Help! Doc is talking c-section — The Bump
March 2017 Moms

Help! Doc is talking c-section

I had an appointment today that just left me equal parts befuddled and upset. Background: I'm 35 weeks, baby has been measuring between the 60th and 70th percentile for size the entire pregnancy. Today I had an ultrasound and the tech measured him quickly--only one measurement per area (in the past they've done 2 for everything), it probably took about 3 minutes total. At the end, she said the estimate of his weight was 6lb13oz--putting him just over the 90th percentile. Then, when I met with the doc, he gave me the "We may have to start talking C-section" speech.

Couple of thoughts:

1. *I* haven't gained 3 lbs in the last 3 how could he?

2. These measurements are notoriously unreliable. If they're off by about a pound, he's right where he's been the whooooole time, near the 60th percentile.

3. Even if he IS 6lb13oz, and he gains another 2 lbs before I go into labor, why would it be impossible to vaginally deliver an 8lb13oz baby? 

I guess I'm just looking for feedback on this. Anyone have an estimate that was way off from their actual baby? Anyone have a crazy measurement one week that went back to "normal" a couple weeks later? Anyone vaginally deliver a big fat baby? Trying to keep myself from going off the deep end weeks before it's even really time to make any kind of decision.

Me: 30, mild DOR
Him: 31, totes fine.
IUI #1: 5 follicles, cycle cancelled :-/
IUI #2: 1 follicle, BFP, chemical
IVF #1: 12 follicles, 9 eggs, 1 fresh 5dt and 4 on ice. BFP, beta #1: 326, beta #2: 841 

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Re: Help! Doc is talking c-section

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  • My doctor has always said it depends on the height of the woman. For example I am 5'1, he told me I can go vaginal as long it's not a 9 or 10 lb baby. Taller women than me could easily handle a baby the size you're talking.
  • All the other ladies hit the nail on the head. Just wanted to add I'm hoping he WASNT being a bully, just insensitive and alarmist for no reason. At least now you have time to formulate a response. I actually love what @kjd291 said: "There's no way of entertain the idea of a csection based on a large ultrasound estimate. I can deliver a 9 pound baby." then As I was pushing I'd be even more motivated to do it vaginally out of sheer spite/stubbornness. 
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  • No way I would agree to CS based on an ultrasound estimate.  Here is what Henci Goer has to say, from "The Thinking Woman's Guide to a Better Birth":

    • Have a caregiver with a low CS rate. OBs with low CS rates are less likely to opt for CSs when they suspect a large baby.
    • Avoid an epidural. Epidurals interfere with effective pushing and prevent you from doing the activities and assuming positions that will maximize your chances of birthing a large baby. 
    • Avoid a low or outlet forceps delivery.  These are deliveries done when the baby's head has passed through the pelvis, which means they are mostly unnecessary except in cases of sudden fetal distress.  Evidence suggests that low and outlet forceps deliveries are more likely to injure a large baby than spontaneous delivery.
    • Preplan with your caregiver to use the all-fours maneuver should there be problems birthing the baby's shoulders.  Assuming an all-fours position seems to be the best and safest technique for releasing the shoulders.  The potential need for this maneuver is another reason to avoid an epidural, although even a mother with an epidural could quickly be helped into this position.
  • More from Henci Goer:

    "Refuse an Ultrasound to estimate fetal weight. Studies show that when an OB thinks, based on a sonogram, that the baby weighs more than 8lb. 13oz., the mother is more likely to have a cesarean than if the baby actually weighs this much or more, but the doctor doesn't suspect."
  • My very good friend has 6 kids. Her 10 lb baby was her easiest labor, and the only one she didn't tear with. She felt that a bigger baby helped more with birth. She is tiny with narrow hips. Unless there is another reason for a c-section, I'd push back too. Good luck!!
  • The other ladies have pretty much covered it all. I just wanted to say I'm sorry your doctor is pushing you like that. Having to stand up to medical professionals is awkward and uncomfortable. They should not be putting you in that position. Oh and I'm a FTM but my mom delivered five babies and I was the smallest at 8.5 lbs, 3 were over 9, and one was 10.5. It's absolutely doable.

    Me 28 DH 28 Married 2012

    TTC #1 since March 2015

    Metformin + Femara + Gonal F + Trigger = BFP 6/24/16 

    EDD 3/3/17

    Found out it's a girl! 9/23/16

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  • No insight with this, but trust your gut! If it doesn't sound right, it probably isn't. These other ladies said it all perfectly. Praying for you!
  • Highly suggest you watch the documentary "The Business of Being Born" - you can find it on YouTube. CS's are more convenient for doctors, plain and simple. You know who it's not more convenient for? Moms! It's major surgery that comes with a ton of risks and can affect you for the rest of your life.

    Agree with what everyone else said - trust your gut. I had an ultrasound a couple days before I had my son. The ultrasound was way off his actual size. They're notoriously wrong.

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  • Your doctor couldn't be more wrong!  Im so sorry that he made you feel upset or worried.  Remember that this is your body and your baby.  You are paying him for a service.  You do what you feel comfortable doing. 
  • That's awful!!!

    Lots if great feedback here!

    Best advice I've heard is that your body will not create a baby that's too big for you to deliver (unless you have some serious GD issues etc)

    My best friend was told her baby was so small they should expect nicu time once he arrived... she was so terrified.. he was 9lb2oz! 

    It's all voodoo. They have no clue lol. You do what feels right for you. And btw.. there is NOTHING wrong with changing drs this late in the game!

  • I agree with all that has been said.  The closer you get to your due date, the more inaccurate the ultrasounds are.  I would not be planning a c-section based on size of baby in an ultrasound.  Position of the baby has way more to effect on how delivery will go.  My 7lb baby ended in a c-section because she was face up and wouldn't descend and started having heart decels.  I pushed out 2 9lb babies after her. One was face up so that took about an hour.  The other was face down and it took 3 pushes to get her out.  Size has very little to do with it.

    I hate it when docs use size at 35 weeks/36 weeks to scare mom's into c-sections. A lot of babies are born weighing 8.5lbs to 9lbs these days as it is.
    BFP #1 7/1/2009 ~ EDD 3/9/2010 ~ Ella Adeline (7lbs 4 oz, 19.5 inches) 3/5/2010 csection (39w3d)
    BFP #2 7/13/2011 ~ EDD 3/16/2012 ~Aubree Olivia (9lbs 1oz, 21 inches) 3/15/2012 VBAC (39w6d)
    BFP #3 5/15/2014 ~ EDD 1/16/2015~Addison Isabelle (9lbs, 0oz, 21 inches) 1/25/2015 2VBAC (41w2d)
    BFP #4 7/20/2016 ~ EDD 3/25/2017 ~ Malachi Mathew (10lbs 0oz, 22 inches) 4/4/2017 emergency csection (41w3d)

  • So, I agree with everyone that a c-section is likely unnecessary, especially just based on this, but you're only 35 weeks and it sounds like the doctor didn't say anything definitive.  Just that he wanted to prepare you for the possibility?  To me, that's not some huge red flag or reason to switch doctors.  Maybe it's a reason to get some clarity (if you didn't already) on what exactly the doctor's c-section rate is and when he would 'require' one.  I've certainly talked through a c-section, when my doctors think one would be totally necessary, and why, but it hasn't made me concerned that they're going to push me into one.  I'm just someone who wants to know all the potential outcomes and what they might look like, and my doctors don't want anyone caught by surprise.

    Do you have another growth scan scheduled?  Mine have varied SO much -- I get them every 2-3 weeks and the babies will be in the 35th percentile one visit and the 85th the next.  No one seems to care.  But if you're having another one soon my guess is the baby will measure much more within the average range and you may not hear another word about a c-section.

    Also, @KellyT22, I don't disagree with anything you said, but reminding a bunch of women in their last month of pregnancy -- many of whom are going to have c-sections whether they want them or not -- that "It's major surgery that comes with a ton of risks and can affect you for the rest of your life" may not be the most supportive thing that you could say at this point.  Some of our members are heading into c-sections today and the next few days and it's just not what everyone needs to hear when it's a done deal/actually necessary for medical reasons for some.   
    babyisthenewblackBok Bagok
  • @anonellis First of all, there is a huge difference between a medically necessary c/s and one of convenience.

    I had a c/s for medical reasons so I'm well aware of the risks, as is any woman who is going to or ever will have one. It's not fun, but it's the reality of it. An overwhelming majority go off without a hitch, but I think if given a choice or the option to advocate for yourself you need to weigh the risks. I doubt there is a single woman here, myself included, who doesn't understand that as they consider a c/s, but ultimately it needs to be the mother's decision and bothers me that there OBs who push for them when it may not be medically necessary.

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  • @KellyT22 I'm not disagreeing with anything you've said.  I'm saying that just because we're all well-aware of the major risks (including the original poster) doesn't mean its the best time on this particular board to be emphasizing them.  I just think we could all err on the side of kindness and consider that some women are literally reading our words from their hospital beds.  I'm even still a candidate for a vaginal birth, albeit with a high c-section risk, and your words gave me anxiety.  The fact that there are way too many unnecessary c-sections that shouldn't be happening is a totally different issue and one that I haven't seen contested by anyone on this board.  

    I wouldn't bring up long term effects of premature birth surrounded by moms dealing with the NICU right now, and I wouldn't bring up long term csection effects/risks to moms heading into the OR either.  Maybe it's excessively sensitive but I'm happy to fall on that side of the spectrum at this point, after what a supportive board this has been since I joined in June.     
    Bok Bagokwintersongdirewolfmini
  • @anonellis Agree to disagree. We differ in our opinions on this, which is fine.
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  • This post has been good for me to read. My baby has also been measuring big the entire pregnancy despite me having normal weight gain, and it's been scaring me that I might have to have a c-section. Thankfully my doctors have been telling me a lot can change in the remaining weeks and to just wait and see closer to the birth. But still I'm nervous about it

  • Whoever posted about the documentary The Business of Birth or giving birth it was really good. I watched it the other night.

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