Discuss: induction due to "big baby"

versed · January 2014

I tried the search function, but it's awful and not helpful at all.

One of the doctors in my practice brought this up at my last appointment. This baby has been measuring exactly on time throughout the pregnancy, but the fundal height measurement at my 37w appointment was 3cm over (40w). She ordered an ultrasound, which I'll have on Tuesday. If baby is looking huge, we'll discuss a 39w-induction.

Some other factors:

- a u/s at 33w had LO at 6lb1oz already

- DS1 came on his own at 37w1day, so we're thinking I won't make it to 39w anyways

- DS1 weighed 8lb5oz 3w early, so I do make big babies ... However, his birth was uncomplicated and easy, even

- part of me is concerned that there's something else going on that would cause such a huge jump in measurement. I also understand FH measurements can differ from dr to dr, so maybe this is all a moot point

I really don't want an induction, and I know it's my call in the end. I've heard that induced labors are more difficult and lead to a c/s more often than natural labors.

Just curious others' feelings towards this viewpoint.

mlynn333 · January 2014

My OB told me yesterday that each day matters, and that studies are starting to point to significant brain development can happen in those last few days. Based on that, even though LO is currently breech, he'd rather wait it out for a CS until as close to my due date as possible (he threw out 39+5 as the minimum). He said we could do a CS sooner if I went into labor on my own. Otherwise, plan is to keep baby in as long as is safe.

In your shoes, I would want to know how much additional risk comes with the baby being larger. My sister delivered a healthy 10lb 8oz baby vaginally at 41 weeks without complications. I'd say if it's possible to wait, then waiting is what I would want to do. Even though I'm so dang uncomfortable. right now :P

ETA numbers are hard

tiggernorton04 · January 2014

I would say no to being induced. So maybe it's a big baby but you should be able to go into labor when you and baby are ready! Being induced can lead to more complications if baby isn't ready yet and often leads to unnecessary c-sections. I delivered my first DD who was 9 lb 6 oz so I am not one to be worried about size. Ultimately it's your call though!

annie0714 · January 2014

Try googling induction and suspected fetal macrosomia and I think you will find a pretty clear answer. Sorry, I almost never post, but do lurk everyday. I just wanted you to get some evidence based information

Scottnsaranhenri · January 2014

I would lean away from an induction if you're feeling confident in your ability to deliver. Plenty of women have delivered 9 & 10 Lb babies vaginally that it shouldn't be an issue- unless you think it is.
My personal concern would be 'how quick will they jump to c/s?' If you don't want a c/s & they're saying your only other option is to induce, then perhaps that's a route you'd prefer.
There are lots of induction techniques too besides just hooking you up to Pitocin. It might be helpful to research those & discuss with your doctor what you would be comfortable trying if you decide to give induction a try.

Soap1 · January 2014

I don't think induction for a big baby is always the right plan, though it can be. DS1 was induced at 39w for a few reasons, one being that he was measuring very big, but he ended up being only 7lb8oz.

It's really just up to you and your doctor. I had successful experiences with induction (DS1 was induced, DS2 was not a scheduled induction but required Pitocin, and DS3 will be induced), but not everyone does.

Soap1 · January 2014

JillAnn317 said:

Try googling induction and suspected fetal macrosomia and I think you will find a pretty clear answer. Sorry, I almost never post, but do lurk everyday. I just wanted you to get some evidence based information

I have to say that I don't consider a Google search to provide "evidence based information"

Dexter&11 · January 2014

I'm being induced at 38w (type 1 diabetic) and was given a leaflet earlier this week. The Pitocen is a last step at my hospital, they'll give me a vaginal pessery to soften the cervix and induce contractions as a first step, if nothing much is happening within 24 hours then I can expect them to break my waters manually to try and push things along, then its the Pitocen drip if no significant progress within another 24 hours.
Induction is usually a more painful labour as you don't build up the natural pain relief and its a forced process. It can also take 3-5 days to get to actual labour, which is why a c-section is more common with induction as Mum's too tired to push by that point!

Hope some of that's useful.....personally I'm going for the old wives tales a couple of days before my induction in the hope things kick off naturally and I get less pain!

Noethola · January 2014

In your case, I would ask to wait it out. Size doesn't always matter, as it really depends on the shape and size of the mother's pelvis. It sounds like you already delivered a pretty good size kiddo, so I doubt size would be as much of an issue for you.

Yes measurements could be off, but they could also be on track. There are a lot of mothers that do well with bigger babies, some do better with smaller babies. Perhaps you could talk through labor positions and what you would be "allowed" to do. Different labor positions also work for different size babies, as they open the pelvis more than the "laying on the back" position that Drs often prefer.

ShePersisted · January 2014

I don't think there is a straight forward answer. Based on little I understand from your post I think there are many factors that will help you decide what's the best option. Size of the baby is a concern for some women and not for some, some women rather get induced than go through c-sec due to various reasons. Plus yes if the choice is yours but the baby is too big for the birth canal it could put you and the baby in distress. Maybe feeling a certain way about induction is one thing but when you get close to that moment of making the decision you will need to consider all factors and do what's the least risky and best option. I don't think the decision is easy and I know it's scary but it is what is it. Hopefully you are able to go into labor naturally when the time comes.

annie0714 · January 2014

I did not mean "try google" in a patronizing way. That was not my intention at all. I apologize if it came out that way. I used those search terms myself prior to posting it. I felt that it gave pretty good results on recommended guidelines. I wanted OP to make an informed decision for herself and not rely on all of our here say. In fact, acog recommendations are in the first several results. I know Google is not best for evidence based medicine; however, it is what most have access to. It can also give good info if you look at the source. For example, acog guidelines or a peer reviewed journal article will come up on google. This would be reliable while a bump forum is probably not. Sorry I wasn't being more helpful initially. If OP would like, I can link her some studies that discuss this. ( I really mean this so let me know if you would like this) Otherwise, I shall go back to lurkdom. I hope everyone has a great end to pregnancy and again sorry I was not perceived as being more helpful Edited for grammar/ clarification

Sweets11 · January 2014

If you didn't run into issues with your first two, it's odd that your doctor would want to induce with your third.

I am small/average framed - read small pelvis/birth canal (yeah, yeah, 'because small'... it's relevant when it comes to fetal macrosomia.) and gave birth to a 9 pounder after measuring four weeks behind in fundal height.

With this one I'm measuring four weeks ahead, have had a large fetus in multiple ultrasounds and I'm projected to have around a 10 pounder. .. we'll see. ..

My doctor said that because I did okay birthing my first vaginally there would be no need for a late growth ultrasound or induction with this one.

Sweets11 · January 2014

ETA - I'm trying not to side eye my co-worker who has told me she will demand that her doctor induce her at 37 weeks because her fundal height is measuring four weeks ahead and she doesn't want a baby over 8 pounds.

That said, I agree with PP that it's your body/baby and if your doctor recommends something it's between you and him.

questisthebest · January 2014

Is there a reason your doctor doesn't think you can push out a larger baby (especially if you've delivered before with no problems)? My midwives helped deliver an 11 and a half pounder last week :O and my my mom had a 10 and a half pound VBAC baby (7 hour labor with no tearing).

versed · January 2014

Thanks for your opinions. We haven't gone into detail about the options just yet because she wants to see the u/a results first. I'll see what I can get from the ACOG on the topic so I can bring that to the table.

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