Refusing fundal height measurements

As a bit of background, my first baby was born via "emergency" c-section and was reasonably large (8 pound 10), although I don't consider this huge. I was told towards the end of my pregnancy that my fundal height measurements were large and a scan may be a good idea. I was reluctant about the scan and thankfully didn't have it.

The “big baby” thing is looming as an issue for my VBAC. Feeling really down about it and about myself all day yesterday and today. I had my first appointment with my midwife at lunch time yesterday and had really been looking forward to meeting her. Unfortunately, I can’t say we clicked. Which isn’t great, as she’ll be looking after me all pregnancy, birth and some appointments after. There were a number of things she said that I just didn’t agree with and she seemed a whole lot more medicalised than I was expecting (as the MGP philosophy sounds a lot different to the way she spoke). I felt less positive with her than I had with the ob, and I thought that was a hurdle I had to get over!!

The worst thing is that she did my fundal height measurement and I was measuring at 27 weeks, and am only nearly 22 along! At first I laughed – a bit in disbelief, but now I am just depressed about it. If I get 3 measurements in a row above the 90% line (this one was well and truly above) then I will have to have a scan to check baby’s size (we all know how reliable that can be) and decide a course of action. I REALLY don’t want to have in my head that this is a big baby when trying for my VBAC. I know that I had niggling thoughts about this when in labour with DD and think it only hinders me. I am just so upset. Went down to mums yesterday afternoon and had a bit of a cry about it all. I am considering not letting them measure me at all for the rest of the pregnancy. I know I have a healthy baby in there and I’m not sure what the point of measuring my size is, unless they want to give me another c-section. Anyone know anything else I am risking by not allowing these measurements?


Any opinions would be most helpful - thanks guys!

:hug: We all know that bub's position has more to do with fundal height than his actual size.
Maybe tell her that your last baby also measured big, but that he wasn't actually that big. 8lb 10oz is NOT big!! Have you got your prenatal notes/card from last time? Maybe compare measurements & see if you can at least reassure your self that way.
I can't see any reason for you not to have your vbac. As long as your bub will fit through your pelvis itself (& there's no reason s/he won't) then there shouldn't be a problem.
Well not IMO anyway.

Are you able to change midwives at all?? I had a similar thing happen this time round. Measured 30cm at 26w, then a whopping 35cm at 29w so got sent for a scan which was the next week (fluid levels were normal) and I only measured 33cm at 30 and have now averaged out to 37cm at 36w. I have a bubba that refuses to drop at all!! I had a bigger baby first time round but they were only concerned if there was excess fluid around the baby. So don't worry too much, maybe baby had a growth spurt and things will average out over the next month or so. Good luck for your VBAC - you can do it.

Oh hun....that sounds totally wrong! During my first pregnancy I was often way ahead in measurements and DS#1 turned out to be only 7 pds. I was 30 kg heavier by the end though...full of fluid! With DS#2 I was heaps smaller and he was over 8 pounds, long and considered by my hospy to be a perfect size (and rather loud!!! lol )

This time round I had an appointment at 21 weeks and was measuring ahead and then at my next appointment at 26 weeks and was measuring 26 weeks! I agree with Clover about bubs changing possy. My babeee was so low the other week, I could have squatted down and sneezed her out and then the next day she was climbing up under my ribs.

Go for your VBAC, it is what you desire in your heart. Can you change middies???

Massive cyber hugs.

xxxx

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Are you able to change midwives at all?? I had a similar thing happen this time round. Measured 30cm at 26w, then a whopping 35cm at 29w so got sent for a scan which was the next week (fluid levels were normal) and I only measured 33cm at 30 and have now averaged out to 37cm at 36w. I have a bubba that refuses to drop at all!! I had a bigger baby first time round but they were only concerned if there was excess fluid around the baby. So don't worry too much, maybe baby had a growth spurt and things will average out over the next month or so. Good luck for your VBAC - you can do it.

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We posted at the same time. lol

I think they do have growth spurts....but remember someone saying up until about 18 weeks they all grow at the same rate....but babies are little people so are all individuals!!!

Thanks girls - I am hoping to speak with my soon-to-be doula today and see what she thinks - she knows my midwife and held back from expressing an opinion on her last time we met, so I will see whether she thinks it is worth swapping.

More importantly, I think I am going to be big all along, and although your reassurances are lovely, I really don't want to be told I am big again. It's a mental thing for me, and I think if I think this deep down a little part of me will not be convinced I can get my VBAC. So I'd rather not know my measurements.

Does anyone know if I am risking anything by not having them done?

I always measured big last time (don't know yet this time as I haven't been measured- can't be that important?). I don't see the big deal- babies will be lying in different positions. And you have an anterior placenta- surely that pokes out the front and affects measurements? I *think* the measurements can help to determine a potential problem with excessive/not enough fluid? So measuring far ahead and then having a scan may find something? I'm not sure though. I don't buy any of the big-baby stuff though. I had a big baby and I think I'm having another. No biggie. Their skulls are designed to moosh up on the way out and I think they all seem about the same size when birthing. Size is pretty irrelevent really.
Whether you decide to keep up with the fundal measurements or not you can choose not to buy into their "big-baby" scare game. It does NOT mean your baby needs to come out early. It does NOT mean your baby hasn't grown to the right size for you to birth. Your baby is healthy just the way they are. I hope you continue to work through your fears around that- you're doing a great job talking about it :hug:

Thanks meow!

Thanks also suga - I am planning to give Helen a call shortly to confirm that I really need her!!! We had a great meeting and I'm very excited to have her on board!

I dont' know about checking fundal height, but it doesn't sound like you're too comfortable with your midwive and that's not a good thing at all:hug: Your midwife shoudl be on the same wavelength as you and leave you feeling reassured and confident. I'd be asking to switch myself.

I would have thought fundal measurements were reasonably important not so much for if your baby is going to be big but if you suddenly blow up with excess fluid which can indicate certain problems.

Hi there!

Fundal height measurements are ridiculous - they are notoriously inaccurate especially given that nearly every mw measures differently.

Absolutely request another mw, re-state that you ARE having a vbac and you want a supportive mw.

And for heavens sake don't worry about being told you are too big - I was measuring 43wks at my 38wk appt. and bub ended up being 8lb 6oz, due to having a completely unsupported vbac I ended up with another cs and was told my DD was just too big (aww gee what a consolation) I then went on to have DS in a very easy vba2c and he was 9lb - but as you can imagine I refused to have any scans (other than to check he was in there at the start) and NO MEASUREMENTS!!!!

The size of a woman or her uterus is no indication of how she will birth - just like foot size is no indication of pelvic size (How many ppl have been asked their shoe size though???)

Aside from always measuring big (my firt was u/s'ed and the Ob said 10lber, she was cs'ed out early and I was left with a BIG scar - all to bear a wee little 6lb 15oz DD :shakehead: ) I am also overweight by heaps! And shortish - SO - you can imagine all the crap I get about not being able to birth a 'too big' baby and having a too small pelvis and of course if your baby and you are big then you must have GD too!! Guess what, didn't and didn't bother having the horrible GTT either!

My 9lb'er came out so easy I say bring on the 10lb'er :lol:

You can have the birth you want, just stick to your guns, don't subject yourself to their crap and say NO when you have to - enjoy yourself and avoid the stress, I would not bother showing up for any more measurements (Hmmm, I wonder what the "course of action" is for a "big baby"???)

Sarah

p.s. If you "suddenly blow up with excess fluid" fundal height will not be the first indicator, excess fluid is marked by swelling - mainly round the face, the fingers and feet and also on its own is not a problem, excess fluid is only a problem when present with high BP and +++ protein in the urine.

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p.s. If you "suddenly blow up with excess fluid" fundal height will not be the first indicator, excess fluid is marked by swelling - mainly round the face, the fingers and feet and also on its own is not a problem, excess fluid is only a problem when present with high BP and +++ protein in the urin

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You are talking about GD. Polyhydramnios doesn't always have these symptoms and and can indicate problems with the baby, or indicate other risks such as early labour.

It's a tough one, the fundal height can be used as an indicator that something is wrong. But i was a few cm ahead my whole second pregnancy and my OB didn't blink and eye. He said it's not so much the measurement as the changes in measurement from week to week. My pre-eclampsia was first picked up by no change in fundal height between appointments combined with high BP. That was enough to make him investigate further. Not that you are likely to have PE in a second pregnancy if the first was
But regardless of your fundal height, i think you should get a new midwife. One of the most important things is to be surrounded by people you trust.

Yep, as krysalyss said, PHA presents differently to GD or pre/eclampsia. Excess amniotic fluid (PHA) will NOT result in maternal oedema or proteinuria, but can indicate serious problems with bub and high risk of prem delivery.

*star*, I've already posted in our BB thread, but wanted to support what the OP's have said... If you don't like your MW and don't feel comfortable and supported by her, see if you can change to someone else. ANYONE else...!!!

Just wanted to give you a :hug:

You will birth the perfect sized baby, because you will grow a perfectly sized baby and you have a MASSIVE VAGINA!

I know women who have homebirthed 14 pound babies. It is possible. If left unhindered, your body knows what to do...you just have to tune in and trust. Easier said than done I know, but we believe in you!!!!!

I think the decision is yours hun, you will be able to birth this baby and do it your own way. I hope you get a new MW and it is someone who is really supportive and she amy have other ways to tracking how you are going. FWIW I have popped a lot early this time and look bigger, but my fundal height has been completely normal :D So jsut because your belly looks bigger, the fundal height may not be :)

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You are talking about GD. Polyhydramnios doesn't always have these symptoms and and can indicate problems with the baby, or indicate other risks such as early labour.

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completely agree with krysalyss and nickle, I had polyhydramnios with DD and it was a really big fundal height all of a sudden that was the marker and a scan measuring fluid leves confirmed it, there was no other indicator the we could visibly see that would have have indicated it.

I say still get the measurements done, there seems to be a slight risk with not getting them done....
the idea and fear of a big baby is something you will have to change. I always measured to date however my gp and a couple other medical professionals suggested that i may have to get a scan to see the size of the baby cuz i might be too small to deliver vaginally. Pre-pregnancy i weighed 45kg and am a size 6. I put on 15kg with my pregnancy and it was all baby related. I was determined to give birth and not have a c-section nor be bullied into any pain relief etc. Even if i had a big baby I wanted to PROVE that I could do it....with that mindset i took the advice from doctors and respectfully declined.
I went on to have an 8lb 2oz baby with no tears! I was quite shocked at how big bub actually was, but i am so proud of myself for doing it! If your midwife will not support your choice for a vbac then change midwives...she will be supporting you in the most stressful time and you dont want to be pressured rather than supported.
all the best

I had a 11pd 2 oz bubba who was 59.5cm long (my last scan 2 days before birth showed him as being about 9lbs), with minimal tearing & no drugs. My GP said that if the hospital had known how big he was going to be I wouldn't have been able to birth there, I would have had to go to a bigger hospital. I can honestly say he was much easier to deliver than my first, and she was only 9lbs..
Don't let the thoughts of size get you down. xoxoxo

Faithful Mumma, that is one beautiful big bubba!

My first was 5lb 10oz, my second 7lb 14oz... my 'big' boy was SOOO much easier to deliver than my 'little' girl.

I'm another that found the bigger one easier... My first was 8lb 3oz and had a long hard labour with an episiotomy and ventouse, with gas... My second (2wks old) was 10lb 11oz, two slight tears, no pain relief, short and sweet labour :)

No one predicted my boy would be that big... And my FH measurements were always spot on or a bit under.

Good luck...

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You are talking about GD. Polyhydramnios doesn't always have these symptoms and and can indicate problems with the baby, or indicate other risks such as early labour.

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Polyhydramnios, does present differently to GD (although I was not suggesting that excess fluid is a result of GD either) However the OP is 22wks along - nearly all cases of Phd start after the 30wk mark. Most wm with Phd notice a sudden increase in the size of their 'bump' as the increase in fluid is marked, often trebled. If mum reports less sensation of feeling bub or the Dr finds it difficult these can be indicators of too much fluid. Also due to the sudden distention, sudden severe heartburn or abdo pain is common.

Wm with diabetes are more susceptible and those who have had positive tests for trisomy 21 and other conditions which effect the babies GI tract.

Mild Phd is unlikely to have any effect on the outcome of a healthy baby and above all servere Phd which will exhibit the above sideeffects occurs in approximately 1-2% of pregnant women.

So before we start scaring all 'big' measuring wm into thinking they have something terribly wrong, lets just put it into perspective a bit, Phd can and more often than not is diagnosed in many different ways other than fundal height measurements.

If the measurements effect you on a negative way there is no harm in not having them, if you have any concern about Phd you can ask for a fluid measurement u/s, this would need to be done after 30wks and would confirm if you have excess fluid.

Sarah :D

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So before we start scaring all 'big' measuring wm into thinking they have something terribly wrong, lets just put it into perspective a bit, Phd can and more often than not is diagnosed in many different ways other than fundal height measurements.

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Sorry who is 'scaring' the mother? I can't see from the posts that anyone is doing that. I am not going to get into an argument with you.

Star - I think everyone has given you some good advice :) Good luck - I hope you can find a midwife you are more comfortable with.

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Polyhydramnios, does present differently to GD (although I was not suggesting that excess fluid is a result of GD either) However the OP is 22wks along - nearly all cases of Phd start after the 30wk mark. Most wm with Phd notice a sudden increase in the size of their 'bump' as the increase in fluid is marked, often trebled.

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Polyhyrdamnios started for me at 24 weeks and same with a SIL of a fellow BB'er (she may have been even earlier), my bump grew bigger but it didn't look that big TBH, and it was the fundal height that suddenly showed me a lot bigger, and in this pregnancy I have compared my photos and at 24 I looked a lot bigger in the bump then I was at the same time as I was with DD yet no Polyhrdramnios....

The scan does not need to be done after 30 weeks either... it really needs to be checked earlier and further testing to ensure that it isn't the result of an infection or GD. I came back clear on both accounts with DD, so we never found the cause.

And I can say there were a lot of waters when they broke at 33 weeks :o

Thanks guys, for the concern and information.

I’m still not sure where I stand on this. But just knowing in my mind that I can choose to refuse them if it comes down to it, is getting me along for the moment. I haven’t decided to change midwives yet – and haven’t discussed with my doula. But I am coming to terms better with the measurement. My course of action at the moment is:

1) I am eating healthier and somewhat reducing quantities of what I eat (not to a huge extent, but not having a free-for-all like I was prior to this wake up call)
2) Discuss with doula whether to refuse the measurement and whether to change midwives, or whether I am basing this on a once-off meeting
3) Possibly get DH to do a rough measurement for me and if I’m still measuring over the scale for the next appointment, I will refuse to get it done (unless I have any of the other symptoms to be concerned about for excess fluid / GD)
4) Meet with midwife again at the next appointment so I can decide (along with doula’s advice) whether to continue care with her

I really don’t think changing midwives is going to change the course of action if I am measuring over 3 times in a row – it is just hospital policy and my previous midwife who I was happy with would have done the same thing (although perhaps was a little more flexible?). It may change some of my other perceptions about her attitude to birth, though, so I will keep an open mind about whether or not to ask to change.

The problem is, now that it has been implanted in my head that we’re already big, the damage is kind of done. So it would be really nice to be able to have a “normal” measurement and be reassured that everything is on track. But I can’t guarantee that this is going to happen, so I know I really need to understand that I can birth the baby that I am creating (refusing to use the words “big baby”) and make sure that those around me agree that I can do it too.

If excess fluid is diagnosed, what are the steps following this – does it change anything?

If the high measurements continue and I have a late ultrasound and the baby is big, I can see the doubt creeping into everyone’s mind that I can birth him / her – but what else is having that ultrasound going to tell me?

What is also confusing me is that exactly 2 weeks prior I had my 20 week ultrasound and all baby’s sizing was within normal limits. I can’t imagine how things changed that quickly. Either that or they are more generous with the baby’s sizing than the fundal height charts?

If there is extra fluid, depending on the amount, it could result in premature labour or issues during labour. If you don't want to be pressurised over the "big baby" problem then you are of course free to refuse consent to measurements, but remember you can also accept the measurements, and depending on what they say use the information to your benefit to make sure that there is no issue with your fluid levels.

Firstly a big :hug: for you hun.

I think you have put together a really good plan on how you want to deal with this and I think it is really well thought out and a measured approach :clap:

If the excess fluid is confirmed with a scan - where they measure the amount of fluid surrounding bubs, this is the course of action that my OB took when I was diagnosed with it with DD they will send you in for the GD test early, and you would do the long test rather than just the short test, because if it is GD they will want to get on top of it sooner rather than later. They would also run blood tests, I can give you the exact one's if you like as I still have my records from DD. This is to ensure that there isn't an infection which is causing the excess fluid.

What it does do is increases your risk for Pre Term delivery, now I don't think i was actually classed as high risk during my last pregnancy, my OB had said that I wouldn't go past I think 37/38 weeks, but I don't recall the use of High Risk coming into it.

The fundal measurement can change as well, so just because you have a high measurement now, doesn't mean that the next one will be, I was high at 24 and 28 weeks, 30 weeks my measurement was exactly back to 30 weeks, but 32 weeks I have "blown up" again and delivered at 33 weeks.

I guess things can change quickly but it is dependant on the cause, they may find out that there was no obvious cause, like they did with me, so after that my OB said we would just go with the flow.

I have the confidence that you will be able to deliver this baby no matter what size, there is a great thread with an awesome link about smaller women birthing larger babies and I will try to find it an post the link and hopefully it will help instill in your mind that you have the ability to birth this baby :hug:
Take care hun xxoo

Just wanted to update on how I went with the midwife on Monday...

Had myself all geared up that if she didn’t give the right answers I would seriously consider whether I could swap midwives or change plans altogether. Turns out I needn’t have worried!!! She came in and pretty much apologised for all the rules she gave me last time – said that was general hospital policy and we don’t have to be as strict!! Holy cow, don’t know what got into her!!! She said she was comfortable not doing the fundal height measurements and could see that I was growing (how could you not!!!), so we’re not going to bother! YAY! Hopefully this removes the fear from both of our heads regarding the large baby! I was so happy after the appointment and just felt great! I can’t really understand why the complete backflip (if I was guessing, perhaps my doula ran into her and mentioned she was going to be looking after me?!!). I am feeling so much more positive about my VBAC now! Even had a good dream about labour last night, LOL!

Wonderful news *star* I am so so happy for you :hug: VBAC all the way hun xxoo

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I am feeling so much more positive about my VBAC now! Even had a good dream about labour last night, LOL!

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:dance: :dance:

It's going to be fantastic! Maybe this whole experience was a blessing as it brought potential issues right to the fore-front and now you and this midwife have been really thorough about making sure your notes contain all this info and you know you're on the same page. I'm so glad you had a good appointment :D