35 weeks "small baby" advised to deliver at 37...

Mijuin · August 2014

Hello, I have been told i have a small baby since around 25 weeks and today at 35 weeks, the situation is still the same. (4.4 lbs)

The Dr told me he would advise me to deliver earlier (cesarean) at 37 weeks. He also told me that small babies are prone to still birth if kept longer in the womb... Of course this scared me and got me worried.

However, I got a second opinion from a different Dr who says the baby is about (4.6 lbs) and he is comfortable to keep the baby in as far as 42 weeks.

My natural instinct tells me to keep the baby inside as long as possible (there is nothing wrong so far with the placenta or blood flow, or baby aside from low weight) but with my first Dr telling me the possibility of stilbirth increasing, i am now scared and worried.

Any similar experiences or advice would be greatly appreciated.

( I am 35 with my second pregnancy. Daughter was a healthy and big baby )

beccalee721 · August 2014

I've never heard that smaller babies should be delivered early because they're prone to being still born. Logically they should stay as long as possible to continue to grow. Are these two doctors part of the same practice? If so I'd request to only see the second doctor from now on. Delivering a small baby at 37 weeks can only bring on more issues and a possible NICU stay. IMO if you let the baby continue to grow they have a better chance of being of a healthy birth weight when they arrive.

Mijuin · August 2014

Hi beccalee721, that was exactly my initial thoughts. No better place than inside the mother's womb. The two Drs are of different practice. I will see each Doctor next week (36 weeks) and see what they say. Thank you for your advice. I feel better

conradraging · August 2014

I feel like there is something missing here, like the first doctor didn't tell you something. Like maybe he suspects IUGR or something? I would just ask more questions of both doctors to see why each has the opinion they do.

ap0wer · August 2014

I would think that if your baby is small, waiting until he/she is ready to come out would be the best option. Unless there is some underlying issue your doctor isn't telling you. Good luck

Mijuin · August 2014

if there is an underlying concern, is it not the Dr's responsibility to inform me about it? Can they suspect something (ie IUGR) and NOT mention it to me??

merc5411 · August 2014

IUGR is associated with an increased risk of the baby dying before birth. Your OB should have told you if he suspects that. There are numerous causes of IUGR. I would talk to your OB and get answers to why he thinks you need to deliver early. Good luck.

LittleLady6 · August 2014

I was told at 37 weeks that my baby was measuring small and to go directly to the hospital to be induced. Had the growth measured more than 1% of w/e they determined was safe then I could wait, but he wasn't. So of course I was freaked out at the time and was like ok. He weighed 5lbs 4oz at birth. Apparently the underlying issue was with the way my placenta and umbilical cord connected; the baby wasn't getting enough nutrients. In the end he had to stay in the hospital a week then was discharged.

My advice would be as others stated find out why they want to induce you outside of weight. It doesn't sound smart if weight is the reason for evicting the baby. In my case it was growth, 2 different things. I'd personally would go with Dr 2 or meet in between. 37wks IS considered term medically. However, health risk are greatly reduced if you deliver a baby 38-40 wks. (I don't know why then they consider 37 term and not preemie) Anyways thinking back I probably would have waited until 38wks to be induced. Might have avoided the week NICU stay.

If the 1st Dr had a concern and was thinking something was wrong, he might not have wanted to tell you until he was definite. There would be no reason to worry you until he knew for sure. He may have wanted to give it another week to see if things progress to rule out anything. Just a guess. It may just be the case of who's more experienced or confident.

MMason12 · August 2014

msspeedymarie said:

Yeah, is the baby small, or is the baby not growing, because those are two very different things. Has the second doctor seen your medical records and measurements of the baby over time, or is he just looking at where you are now?

This! There is a big difference between a "small" baby and a baby who isn't growing well. It is true that if your LO is not growing well that after 37 weeks they are better on the "outside" so they can actually start to gain weight and grow.

I am having growth ultrasounds every 4 weeks, which started at 28 weeks. And although they are not super accurate, they do give my doctor's an idea on whether or not she is growing well or not.

baloneydisc · August 2014

I agree with everyone else, a "small" baby isn't reason to deliver early, but if LO isn't growing properly (IUGR) that's different. You need to clarify with your doctor what their concerns are. DD was borderline IUGR (12th%, but her belly was less than 2nd%), we started appointments twice a week at 32w for BPP & NSTs with the knowledge that we could be sent direct to the hospital at any point after 36w. DD was "stable" so we pushed induction to 39w4d. Turns out she's just small. She's been around 5th% since birth and at her 2.5yr appointment she was only 22.8lbs 32.5".

JubilantSquirrel · August 2014

The definition of full term has changed.

https://www.acog.org/About-ACOG/News-Room/News-Releases/2013/Ob-Gyns-Redefine-Meaning-of-Term-Pregnancy

To echo PPs, there is a difference between a small baby and a baby that isn't growing properly. Talk to your OB and find out what his concern is.

Justabean3 · August 2014

My first baby I carried to 41.5 weeks but he was still slowly growing at each ultrasound so they let me carry him. He was 7 pounds 2 oz at birth

But at 36 weeks he was only 3rd percentile and around 4 pounds.

He had an extra long cord wrapped around his neck twice and his torso. Maybe they can do another ultrasound and see if the baby is growing still.

JSS1002 · August 2014

My only piece of feedback is that those measurements they take while in-utero are usually wrong, up to 2 lbs in either direction. They told me the whole time with my first that I was going to have 10 lb baby, and he was 8 lbs 4 oz...

SanRemo · August 2014

I am going through this right now. DD has been measuring around the 63% at 28 weeks and then suddenly at 32 weeks dropped to the 10%.

I am now 36 weeks and she has grown to the 14% but due to the dramatic drop previously both of my doctors have recommended inducing at 37 weeks. I am fine with this decision because something happened inside of me that has caused this dramatic growth change. IUGR was discussed. I am also older too so that has factored into the decision.

lookame3639 · August 2014

My baby suffered from IUGR and pre eclampsia upon delivery we found her cord was wrapped around her neck twice and she also suffered a satillite placenta (the placenta sections itself off and becomes 2 placenta or one placenta divided)

my expirience is she stopped growing about 5 weeks before my last growth scan. During the scan they estimated her weight at 4 lbs 5ozs. The tech focased a lot on her cord a lot how it flowed and the pulse, no one suspected it to be wrapped around her neck. Also during the scan LO didnt move all but maybe 3 times. Deep down i felt something was wrong however before the scan i didnt expect a thing.

I was induced asap. My daughter was born at 36 weeks weighing 3 lbs 7 ozs. She was literally not getting any nutrients in the womb and had a 9 day stay in the nicu. She was perfect aside from weight.

Just food for thought. I'dsay Iif your LO hasn't gained any weight or very little it may be worth the induction...or at least a serious discussion about it. Usually with IUGR the baby is much better out since they can no longer gain weight or get enough nutrients. However i also understand my case is probably an extreme case in which everything went wrong, your case is probably very different.

laurenita8 · August 2014

Get a third opinion. Get a fourth.

buddha2490 · August 2014

JSS1002 said:

My only piece of feedback is that those measurements they take while in-utero are usually wrong, up to 2 lbs in either direction. They told me the whole time with my first that I was going to have 10 lb baby, and he was 8 lbs 4 oz...

+1.

Pre-delivery estimations of fetal weight are notoriously inaccurate and doctors know this. Despite this, it is often a reason to perform a c-section because the baby is too big for labor to progress. Baby comes out and is found to be normal sized, doctors should know better.

But this is a different issue and it doesn't make sense. Clinically there is no reason to expect that a small baby needs to be delivered early simply because it is small. I think there is something else going on.

hellokittyaaaa · August 2014

Is IUGR when the umbilical cord only have 2 vessels? If so.... my second child had this.

Pinkmom19 · August 2014

OP, they suspected same issues with my LO. Growth scan at 34 weeks showed 4 lbs and small belly circumference out of proportion to everything else. Yesterday, at 37 week scan, he measured 6lb 8oz. Clearly there is some testing error to take into account but your baby might be about to have a growth spurt too. Belly is still smaller but within normal range. Don't let the dr. scare you. Get another opinion if necessary and if they want to induce they should be very clear on the reasons why.

SanRemo · August 2014

hellokittyaaaa said:

Is IUGR when the umbilical cord only have 2 vessels? If so.... my second child had this.

IUGR is intrauterine growth restriction. It can be caused by any number of things or simply just be happening. I have been diagnosed with it but there is zero issue with the cord. I have had 2 growth scans since I was diagnosed and I am comfortable with the decision my doctors have come up with. Of course I would like her to "cook" longer but I also want to bring home a baby.

tbarker14 · August 2014

I don't have any experience with this. However I would suggest that after your next visit with the two doctors if they are still saying the opposite then get a third opinion.
Hope everything works out well for you and your little one.

nilvero · August 2014

Definitely ask more questions. At my scan this week, baby still measured normal (18th percentile) but abdomen was smaller and blood flow to cord was slightly high. Both of those things can be indicative of placental issues. In this case, he may do better out than in. I'm going back this week for another u/s.

So ask your doctor if there are other concerns. If the only concern is that he is small, I don't think that would be a reason to induce.

Mijuin · August 2014

HI Pinkmom, thanks for your reply. It's given me some hope..I keep thinking that she is just wating to have a growth spurt. I am going for my check up with the second Dr tomorrow, so fingers crossed! Thanks again:)

Mijuin · September 2014

HI Everyone, Thank you for your replies. Just wanted to let you know that we have decided to switch Doctors. Original Doctor would have scheduled for a Cesarean today. Strange things is, she kept saying water was low when just the day before the second Dr was saying my water was excellent.... No signs of labor yet so we will hang in there! Thank you for all your answers

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