Potenial Induction due to BIG baby....similar to pp :)

iVillage Member
Registered: 05-06-2008
Potenial Induction due to BIG baby....similar to pp :)
9
Sun, 08-07-2011 - 2:35pm

So, I've been measuring 1-2 weeks big for more than half of this pregnancy. My DH and his brothers were all BIG babies at full term- 8.5, 9.13, and 10.4, and I was 7.13 at 10 days early so it's not out of this world to think baby Jack will be big.

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iVillage Member
Registered: 03-04-2008
I had a c-section last time, too. Not to be a fear monger, as I'm sure your doctor knows what he/she is doing... My OB told me she would not induce unless my cervix was really making some progress already because induction increases the risk of rupture. Increases it from 1% to about 2%, so still low, but... I'd ask about that first. I'd rather have an emergency c-section because of failure to progress than an emergency c-section because of rupture.
baby
iVillage Member
Registered: 12-04-2009
Don't do it. To start us/s aren't reliable measurements. You could be measuring 1-2 weeks too big from extra fluid. The threat of having an "emergency c-section" due to a big baby is still. You go into labor and if you have been pushing and pushing and your baby is not descending and engaging in your hips and you have tried to change positions too then they may decide to have a c/section to get your baby out. But even in that situation, it's not an emergency c-section. Emergency c-section is when you or your baby have plummeting heart rates or something threatening your life.

If you are induced, especially if you are only 1cm, you are more likely to cause a situation where an emergency c-section will occur. Inducing before you and your baby are ready can cause sever stress to your baby. Babies heart rates drop, they get stresses from over squeezing, the get miconium in their fluid, and then you can still have a c-section. Then you get even more stuck because any future babies they just want to give you another c-section.
iVillage Member
Registered: 07-10-2007
HI there...I'm the pp, but I just wanted to say that all the doctors I spoke to all said that induction at this stage is not a good idea for a full-term baby. They explained that if you induce and the baby is, in fact, too big, you will end up with a failed induction/emergency c. They basically said I have a better chance doing it naturally when my body is ready, then pushing it along with induction.

As far as ultrasounds not being reliable, I really hear that, but the only problem is what is the alternative? What is a reliable indicator of size? I have not seen a thing that shows me that a midwife or ob has any better indicator other than the ultrasound? The fact remains that shoulder dystocia is more likely to happen with a big baby than a small baby. Also an ultrasound does measure the amount of fluid, so it should be able to tell you if the baby is big versus too much fluid.

Anyhow, it's a tough decision. I'm scheduled to go tomorrow and I'm really torn. I feel like I'm going to feel bad about this either way. I mean, if I get a c-section and the baby is only marginally larger thant he my daughter (7lb 11 oz), I will feel really angry that I had a c for no good reason. Of course, if I went ahead on prayer that the ultrasound was wrong and/or that body could just push out a big baby (despite my troubles with the 7lbs 11oz baby) and God forbid something happened to the baby, I would never forgive myself.

Of course, if I could be one of those super duper earth mama who pushed out a 9+lb baby without so much as a tear, I would feel so proud of myself, but I just don't think it's worth the risk for me.

In the end, I'm going with the lesser of two worst case scenario....that is hte possibility of an unnecessary c-section based on my doctor's medical advice, which to me would be good, but much better than the other worse case scenario which is shoulder dystocia.
 BabyFetus Ticker
iVillage Member
Registered: 03-04-2008
Here are some stats that might put it in perspective.

Uterine rupture (in vbac patients who are not induced) is 1%.
It doubles for vbac patients who are induced.

From the American Academy of Family Physicians:
http://www.aafp.org/afp/2004/0401/p1707.html
The overall incidence of shoulder dystocia varies based on fetal weight, occurring in 0.6 to 1.4 percent of all infants with a birth weight of 2,500 g (5 lb, 8 oz) to 4,000 g (8 lb, 13 oz), increasing to a rate of 5 to 9 percent among fetuses weighing 4,000 to 4,500 g (9 lb, 14 oz) born to mothers without diabetes.

I can't find any statistics on the frequency, but the major complications from a c-section are said to be extremely rare. The most common ones are infection, excessive blood loss, and clots.
baby
iVillage Member
Registered: 07-07-2003

I am facing the same dilemma, for both the same and different reasons.

iVillage Member
Registered: 08-17-2010
Mon, 08-08-2011 - 10:12am
ok, pet peeve: the term "emergency c-section" is used incorrectly most of the time. if you go into labor/ are induced and have a c section because of a "faliure to progress" that is an unplanned c section... not an emergency c section (as moxie pointed out). emergency c's are when the mom and or baby are in a life threatening situation (ie. mom's in a car accident and baby has to be taken to save both their lives or baby's heart rate drops and stays low during labor) i know it's kind of a matter of semantics, but labeling it "emergency" makes it sound like there were no other options and mom or baby's life was in emminate danger, which a lot of the time simply isn't the case.
iVillage Member
Registered: 01-12-2006
Just wishing this was facebook and I could "like" your post!

A failed induction does NOT have to lead to a c-section ... my hospital send you home if you never make it past 4 cm and they call it a "failed induction". If you labor extensively and "fail to progress" but have made it into active labor ... your doc may recommend a c-section, but as has been rightfully pointed out ... this is not an emergency.

Inductions do up the risk of c-section because they are frequently initiated before the mother's body is ready to deliver a baby. C-sections prior to 39 weeks (except for medical emergency ... health of baby) are not recommended and outcomes for baby are frequently not favorable (NICU, etc).

But I will say that if my doc was very concerned about the size of the baby and really felt strongly that I should not go to term, I would try an induction BEFORE jumping right into a c-section. However, I think it's worth noting that I think this is one of those things where a lot of the "too big" babies NOT associated with gestational diabetes are due to our poor labor practices in the US (poor pushing position, induction before mom is ready so induction fails and doc says baby must have been too big to descend, etc). There are times baby is not ideally positioned for labor, which can certainly make labor more difficult and make baby's descent very difficult ... but again, most OBs don't really inform moms of the importance of certain exercises to improve baby's position for labor (and although I've had 3 unmedicated births I've never done these exercises and frequently as I should ... and baby #3 was born in a bit of an awkward position - sort of on her side with her hands on her face, which resulted in my tearing ... fortunately only a 1st degree tear).

Anyway, i'm sort of rambling ... the US medical system makes a lot of decisions with the goal of avoiding medical malpractice, which makes us think that certain things are riskier than they really are ... (VBAC for example is not allowed in my state by the state's physician liability insurance company. There is only one hospital that can do a VBAC and that is because all docs at that hospital are part of a separate insurance group than the one that covers all other docs in the state. But in reality, there is only a marginal increase in risk of uterine rupture w/ VBAC, particularly when pitocin ... shouldn't be needed for normal labor ... is avoided. And the ACOG recommends VBAC over c-secitons ... but most docs encourage moms to do a repeat c-section because of the big scary risk.

In other countries, mamas deliver big babies all the time because they don't know they're having a big baby and their doctor hasn't thought to scare the daylights out of them!

BUT all that being said, every mom has to do what she's comfortable with. I wouldn't want to do a c-section because of a "what if" scenario. But I understand that if mom has had fairly challenging labors in the past, how she might feel much safer with a c-section.

Every situation and birth is unique.

Good luck to everyone!!
iVillage Member
Registered: 07-10-2007
Hi, I will write more later but just wanted to let you know in my case the u/s was not a totally unreliable predictor/scare tactic. Ultrasound said 8lbs 13oz, she was actually.8lbs. 12 oz. I will say if not concerned about.complications I much preferred.the vaginal birth. Just felt more intuitive and natural but I am.glad that I did not take the risk of delivering a pound heavier (and stouter) baby after the trouble I had with the first getting stuck.
 BabyFetus Ticker
iVillage Member
Registered: 05-06-2008
Tue, 08-09-2011 - 10:17pm

Ladies, thanks for the advice....and for the emergency c-section vs. c-section clarification! :) I was not aware of the distinction and PRAY I don't have an emergecny c-section. yikes!

I'm still just in a holding pattern until Friday appt. Been DTD as often as possible....and doing squats even though my knees ache and crack (what is THAT all about?!) It's sooo hot to walk and my feet/legs are swollen and it hurts to walk around often....perhaps I'll get up early tomorrow to try to beat the heat. Maybe.

I'm so praying that Jack just comes on his own.....or if my Dr. seriously wants me to be induced and DH and I agree that that's our best option, then she'll let us schedule it for later next week to give Jack more time to come out rather than planning on putting that Cervadril in Sunday night......if it's placed Sunday night, would I go in on Monday sometime?

Oh, how fun this waiting game is!! ha!

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