so i met with my midwife last week.... she's 1 of 2 (and a doctor) at the practice i'm going to this time around. i really liked her. she was VERY PRO-VBAC. funny. and great personality.
then..she suggested this to me. going for a level 2 ultrasound (which measures baby...as far as size, not just the anatomy inside the baby) ... and she said they can give me a better "idea" if vbac is possible for me, since i have a history of BIG BABIES. (DS was 9lbs. 5oz.) ... She said that they might recommend inducing me anytime from 36 weeks on, which would be considered full term, since the baby gains so much weight in the last couple weeks.... Which could up my chances of having a VBAC. My doctor's office trusts these OB's doing the level 2 ultrasound, as their connected with the practices..
Now let me add, I was induced at 40w2d with DS, went through entire labor beautifully! pushed for 3 hours..and he wasn't budging. I had an epidural (which im not doing this time around...if i go VBAC all the way), so i couldn't get into another position on my feet to try to get baby out.
therefore, she thinks he was just TOO big to fit and allowing the baby to be smaller might heighten my chances of VBAC this time.
I dont know what to think now... I'd rather go naturally, which i think makes my chances greater for a VBAC, rather than "be set up for failure" again. I'm so confused. Especially since every labor is different, every mom is different, and every baby is different.
Any advice or tips would be appreciated. TIA
Re: inducing before 40 weeks...thoughts? kinda long, sorry
Just my thoughts here, not a researched opinion...
I would decline the u/s to measure baby. They are notoriously inaccurate, and even if the measurement was right on, it doesn't tell you much. 9lbs 5oz is big but not ridiculous- plenty of women have pushed out babies that large and larger. (Now if your DS had been 11, 12 lbs my opinion might be different...) Positioning is so important- like you said, not having an epidural this time around might allow you to move around enough to get the baby out.
There is just. no. way. I would be induced at 36, 37, 38, or even 39 weeks solely on the speculation that baby might be too big. It sounds like a good idea to keep baby from getting too big, but there is a good reason pregnancies last as long as they do, and I couldn't justify taking the risk of taking LO too soon in order to have a vaginal birth. That early, the chances of your cervix being favorable for an induction are lower, and it's common knowledge that inductions increase the chance of a c/s. I'm really surprised the MW even suggested this.
One thing you could ask about, since size is a concern, is a dietary approach to controlling LO's size. Especially since you are only 11 weeks now, could following a very-low sugar diet or even the GD diet prevent an overly large baby? Again, just my thoughts, not a researched opinion.
I would just be really hesitant to base any decisions on previous labor and a measurement u/s... it really doesn't sound like there is any reason to doubt your ability to have a successful VBAC.
Did the midwife state what method of induction would be used? Most O.B.s won't even consider inducing VBAC patients.
Personally, I would rather let the baby stay in, even of it eventually led to a RCS, and choose their date to be born (as DD did) then make any medical effort to induce labor prior to 40ish weeks.
This. You have a better shot at VBAC success if you wait to go into labor on your own. It doesn't sound especially promising if your MW is suggesting induction as early as 36 weeks - EDDs are just that, and if you're off with when you think you got pg, you could have a seriously early baby, you know?
You'll also up your chances if you stay upright and don't have an epidural for most of your labor, like you said before.
It's not the same situation, but my VBAC baby was 10lb, 10oz (DS1 was 8lbs), and when I talked to my MW about future pregnancies and the chances of having another big baby, the main thing she recommended was to have a provider experienced with shoulder dystocia, and maybe get sizing u/s to keep an eye on how big the baby might be. But she specifically said she wouldn't recommend induction or a RCS (DS didn't have shoudler dystocia or anything, btw) for a suspected big baby. hth
DS2 - Oct 2010 (my VBAC baby!)
This, except replace "surprised" with "concerned." Honestly, I question her competency if her reaction to your previous baby being on the larger side of normal is to offer an induction that is very likely to fail.
I am shocked that a medical professional would suggest inducing at 36 weeks, strictly due to size concerns. My son was born at 35w 6d because I had a very serious medical condition develop. He was a good size too - 6lbs, 6oz. He had to be put on a cpap machine to breath, was fed through tubes because he had no suck/swallow reflex, and spent 10 days in the NICU. Apparently babies born before something like 39 weeks have a MUCH higher chance of needing NICU time. I can't tell you have traumatic and stressful it is to go through something like that with your child.
Even after that it was weeks before he acted anything like a normal newborn, and here years later I still worry unceasingly about his development. Studies have shown that even late term preemies like my son have a higher rate of learning disabilities and other similar difficulties. He does in fact have communication delays, and was in speech therapy for a year.
Nothing on this earth could convince me to take an otherwise healthy baby, in a healthy mom, any sooner than 39 weeks at the VERY earliest. Even then, there would have to be some extremely compelling reason.
My DS was over 10 lbs and no one suggested growth ultrasounds for my second child. I was successfully induced with my VBAC at 41 weeks. I would never have allowed it even a day sooner.
I did try to watch the carbs and extr calories I took in for my second pregnancy. Not sure if that worked or if DD just wasn't going to be as big. She was 8 1/2 lbs.
No one should be induced at 36 weeks unless there is a serious medical condition.
Yes. I'm also shocked that a midwife would suggest this and would say that 36 weeks is full-term. 36 weeks is not full-term. Babies delivered electively before 39 weeks are more likely to have breathing problems and need NICU admission. If the risk of continuing the pregnancy is high, the chance of delivering a baby with immature lungs might be worth it. But if she's recommending it based on size alone, I think that's nuts.
No, I refused a late u/s to check for amniotic fluid (it was part of a non-stress test bc I was late), partly bc I didn't want them doing a size estimate. So I had no idea he was that large, though I was late (at least 41+ weeks). I only had two u/s total that pg.
DS2 - Oct 2010 (my VBAC baby!)