Talk to me about macrosomia and early inductions
Had a doctor's appointment this morning and baby is measuring WAY huge. I know that measurements from ultrasounds can be off, but with my first DS they actually estimated him smaller than he was born. I know it's still early and baby's growth could even out, but I want to be prepared in case it doesn't.
Doc was hinting at possibly inducing early if baby continues measuring this large and as much as I have always been against early inductions due to baby's size, my experience with my first delivery is making me more open to it now. After reading some on delivering large babies (macrosomia) the complications of waiting seem to be a lot worse to me than inducing early. AS LONG as I have a high bishops score going into induction, what would be the negatives to inducing just a week or two early? Feel free to bombard me with all info/resources you can - I really do want to be prepared to make an informed decision and will not be offended if someone has an opposing opinion to what I'm thinking.
Re: Talk to me about macrosomia and early inductions
To me it's enough that the ACOG does not recommend inductions for suspected macrosomia in the absence of other factors.
That being said, this is certainly a decision you must make on your own. But please know that part of what your doctor is doing is covering his own behind. It's sad but we are living in a society where a potential law suit is in the back of every doctors' mind especially in obstetrics.
This.
Also, how early is early? Because there are risks with having a baby before 37 weeks. That should be considered, too.
How big was your first? Was it a hard birth? I think if you've had a successful vaginal birth with one baby, chances are good you can have another with an even larger baby.
This is a really good post (with cited sources) about suspected macrosomia: https://birthsen.tmdhosting930.com/?p=1531
You also have the option of getting another opinion from another provider (one that doesn't practice with your current OB) or asking for a repeat sizing u/s from a different tech, too. hth
DS2 - Oct 2010 (my VBAC baby!)
I would weigh the risks associated with macrosomia with the risks of having a baby too early or having a c-section from a failed induction and go with your gut feeling on that research.
How sure are you about your ovulation, lmp, and conception dates?
Will you be allowed to move around in labor and birth in positions better suited to opening your pelvis?
And not that thiis has any bearing on your ultrasounds, or your baby, or your brith but my surgical records state macrosomia as the "reason" for my c-section. My 7lb 14 oz macrosomic baby.
I would never agree to any induction before 37 weeks unless it was a life or death situation for me or baby. My doc seemed to be hinting at just a week or two early so 38-39 weeks which doesn't sound TOO early to me, but I'm not really sure.
My first was 9lbs 6oz (but they estimated him to be only 8lbs so, yes, the ultrasound was wrong but in the opposite direction of most people) and labor was a breeze but I ended up with a very severe 3rd degree tear, on the border of 4th degree (and need some major work done to repair it) and recovery was absolutely awful - I never want to go through that again and I will do whatever I can to avoid it.
I guess my fears with choosing NOT to induce early if baby really is measuring big (doc estimates this one to be around 11lbs) is shoulder dystocia, severe tearing, and ending up needing a c-section because I waited too long and baby got even bigger.
Also, if I get to the point where doc is wanting to induce early but my bishops score was low I would push to wait because I would definitely not want to go into an induction if it's looking to be unfavorable and then end up with a c-section due to non-progression.
I guess I'm just wonder what complications I would need to worry about with an induction at 38-39 weeks.
An induction before 37 weeks puts you at higher risk for a c-section point blank. I would tell that doctor exactly where to go shove it and I'd end up switching doctors. I don't do that whole "Oh well...I think we should do it this way just because of this" because the doctor would rather keep things anally controlled because they're worried over malpractice.
Every baby is different and some need more time than others, so inducing at 38 or 39 weeks could be ok for one baby, but not for another...and there is really no way of knowing what will be the case for your babe. Your baby can still end up in the NICU at even 40 weeks or later because in the end, your DD is just an estimate.
Macrosomia is one of those things that can ONLY be diagnosed after you have your baby and it is VERY rare, so the odds of you actually having that big of a baby is less likely than it sounds like your care provider is making it out to be.
Antidotally- I had a REALLY bad 3rd degree tear with my first who was 9 lbs 15 oz and was also scared of tearing again with this one, however I let her come when she was ready and she was 10 lbs 10 oz...and I didn't tear at all.
GL
This actually helps me feel a little better - thanks!
What about shoulder dystocia with your second? Did you feel like she got stuck at all? Was pushing harder/longer or easier because it was the second time around?