August 2016 Moms

Big baby? Induction/Csection

My doctor did ultrasound today at 36 weeks and baby girl weighs 7#14 already. She wants me to choose to schedule an induction or C section for 39 weeks bc she is thinking she will be 9.5# at birth. Does anyone have suggestions or experience with this? I am FTM and my husband thinks we should try induction and IF it doesn't work then we would do C section.. 
He was 9.5# when he was born and I was only 5#3 so this is all his fault. Haha
I have read there are pros and cons with either way... I've heard horror stories with both ways... so frustrating to decide this....

Re: Big baby? Induction/Csection

  • Honestly, those are just guesstimates at best. My best friend was told her baby weighed 8.5 lbs at 36 weeks... he was born two weeks later and only weighed 7 lbs 4 oz. 
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  • There is already a thread called "let's talk about inductions" that offers lots of different perspectives on this topic.
      


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  • My OB practice said that they may induce for a large baby depending on measurements and proportions.  Apparently if the baby's shoulders are wide and the mom is smaller down there they have some maneuvers they can do but there are complications with taking a baby out that is wider than the mom.

    That being said, the weight from an ultrasound can be off as much as a pound or two.
  • gadzooks_3gadzooks_3 member
    edited July 2016
    Do you have gestational diabetes or another condition thst would add to concerns over shoulder dystocia?  

    Macrosomia alone is not considered a reason for a scheduled c-section by acog. You might want to seek a second opinion.

    https://www.aafp.org/afp/2001/0701/p169.html

    You might ask some questions like:

    Why exactly would they like you to induce? What Are The Specific concerns? What, with your stats, is your likilihood of shoulder dystocia?  (My OB was able to tell me this. I also have a baby measuring big and GD which increases shoulder dystocia concerns).  If you go with induction what will be the process? How long will the "allow" you to labor before considering it unsuccessful or stalled? Is your baby's head bigger than their belly?

    Good luck!
  • I agree with others - I would definitely be asking a lot more questions if it was me.  I come from a family that has big babies, probably an average of 10 pounds, the biggest being over 12 pounds (born vaginally).  So it's definitely possible to have a large baby vaginally.  

    I am NOT bashing OBs - I use an OB and I really trust her, but at the same time it's important to remember that women's bodies are designed to give birth.  Large babies are not a recent phenomenon, but with the legal environment doctors face these days they are more prone to encourage "unnecessary" procedures to help protect themselves from lawsuits in case something DOES go wrong.  

    I am also not judging or bashing anyone who would want to go ahead with the induction or c-section, just saying that personally I would have a lot of questions and would want more information.  I was induced the first time and while my body responded well to the induction, I had a hard time focusing because of my epidural which led to a drawn out delivery because I just couldn't focus on what I needed to do.  We also had a hard time establishing breastfeeding in the hospital because my daughter wouldn't want to wake up for feedings.  Who knows if this was caused by the epidural or the induction, or if it was just me?  But this time around I'm really striving for an unmedicated birth in the hopes that it will be different. 

    Good luck!



    Me:  28  DH:  33
    Married:  10/04/2014
    DD1:  03/02/15
    DD2:  08/04/16
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  • slycatslycat member
    A good friend of mine was induced at 41 weeks 3 days. Her baby was estimated at 9lbs. She was in labor for 26 hours and pushed for 3 hours before she had a c-section. Her baby girl was born with so many bruises and her head was so swollen she was immediately taken away and admitted to the nicu. She was not able to see her daughter for 3 hours after her birth and then it was very brief. The bruising on her face was significant enough that the pediatricians thought she may have fractures. The baby ended up being 8lbs 6oz. She regrets her decision to try laboring first.  I still would like to have a vaginal birth but the choice will not be mine if this little one doesn't turn around. 
  • I was told at 38 weeks that my first son was 9.5 pounds (per the growth scan) and would be 10+ pounds. They had the discussions about induction/possible c-section with me as well. He was born the next week, vaginally, and was 7 pounds, 2 oz. I don't put a lot of stock in growth scans late in the pregnancy.

  • @DDRRT1982 A lot of the benefits of being born vaginally are still conferred is there is labor then a C section. The actual contractions help force fluid from the lungs, and there are a bunch of hormones which are released during labor they have shown have various impacts.

    https://well.blogs.nytimes.com/2015/12/14/c-sections-are-best-with-a-little-labor-a-study-says/?_r=0

    There is a link to the study I was thinking of in the article.

    Also, without specific medical concerns, I would push back a little on "your baby *may*be big." Can you schedule another US at 39 weeks, assuming you haven't delivered and reassess? 

     




  • Just referencing my first was measuring 8#13z at 36 weeks and was born after induction at 39w at 9#7oz

  • cm716cm716 member
    edited July 2016
    I'm in the exact same boat. unfortunately the best indicator of how big your baby will be at Birth is the birth weight of your previous children.

    Dd1 was 8 3.My second daughter was 8-5 at 38 weeks 6 days. So i know that i will most likely have a baby over 8 lbs.
    Subsequent children tend to be bigger than their siblings and boys tend to weigh more at Birth than girls. I have both of those things going against me.

    As a FTM, I would be hesitant to induce because as pp's have mentioned their measurements aren't always accurate. As a STM+ I would be less hesitant because you can base it on your history. Does that make sense?

     Hope that helps.
  • Allisun85 said:

    @DDRRT1982 A lot of the benefits of being born vaginally are still conferred is there is labor then a C section. The actual contractions help force fluid from the lungs, and there are a bunch of hormones which are released during labor they have shown have various impacts.

    https://well.blogs.nytimes.com/2015/12/14/c-sections-are-best-with-a-little-labor-a-study-says/?_r=0

    There is a link to the study I was thinking of in the article.

    Also, without specific medical concerns, I would push back a little on "your baby *may*be big." Can you schedule another US at 39 weeks, assuming you haven't delivered and reassess? 

     

    I am kind of confused...are you trying to tell me that being born vaginally has more benefits than c-section unless there is a medical necessity, bc that's what I was saying above.  Disregard if you were just supporting my statement.  
  • cm716 said:

    Subsequent children tend to be bigger than their siblings and boys tend to weigh more at Birth than girls. I have both of those things going against me.

    FYI - My second was a boy and he was smaller than his older sister (still over 9 lbs but still).  Hope it gives you some hope. 

  • @DDRRT1982 Yup! I was agreeing with you. I was also saying that recent research has shown that being born by c section after labor still gives the baby some of those benefits you were talking about. (as opposed to going straight to a c section) Sorry if I wasn't clear, baby brain for the win yesterday!






  • Hey @Allisun85 do you have a citation for that research? I would love to look at it.
  • I think the bottom line is you need to do what you're most comfortable with based on your body and what your doctor suggests. At 39 weeks my first daughter measured 9.14 so they recommended a scheduled c section because my frame is very small (always been very skinny, ~112lbs) and the risks of shoulder dystocia/oxygen deprivation during labor were discussed. My bump was huge and fluid levels were high, which were additional indicators to a big baby. I decided to do the c section to avoid any possible complications. She was born weighing 8.13 - still on the larger side although not as big as the US measured. Could I have had her vaginally without any issues? Maybe. But I'm content with my decision. She's been a wonderful healthy baby right from the start and that's all that matters. 

    Im now 37 weeks preg with twins and they've measured big this whole pregnancy. My last growth scan was at 34 weeks and they were 5.10 and 5.9. Since I had a c section less than 2 years ago and it's twins I'm having another one scheduled at 38 weeks next Wed. They're both head down so some doctors have asked if I want to try a VBAC but I'm going with my gut once again and feel the safest route is another c section (most doctors agree with that choice but a couple have mentioned the VBAC). I just want healthy babies. 
  • @LoveOBX917 - Bless you!  I only have one that was measuring 5.10 at 34 weeks!  I agree, go with your gut! 

  • charmedlifex3charmedlifex3 member
    edited July 2016

    @liljabee Like I said it all cutting edge research, not "new guidelines" or even anything super solid, but there have been several recent articles summarizing long term studies which show a difference between babies born by planned C Section vs Emergency (post labor) and the emergency babies are better off 5-10 years down the road. Not to deter anyone planning a C section, better a safe baby and mom with potentially a slightly higher risk for a few things. I just thought this research was super interesting, that a baby born after labor by c section is able to still reap some of the benefits the medical community has long associated with vaginal birth vs c section, and how cool we are starting to understand the birth process, from a scientific / evolutionary standpoint.

    https://well.blogs.nytimes.com/2015/12/14/c-sections-are-best-with-a-little-labor-a-study-says/?_r=1

    https://www.upi.com/Health_News/2016/02/27/Study-Possible-link-between-pre-labor-c-sections-childhood-leukemia/6061456604144/

    https://www.sciencemag.org/news/2016/02/how-give-c-section-baby-potential-benefits-vaginal-birth

    https://www.theguardian.com/society/2016/feb/24/vaginal-seeding-babies-born-c-section-infection-risk

    https://www.nature.com/articles/nm.4039.epdf?referrer_access_token=rd-4rLYq7zImjliYfn2Jf9RgN0jAjWel9jnR3ZoTv0N52P-sU0SaylioNKJaxyGd7HZAwMq8RIdmyXIKJSElFs18PZarmBU5LDl67RzR1JVv44FZbATNsQQC8-bNWws63u4TExtVPf6k7lxJLee2ZcwBLTWMdMQ4ErKXuc4yjAP_BfQE1PQ3UeUQ35kINHYJY8o7fRn3w-BS_H33rmLsU0IplGcd8DX-XJELrT67z4qNEhNL9KpfMvL-SU8bvrSA&tracking_referrer=www.abc.net.au

    I think the thought behind it is two-fold.  1. there are hormonal changes which happen to trigger, and progress labor. We (as in modern science) don't totally know the impact of exposure to those hormones on the baby, and of course a planned c section avoids all those physiological changes and 2. the baby is exposed to microbes during labor (and further exposed during birth) which we are *starting* to know the role of. There have been some studies I ran across done where c section babies are "swabbed" with the mother's vaginal fluid to try and replicate these changes, but the various studies had mixed results on the risk to benefit of this. They call it "vaginal seeding."

    Also - I'm a total nerd, and now you all know.

    I know as a FTM I was thinking - well if I end up with an emergency C section all that effort in labor is WASTED! Why didn't I just go straight there? I know I found it reassuring to know it is looking like it isn't a wasted effort to labor - even if it ended up in a c section.




  • @Allisun85. Thanks! I just thought it sounded intereating - I am a medical sociologist so I actually do read this stuff for fun. Such a nerd, right?
  • I would opt for neither.  Size shouldn't be a reason to induce or for C-section.  

    That said, I would NEVER again opt to be induced.  I'd go straight to C-section.  No fuss, no muss, you schedule it and no need to worry about induction not working and being miserable for several days while you wait and wait. 
    DD  <3 6/15/2014
    Baby #2 due 8/11/2016

  • Size can be a reason for a c section depending on certain factors, like the mother's size or med hx. Just FTR
  • My doctor is concerned that at 37+3 there's been no dialation, ripening, or anything, despite already having a 7lb 14 oz baby per ultrasound (he's been trending big since 34 weeks so we have a good basis for him being on the larger size) so if we induce, my body won't respond to the drugs and there's a good chance that I won't be able to deliver him anyway.  So we're talking scheduled c-section, but with enough time that I can try to go into labor on my own. 
  • @christineehh -My kiddo was 7.5 lbs at a 35 week ultrasound and no dilation at all at the 36 week check, and baby measured in the same percentiles at the 20 week sono (but obviously not 7.5 yet).  I'm curious to see if there's any dilation at my 37 week appointment tomorrow. Baby boy is at least head down. We have a C-section scheduled for me for other reasons at 39 weeks, but I'm definitely curious to see if baby is just going to keep getting more huge, or his size will progress me towards labor at all before the scheduled C-section.
  • @kwilliams3402 I'm curious to hear what happens today!   Starting at 38 weeks I'm going to try everything I can to go into labor, maybe if I go right around 39 weeks I can get him out the old fashioned way! 
  • No dilation, head fairly high up (but head down) at 37 weeks. So huge baby does not equal progressing toward labor!
  • @kwilliams3402 apparently not! hang in there.  I'm 38 weeks tomorrow, next appt is Monday.  People are saying that I'm looking like he's dropped, I'm not convinced :-).   But I'm going to start on the evening primrose tonight I think. 
  • Thanks @christineehh! Hopefully you get good news next Monday.  I started drinking raspberry leaf tea, one cup a day, a couple weeks ago, and upped to 2x per day yesterday.  I know God already has baby boy's birthday picked out, but man, is the waiting hard!

  • liljabee said:
    Do you have gestational diabetes or another condition thst would add to concerns over shoulder dystocia?  

    Macrosomia alone is not considered a reason for a scheduled c-section by acog. You might want to seek a second opinion.

    https://www.aafp.org/afp/2001/0701/p169.html

    You might ask some questions like:

    Why exactly would they like you to induce? What Are The Specific concerns? What, with your stats, is your likilihood of shoulder dystocia?  (My OB was able to tell me this. I also have a baby measuring big and GD which increases shoulder dystocia concerns).  If you go with induction what will be the process? How long will the "allow" you to labor before considering it unsuccessful or stalled? Is your baby's head bigger than their belly?

    Good luck!
    This. Read the ACOG guidelines. I would never schedule an induction or a C section because they thought my baby might be big. Inductions are more likely to lead to C sections. C sections are higher risk for both mom and baby. For the record, weight estimates are notorious for being wrong. They told me to expect a 10 lb baby at EVERY visit. He was 7 lbs 15 oz!
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  • Leeny3Leeny3 member
    I don't really have an opinion on this either way (I'm not sure what I would do in this situation personally) but I always hear a lot of people saying things like your body can't make a baby that is too large for you, that it's not a reason for a c-section, etc. My mother is a larger woman at 5'7 and never had GD or any other pregnancy complications yet all three of her children were over 9 pounds, with myself weighing in at 11 lbs 11 oz. My brother did have shoulder dystocia and his shoulders are still at different heights at 28 years old, and my mother suffers from severe prolapse. So there are real risks that people should be aware of. 
  • There are risks either way. I think for me and my OB, it's the projected size, plus the lack of any progress towards labor, that we're concerned about. She doesn't want to force an induction only to have it stall out. So the ideal for all of us is for me to go into labor naturally, on or before my due date, but if that doesn't happen, a scheduled c -section might be preferable to an induction. Just some thoughts. 
  • slycat said:
    A good friend of mine was induced at 41 weeks 3 days. Her baby was estimated at 9lbs. She was in labor for 26 hours and pushed for 3 hours before she had a c-section. Her baby girl was born with so many bruises and her head was so swollen she was immediately taken away and admitted to the nicu. She was not able to see her daughter for 3 hours after her birth and then it was very brief. The bruising on her face was significant enough that the pediatricians thought she may have fractures. The baby ended up being 8lbs 6oz. She regrets her decision to try laboring first.  I still would like to have a vaginal birth but the choice will not be mine if this little one doesn't turn around. 
    My daughter was 8 lbs 6oz also and I had her vaginally with no complications. I am a small person. I agree with the above comments that our bodies are designed to give birth vaginally and C sections should be saved for emergency purposes only. 
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  • Ultrasounds that late in pregnancy are notoriously wrong.  I was 9lb8oz, husband 8lb12oz.  Had my first son, via induction then emergency c section 9 days after his due date and he was only 7lb8oz.  I would delay an induction until after your due date. 

  • I have gestational diabetes and a family history of big babies- my dad was over 8 lbs, my brother was 9.5 lbs and I was 9lbs 14oz. According to my OB, she wants to induce during my 40th week, though we're all hoping I go into labor spontaneously. I have had to have lots of US for a different issue and my Maternal Fetal medicine specialist suggested induction at 39-40 weeks as well. Baby has been measuring two to three weeks ahead of his gestational age. He is in the 95th percentile. Plus I have a lot of amniotic fluid. The OB strongly agrees with me that c-sections are a last resort, especially since late US can be off by so much on estimated size. I am just hoping he drops soon- my ribs are killing me. 
  • Update! So I made *slight* progress as of my appt yesterday and doctor now wants to to try an induction, said she won't make me labor for three days before a c-section, but it's worth a shot.   We scheduled it for 40 weeks + 3 days.  Still hoping to go into labor on my own before then to limit his size :-) 
  • @christineehh - Glad to hear you're making progress!!! Had my 38 week check today, and not a bit dilated, but baby is nice and big and high and probably 9 lbs by now.
  • My DD was measured at 8lbs 7oz at 40w and was born 8lbs 4oz at 41w. My LO now at 40w is measuring 9lbs 6oz and we will be inducing Wednesday night. Hoping she is comparable to my first daughter...mid 8s. We will see.
  • @mrsmommya good luck and keep us posted! 
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