Automatic c-sec or trial of labor first?

iVillage Member
Registered: 01-23-2010
Automatic c-sec or trial of labor first?
5
Sat, 07-31-2010 - 8:49am

My doctor had been leaning towards saying a c-sec would be medically necessary for me, but since my appointment last week, the baby's estimated measurements showed he'll be just below the 5000 gram (11 lb) threshold by my due date my OB office uses to determine whether a c-sec would be medically necessary due to the baby's size. He will still likely be just a few grams below that threshold by that date-- so still probably at least an estimated 10.5 lbs. That means it's completely up to me at this point to decide whether to schedule a c-section for close to my due date.

I have a couple of other co-occurring issues to consider. One is an excess of amniotic fluid. Although that level did decrease a bit in the past couple of weeks, it's still above average. Another is that I turned 43 in June and this is my first baby. And while we don't necessarily give birth as our mothers did, I don't consider the fact that my three sisters and I were all delivered by c-section to be completely irrelevant. Like my mother, I don't have very wide hips. My oldest sister had a long and difficult labor with her daughter that was possibly partly responsible for the learning disability she has today. This sister had a subsequent c-section with her son because he was also well above average for size and had a gigantic head (lol). Another sister was pregnant with triplets and had to be delivered by emergency c-sec at 28 weeks after one of the boys died in an umbilical cord accident. However, she did go on to deliver her daughter by VBAC a few years later, although her daughter was in the average range for size.

My belly is so gigantic at this point I keep getting asked if I'm having multiples and my whole body hurts. So I am leaning towards scheduling a c-section for right around my due date, rather than a few days past-due when my son would hit that estimated 11 lb mark for size. I just can't see going past due at this point. So I'm considering Friday the 13th for a scheduled c-sec (if I can talk my doc into coming in to do it on his day off), just two days before my due date, which falls on a Sunday. What I'm less clear on is what I'll do if I go into labor before then. If it's in the next week, I would probably want to at least have a trial of labor, but more than a week out, the baby could be more than 10 lbs and I still have all the other issues to consider. Because I have heard that a scheduled, or even "unplanned" c-sec is better than getting into a situation where you need an emergency one, I'm still a bit torn about what I should do. Any suggestions?

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iVillage Member
Registered: 08-16-2004
Sun, 08-01-2010 - 6:46pm
I would do the trial of labor if you go into labor before the scheduled date (very near EDD). I wouldn't feel the risk of needing an emergency cesarean during a TOL would be greater than the benefit of an unplanned early cesarean in your case. I always have polyamnios but never considered it a serious risk.


Jeska




iVillage Member
Registered: 01-23-2010
Sun, 08-01-2010 - 8:55pm

Thanks for the input. That is most likely what I'll do, with a c-sec being the plan B I would switch to if a trial of labor doesn't go well.

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iVillage Member
Registered: 03-18-2009
Tue, 08-03-2010 - 12:39am

Congrats on your new little man to-be.


I think I'd try the trial of labor as well and then see what happens. I don't think that you'll have that much more difficulty with an "emergency" C vs. one that is scheduled. Remember that ultrasound is very unreliable especially with the excess fluid -- so, I think it's worth a shot. I think the risks will come in the pushing phase with a big baby and it will be very obvious if baby will not fit. Are you thinking of having an epidural or trying natural? If you opt for natural, you likely have a higher chance of success pushing baby out due to the ability to change positions, etc.


Good luck with your upcoming birth!!!

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iVillage Member
Registered: 01-23-2010
Tue, 08-03-2010 - 7:06pm

Actually, the game plan has changed now. I have scheduled a c-section for August 10. On top of my other concerns, baby boy decided to turn transverse again, so an induction can't be scheduled at this point, and the alternative would have been letting things go indefinitely or until I'm more than a week past due. My doctor is out the rest of next week after the 10th, and the OR is booked for the entire following week, so he'd most definitely be above that estimated 11 lb mark by the next possible date that would mean a c-section due to size anyway. I just wasn't comfortable possibly letting it go that long. Again, I think the measurements are fairly accurate in my case because my belly is enormous-- no one can believe I'm not carrying multiples-- yet the fluid level, while still above average, has decreased since two weeks ago.

That being said, if I should go into labor before next Tues, and if the baby is found head down again at that time, I will most definitely try to deliver vaginally (not without an epidural, though-- I am not that brave). But I am far more comfortable with this plan than having so many questions hanging in the air.

Thanks for the input. The plan going forward is c-section next Tues or trial of labor before then, if his position makes it possible.

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iVillage Member
Registered: 03-18-2009
Wed, 08-04-2010 - 1:05am

Wow - all these plan changes... you sound like you're rolling along with it well. Of course the most important thing is a healthy arrival of your little one... there are only 2 ways that they arrive and it's my belief that as long as you and the little one are okay in the end... we can declare success!!


Good luck in the upcoming days...

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