Help... Baby too big? - Is scan/induction necessary?

[GregMonarche]

Hello (mostly) ladies...

First some background:

I am 39 and my wife is 41 years old, pregnant with our third child, due 3rd July (supposedly). There were no problems with the previous two births (1996 & 1999), apart from Branxton Hicks contractions (which medical staff made a super-fuss over at the time, but we now know were completely normal).

Our first baby arrived 7 hours after waters broke. Second was just 45 minutes after waters broke. (And it took me 15-20 minutes to drive her to the hospital!)

Fast forward to today, when my wife and I went to a midwife visit.

The midwife measured my wife's uterus (multiple times) with a tape measure, which showed 41cm. She is due July 3rd, so has a bit over 6 weeks to go. With previous two pregnancies my wife bloated up with fluid, especially her legs and feet. So midwife tested her urine for protein. Test showed none, so there is no pre-eclampsia. (My wife also had no post-partum pre-eclampsia with the previous two pregnancies.) She also took a swab for "strep B" (I think it was), explaining if we didn't rule it out, doctors may press my wife to remain in hospital longer.

My wife has had Branxton Hicks contractions with this third pregnancy as well. (So everything seems the same as the two previous pregnancies.)

After measuring the 41cm with a tape measure the midwife said she would like us to have another scan, saying baby is bigger than it should be - and have a blood test for gestational diabetes (explaining this can apparently make the baby grow larger than normal).

We said to her we have read there is some concern and evidence ultrasounds can alter the baby at a cellular level. (We only found this out after having all "required" scans of course.) So we asked was it really necessary to have a scan now; since there's only 6 weeks to go; my wife has had no problems in the past; this pregnancy has been no different to the previous two; my wife was "quite tight" in the uterus (like a drum in fact) with both previous pregnancies just like this one; that a few cm isn't that big a difference is it...; can the tape measure really be considered accurate; and couldn't variations from body fat etc. from person to person, account for a few centimeters difference?

She replied that with some overweight women it can be hard to measure through the body fat. But with my wife (who is also overweight), "I can feel the uterus right there... I can feel it quite clearly and it's definitely 41cm." Then she measured several more times to be sure and came up with a couple more at 41cm and one 40cm.

So I asked wouldn't the measurement change if the baby changes position? She said not really, that she was measuring the fluid and uterus that the baby moves within - not the baby - so the measurement doesn't really change if baby moves.

We then asked about ultrasounds possibly not being all that accurate - and couldn't the due date be out anyway, meaning baby was possibly not big at all, but normal if conception/due date were incorrect? She replied that at the 6 week scan, all babies are the exact same size and it only varies *after* that - and that's how they know the conception/due date (by looking through the scans until they find that particular size point).

We asked what would then happen if the scan showed the baby was big. She said we maybe we should consider inducing at 38 weeks. That it could possibly prevent a difficult birth from an oversized baby, which could result in a C-section; on the rare occasion a possible ruptured uterus if the baby grows too big; or another rare occurrence could be the baby possibly getting shoulder distocia.

We have grown very cautious with medical intervention over the last decade, after learning of the numerous possible dangers (and often ineffectiveness) of vaccination. So we now carefully research and question where we can. We believe that with most normal, healthy, women - labor will happen once the body has prepared itself in the correct order and time - and interfering in that process invites trouble. The large amount of info I have read on this site today confirms this as likely.

BUT... We are not being left with much time to decide. The midwife will be probably be phoning tomorrow (Wednesday 27th May) with an appointment for a scan. We have told her we are not comfortable with ultrasounds after reading the concerns some medical folks have about them affecting a baby's cells - that we are definitely not comfortable with talk of early induction - especially when both previous pregnancies were fine and we see a few extra cm as a healthy baby - and that we don't mind the diabetes blood test, but if it were positive, we would probably only consider a diet adjustment rather than injections.

HOWEVER... We don't wish to make a foolish decision either - such as saying an outright NO to induction, *** IF *** that 41cm really *IS* "TOO big".

So with that in mind:

* Is 41cm using a tape measure accurate?
* Will an ultrasound be more accurate?
* Is 41cm at 34 weeks too big?
* Is 41cm enough to be concerned about?
* Is it true that baby moving would not change the measurement?
* Is the size difference worth the risk of harming the baby with an ultrasound?
* Any other thoughts?

Apologies for the length... But I wanted to explain clearly enough so people got the entire story from one message and could reply, considering how little time we have. (But please still reply even if you read this a few days later.)

Oh - and we are in the Newcastle area, NSW if anyone is interested.

Thank you for reading...

[Trillian]

Hi and welcome to BellyBelly.

I am going to be perfectly honest and upfront with you. You have been given a bum steer by this midwife and there is no problem at all with your wife's fundus being 41cm because all that indicates is the height of the fundus and has no bearing whatsoever on the size of your baby. This is her third baby - this means that her uterus will be bigger anyway and if she has had issues with her previous pg's with extra fluid then this will play a part too, and the position of the baby can affect the fundal height too. Don't forget that your wife has had two very easy births so there is no reason at all why she can't have a great birth this time too - even if baby is *big*. And Shoulder dystocia is largely a positional problem with the baby (when baby is not in the best position for birth) - NOT because it is too big - 6lb babies can have shoulder dystocia too.

I am actually quite disgusted at the information your midwife has provided you with and is looking for trouble when there is none kwim? She should take into account your wife's previous history. So I think that if both of you are adamant that you don't want another scan, then don't have it - there is nothing to gain from having another scan at this stage if you know everything is otherwise well with the baby and the pg. You sound like a very smart couple, researching all your options, so make good use of that and ask for evidenciary proof that she will be unable to birth a supposed big baby instead of the midwife simply telling you that you can avoid a difficult birth by having an induction - which is stupid logic if you ask me - an induction will be far more difficult for her than letting baby choose their own birthday.

[MantaRay]

Greg, I totally agree with Trillian on this. There is a great youtube video someone posted the other day of women birthing large babies naturally - I will see if I can find the thread for you. It dispels the myths about women being unable to birth large babies (which is a myth, women have been doing this for many years!!).

Also, an u/s will not necessarily give you an accurate size. We have had many members have inductions and c/s due to babies that were shown to be large on the u/s - and then the babies were actually 7 or 8 pounds - not so big at all and all that unnecessary intervention!!

I say go with your instinct. If you are not keen on intervention, don't have it. You seem very well informed to me, good on you for that. I wish you and your wife all the very best.

[Snoopea]

Greg, I agree with the others on this one, I wouldn't be concerned about the measurement, I measured 4cms to big from 32 weeks and my son(my second bub) he was born 7lb 12.5oz which isn't a large baby. Please do what you guys think is right don't let the midwife push you into anything you don't want to do(the scan in particular). I wish you and your wife the best of luck over the next few weeks and from the sounds of it you'll be having another wonderful birth soon!
Snoopea

[chocolatecatty]

Ibid to all! Is this a midwife who you have been consistantly seeing or was this the first time you met her? Remember that it is well within your right as a patient (public or private) to request a different midwife if you don't gel with the above one.

At any rate, you certainly sound like an informed couple and it doesn't sound like you will get pushed into something you don't want. Re. the ultrasound and induction....no one can force you to drive to the hospital and get them done

Good luck. Hope you enjoy perusing BB....it's such a great site!

[diannescruffy]

Hi,
I also agree with the above responses. With my last pregnancy I was measuring small (can't remember measurements) at 36wks and my midwife was concerned and sent me for a scan which showed bubs was actually the size of a 38wk baby. I too think it's fantastic that you and DW are doing your research and welcome to BB.
Regards,
Dianne

[christy]

I don't have much more to add to what others have said. It makes me angry to get such scare tactics from the midwife.

My DD2 always measured 4 weeks ahead. I had a scan 2 days prior to labour & it shows a 10lb 11oz baby. She was 8lb 13oz at birth. Born at 41wks 2 days. VBAC

[sushee]

My son Charlie also always measured 4 weeks ahead, and with my DS2, the midwife said I was enormous - I couldn't fit into any maternity clothes in my 8th month and had to wear specially made sarongs. Charlie was 7lb 14oz at full term (39+6) and DS was 8lb 1oz born on his EDD. Charlie apparently had a head circ considered to be quite large, too, at 39cm, yet he (and DS2) were both were born vaginally.

[GregMonarche]

Trillian said: "an induction will be far more difficult for her than letting baby choose their own birthday"

Well, we did mention to her when we first met, that my wife went into labor at about 2-3am both times.

chocolatecatty said: "Is this a midwife who you have been consistantly seeing or was this the first time you met her?"

This was about the fourth time.

I should probably mention in the midwife's favour, she has been fine about our "non-conventional" statements and decisions. For instance, we researched vaccination quite thoroughly when problems occurred upon vaccinating our first son. Therefore when we first met her, we said under no circumstance would we be accepting Vitamin K in any form (injection or oral). She asked why and I summarised what I had found. (That cutting the cord before it has stopped pulsing could be one reason some babies are Vit K deficient... The simple act of breastfeeding provides baby's gut with the correct flora to begin producing Vit K naturally... Unless the birth is highly stressful, there's minute risk of bleeding... The concentration of Vit K is many times the dose required by even an adult... etc.)

She listened to our decisions/concerns - and really, we haven't been able to tell either way if she agrees or disagrees with those decisions. With the Vit K, she said something like, "Obviously you've put the effort in and I'm not here to change your mind. It's just that I'm legally required to check you understand any risks to cover me/us/Hunter Health."

With the 41cm measurement, she has been a bit more matter-of-fact though... Scare tatics is possibly a little strong - it's more like... "Unless you're dead set against the scan, you really should have it to check there's not a problem." The things I mentioned above (shoulder distocia, ruptured uterus) were her answers in reponse to our questions like, "What is the test looking for - and is it even accurate?" Then she gave some possible worst-case scenarios. Then we asked "So what would then happen if the baby did turn out to be too big."

In other words, we wanted to know what kind of things they would expect us to do after the test. Because if some doctor would then press for induction or c-section, based on a few centimeter difference (or innaccurate test result) - there's no point doing the test in the first place. (Plus our new concern over ultrasounds possibly putting baby's cells through a blender.)

She even said at one stage, "Ok then, if you don't want to, don't have it." (But as these folks always do, she again then gave the reasons why we should.)

On the other hand, she did say my wife should consider induction a couple of weeks early because of the few cm difference. I guess it's hard to tell where unbiased information ends and scare tatics begin.

I had said to my wife after the appointment, I think the problem today is too much information - and they don't even know what to do with it all. I'll never forget during a scan of one our earlier children, they told us one kidney was larger than the other. This sent us into a worrying-frenzy, until someone mentioned days later the difference was actually a couple of millimeters. (How ridiculous to make us worry over that. No-one's body is exactly symmetrical on both sides anyway!)

So after our constant battles over refusing vaccination on safety/health grounds, we are always in "mistrust mode" - always on the lookout for misinformation.

I noted the "large" (healthy) sizes of some of your own babies - and the photos in another thread of that male widwife in the USA (I think) - and showed them all to my wife. We've decided to do the gestational diabetes test because it can be corrected by diet if the test shows positive. We've decided against the scan.

Thank you all for the welcomes and replies.

[GregMonarche]

The appointment for the scan arrived in the mail a few moments ago. With it there was another piece of paper, a request that a test be done for:

BGA
Hb

We are going to ring the midwife to cancel the scan. But as we're not sure what kind of reaction we might get from the midwife, does anyone know what those abbreviations stand for? (I was thinking Blood Glucose something - and Hep B, but who knows...)

[MantaRay]

Hb is haemoglobin I think (bascially a check of iron levels). Not sure about the other one.

I am glad that you have made a decision you are comfortable with. Once again I applaud you for doing your research and making informed decisions.

[Trillian]

I'm glad you are both at peace with your decision and fully confident you are doing the right thing. Now I know what the lead in was to her answers to you, I agree that it isn't so much scare tactics as such, but she certainly did bonbard you with information. Also, GD is a rather dubious test and diagnosis too - there is an article on the main site about it by Henci Goer which you should really read too.

Women birth large babies every single day without drama - your wife could well be one of these women too. And the thing to remember is, if no one ever said to you that the baby was going to be big, you wouldn't even be concerned about the ability to birth it - you just do it and don't even think about it till the baby is born - for all you know your wife could be carrying a 2ft long 6pd baby LOL.

[MantaRay]

Ah, just pinged - BGA will be blood glucose I think.

[GregMonarche]

Thanks Trillian - I finally found the Henci Goer text and printed so DW can read. I get the feeling I better highlight some of it too. We may need it as the midwife rang late yesterday and said some doctor wants to talk to us because DW is a (supposedly) higher risk (of something) at 41. And when we do, we're to tell him we do not want induction. Something was also mentioned about either 40 weeks + 3 days, or 41 weeks + 3 days. So I can only imagine. He probably wants us to accept induction because DW is a "high risk." (Hmph. Yeah right.)

[BellyBelly]

The whole age things is crap. Can she get pregnant? YES! Then she can give birth too!

[chocolatecatty]

Looking forward to reading your birth announcement.......'Doctors and midwives in shock after witnessing a 41 year old woman birth her third healthy child after going into labour spontaneously having refused induction and late sizing scans'.

Lol. All the best for these last few weeks.

[GregMonarche]

Ha!

[meow]

My Mum birthed her 3rd baby when she was 40... a 10 pound homebirthed bubby with no problems at all. Even if bubby is big (and hey- it's probably just fluid!) your wife can most definitely do this! All the best