elective c-sections due to projected size. And they, too, need to open their eyes and realize that every woman is different and every woman's emotions are different regarding the birth of her children.

OP - This is an extremely personal decision and you have to do what's right for you. I think a lot of it depends on whether a vaginal delivery is something you want to experience or not. Will you feel like you've lost something if you don't deliver vaginally? Some women grieve the loss, and some are more than happy to elect for a c/s and never have to go through labor and pushing. Talk to your husband and your OB and weigh all your options before making the decision. One thing to consider and talk to your OB about is how many children you want. The risk of c/s goes up with every surgery, so many OBs don't like to do more than three on one woman, but this varies. Many women on this board have had four.

DD measured large throughout my pregnancy and they estimated she'd be 9lbs at birth. Electing never came up and I would not have considered it if it did. I ended up with a c/s and had a horrible experience and recovery. DD was 8lbs 14oz, so right-on as far as the measuring u/s, but I do not believe that she was too big for me to deliver. Decisions on my part and a bad combo of drugs led to a stalled labor. Next time around, I will have to think long and hard about whether or not I want to try to deliver vaginally again. If the baby measures big again, I may elect c/s, because I do believe that c/s recoveries are easier if you don't labor beforehand. Unfortunately, I was one of the women who had a very hard time coming to terms with the inability to deliver vaginally, and I didn't know I would feel that way until after DD was here. So, for me, trying again, even if it ends up in surgery, will probably be more healthy than electing c/s.

Again, the birth experience is personal and yours alone - do what you feel you need to do to make it a good one. GL.

 

rockychryslerb2010

skio:

rockychryslerb2010:

If you get into trouble, best case is that the emergency csection happens in time. Worst case scenario is something happening to your LO and not being able to get him out in time.

I had great csection experience and my LO is here save and sound, who cares if I didn't give birth vaginally. I'd rather have my baby than bragging rights about birthing a large baby vaginally. 

Something happening to the baby is the worst case scenario in ANY delivery and no one should be going into a birth thinking in terms about what the worst possible outcome could be. This isn't very encouraging logic.

True, but to make an informed decision like this, one must consider all possible alternatives / outcomes.  I was simply pointing out that the comment about an emergency c-section was a little too light for me - emergency c-section implies something is wrong with the baby, which I know we would all like to avoid.

And regarding the second bold part, that's a really narrow point of view to have about birth experiences. I don't think that women who do succeed in delivering vaginally, whether it's a large baby or not, are looking to brag about it. They're probably thrilled that their birth plan went according to plan. Do you think that they're any less happy that they have a healthy baby in their arms? Of course not. But the "at least you have a healthy baby" line can be hurtful to a woman whose birth plan failed. It's very dismissive of the feelings of failure many women experience after a birth plan ends in surgery and adds guilt to an already emotionally-charged situation. Of course every woman should be happy to have a healthy baby, but can a woman whose birth plan fell apart not also feel sad about it? It's great that you're happy with your c/s, but a lot of women are not. And FWIW, I agree that there are people out there who think negatively about elective c-sections due to projected size. And they, too, need to open their eyes and realize that every woman is different and every woman's emotions are different regarding the birth of her children.

I didn't go into it, but this was me.  My birth plan went horribly wrong - I was planning a natural, water birth assisted by a doula and midwife, and I had a planned c-section due to size.  I am happy with my c-section, but only because I keep telling myself it was the right thing, because I have my baby safe and sound.  Of course there are times I think 'what if' and 'did I make the right choice'...

eyenigh

I'll sit back and get ready to accept the flaming that might occur, but, although they seem to be in the minority on TB, there are also women like me who had absolutely zero concern about a birth plan. I would've had him out of my mouth if it was the easiest way out. All I cared about was that I safely delivered a healthy baby and I honestly just didn't care about the process or experience at all. The less pain and waiting, the better,if possible. I was violently ill throughout my entire pregnancy so, I have to admit, I wasn't excited about the prospect of more discomfort but, ultimately, I was ready to roll with whatever came up as long as I made it full term and kept him in there as long as was good for him. For that reason, when my baby measured in the 95th percentile or above my entire pregnancy, and the doctor started discussing options, I had no problem picking the c-section and, to be honest, I was relieved. I'm much more comfortable being able to plan things. I had no stress about when the baby would come or if he might get stuck. I educated myself about what to expect, and steeled myself for the worst, just in case.

The c/s couldn't have gone better. I went in relaxed after a good night's sleep and had my son 2 hours later. My pain was minimal. In fact, if it weren't for the baby,  I'd could've went back to work on Monday (my c/s was on Friday)-- I felt that good. The baby came out screaming his head off, healthy and big. I only took pain meds for 3 days and switched to over the counter ibuprofen after that. I've always only wanted one child but I'd pick this way again in a second if I ever had plans for more. It was just a good choice for me. I'm glad that I skipped labor and definitely have no regrets about that. 

I've never felt like I missed out on anything and, to be honest, I didn't realize this was even a feeling that women had until I started reading stories on the Bump. I never had a moment that I felt like I had to "accept it and move on." I was cool with whatever happened and don't regret anything! I don't say this to be insulting to anyone who does feel like they've missed out on something because your feelings are as legitimate as mine. For the the same token, though, you have to realize that some women really don't have an attachment to the experience so these decisions don't carry as much weight as they would for someone who really wanted things to go a specific way. 

bridein08

DS measured large early on (I had preterm labor x 2 around 31 and 33 weeks and he measured 5.5 pounds at 31 weeks), so we scheduled a growth scan at 37 weeks. He was measuring on track to be over 9 pounds at 40 weeks (and bigger if I went over, which most FTM do). 

We decided on a cesarean, and he ended up being 9+5 at 39 weeks to the day. I am so glad I opted for the cesarean (due to size, and he had a nuchal x 3 and a tight true knot that would have left us with an emergency c-section at best, and possibly without a baby, worst case scenario). I will be having a RCS for all future babies- the recovery was actually very easy.  

 

ETA: I asked the doctor straight out if a cesarean was an option and we discussed it an length, and he was open to it (before the scan, pending the results of the growth scan). As soon as he took my son out, saw his size and cord situation, he said "Great job choosing the cesarean- you made the right choice," which made me feel better, too. Make the choice that is right for you!  

bridein08

eyenigh:

I'll sit back and get ready to accept the flaming that might occur, but, although they seem to be in the minority on TB, there are also women like me who had absolutely zero concern about a birth plan. I would've had him out of my mouth if it was the easiest way out. All I cared about was that I safely delivered a healthy baby and I honestly just didn't care about the process or experience at all. The less pain and waiting, the better,if possible.

 

I am so with you on this. I don't understand the obsession with birth plans- and I am a ridiculous, ridiculous controlling planner. Maybe it has to do with my medical background (being a nurse), but the romanticizing of this "plan" that everyone has and refusing to accept anything different, really bothers me.

Everyone's goal is the same- a healthy baby. I was like you, do whatever you have to do... just get him OUT, healthy. I never had a plan.  (I am not saying someone else shouldn't- I am saying I do not understand people who refuse to have a flexible plan, if they have one at all. L&D is not a predictable, static thing- every person's is different, which is why a rigid, strict plan will not work for MOST people)

nosoup4u

If you attempt a vaginal birth and it comes to the doctors asking to use forceps, you can opt for a c/s instead, it's your choice. And most unplanned c-sections aren't "emergencies" per se - in the vast majority of cases, the baby is doing fine, and the c/s is for FTP or FTD.

I would at least attempt a vaginal birth. My second son (who was a VBAC) was just over 10.5 lbs, 23.5 inches and a giant chest. No one had any idea he was that large. I had a second degree tear, but the recovery was still easier than with my c/s.

Like someone said above, it's a really personal decision (and a hard one at that!). But having an initial c/s does affect your future pregnancies - being a VBAC candidate is hard, and just because you have one large baby doesn't mean your next ones will be really big, too.

Good luck deciding!

callalilly323:

The section itself was not bad. The worst part for me was getting the spinal because DH couldn't be in the room and I was a bundle of nerves. I wouldn't have been able to hold th baby much even if I had delivered naturally because they check the sugar in large babies (I did not have GD and DS had no issues but it's procedure).

This wasn't true for the hospital I was at - DS2 had his blood sugar checked a few times, and I held him for all of them. It definitely depends on the hospital.

 

mrsmullins11

I was placed on bed rest at 36 weeks (BP was shooting up, labs showed I had mild preeclampsia). At my 38 week appointment, my OB checked me and found I was 2cm and 80% effaced. She sent me to the hospital to be monitored with plans of inducing me in the next few days. She ordered an US (LO was measuring 1.5 weeks bigger than planned at 31 weeks, estimated weight was 10lbs+). The tech did the ultrasound, measured his head at 42weeks (I was only 38 weeks) and said he weighed close to 9lbs, give or take a pound. My OB suggested a c-section based off labs and head size of my LO. The c-section was a breeze, I have no complaints, but when baby was delivered, his head measured 14 inches and he weighed 7lbs 10oz (a ways off from the estimated 9 and 10 lbs). I went to have my staples removed and overheard her telling my story to a resident and the moral was "You can't always trust the ultrasound!" haha

hasenbank

I had the same issue.  DS measured big the whole time and at 38w5d, he measured at "9 lbs. 3 oz." now we knew that could be off, but my dr. was not comfortable delivering him vaginally...and to be honest, neither was I.  The possibility of should dystocia was not something I wanted to risk.  I ended up having a SCS at 40w1d.  

By the way, DS was born and weight 9 lbs. 14.9 oz.    AND was face first so I wouldn't have been able to deliver him anyway.