VBAC - What Happens if Ob deems bub to big??

[Jakabella]

Ok I had a emergency c-sect with DD.

I am trying for a VBAC with this bub - I have seen 2 very very pro VBAC Obs over the last 35 weeks and I have some very supportive MW's too. So I that regard we are all set.

I had a "growth Scan" this morning - and as I was watching the screen I could see some of the measurements were getting up tp 38-39 weeks - im 35 weeks today! Im not really sure what the bits were as bub is so big that it doesnt all fit on the screen like it used to so I was a bit lost!

So anyway I have a appointment with my Ob on Monday and I just want to know where I stand if he says that bub is big....
I guess I have the right to still try but I guess they will only give me a certain time to get there?? I guess I want to know if I should or if I can fight for it?

I am very passionate of going for my VBAC and so is my Ob - but if it came down to it and a c-sect was the only safe way - then I would certainly do it.

Probably jumping the gun as I will know on Monday - but Mondays just so far away!!

[Traveller]

Growths scans at this late stage of pregnancy are notoriously inaccurate. I'm sure you will get many anecdotes but mine are

2nd birth: told at 39 weeks to expect 6 or 7lb baby, 8lb2 baby born a few days later
sister's second birth: Growth scan predicted 10lb baby, 8lb 2oz baby born a few days later by elective CS.

If your OB has concerns about bub's size then of course it would be silly to ignore these fears, but this does not mean a CS for certain. You can still have a trial of labour, with emphasis on good positioning to assist a ?larger baby to navigate the birth canal. Particular consideration should be given to the position at time of birth to reduce the risk of shoulder dystocia or tearing (for example if you give birth semi reclined on your back this is more likely that if you are on all fours).

Hopefully your OB will tell you everything is fine on Monday though

[Heaven]

That's why I didn't have a growth scan. They can be very inaccurate and even if bub is big it doesn't predict how your labour will go. The size of the baby has little to do with if it can get out, more important is the baby's position so just make sure you do your OFP stuff.

If they try to tell you that it would be better to have a c/s because of bub's size ask them to see the evidence which says a big baby is dangerous for a VBAC. You want to base your decision on the evidence, not their opinion, so see if they can show you the evidence.

No matter what bub's size is you can do it! You want this and I have faith in you that you can get that baby out all by yourself!!

[Fleur]

I didn't have a growth scan - it wasn't suggested but I would have declined anyway, I don't need to know what's ahead of me! adn it wouldn't have changed my position on birthing my baby.

I did have a quick scan at 41 weeks as she hadn't engaged & he wanted to make sure she was head down. When he finished he just said 'So, your other babies were big?' and I said 'yep... I guess we are having another big one' and he said 'mm hmmm' and left it at that. Pie was 10lb8 (I think, can't remember exactly) - about 4.7kg and my VBAC went fine.

I agree with Heaven, if they tell you that you will need a CS due to size, ask them for evidence of this. And remember you don't have to do, or agree to anything.

Good luck with your appt on Monday

[Jakabella]

Thanks ladies.

My Ob is the head Ob and he is very pro VBAC and Im sure that he would still gove me the change - and he has never said anything about size factors. Infact I have been measuring ahead from early and he has never even told me - as he isnt worried about it at all. If I have to see another Ob (mine is the head professor and teaches a fair bit!) then I guess I may run into some trouble.
DD was 8 pds 2, not sure if that has a bearing on seconds babies weights at all. I will still definatly fight for my VBAC, and Im pretty sure that my Ob's will too... guess I just like to know all of the the facts!

I do have faith that I can deliver this baby naturally and I know it doesnt really matter what size - as that what my body is made to do.

Thanks again xox

[Arimeh]

Lovely - all I'm gonna say - is that we have "apparently" big babies cos our husbands are tall - long legs yes? They do most of the measurements based on the leg length and since our kids are all long limbed, we get told they are "big" babies. And they measure ahead, of course they do, DD1 is way off the charts at 2.5 years with her height, hasn't changed since she was in the womb.

She was supposed to be 10 pounds 4. That was taken the day before she was born. She came out 8 pound 11. They got the measurements from her legs to determine her size. Plus she was supposed to be 40cm around the waist - she was the skinniest little thing when she came out - just long. Same as what she is now.

I hate growth scans.

ETA - and 8 pound 2 at 42 weeks?!??! Thats only a little one... I wouldn't worry about the size of this one at ALL.

[Jakabella]

Yeah I know Mel! If they measure the legs of this chicken it would be measuring 40 weeks im sure! Bella was long and skinny - I wonder where she gets that from LOL!

I saw the chart he put up on the screen and this bub is in the 97th percentile - just like his/her sister! Bella is still off the charts!

[ladybird11]

are these growth scans usual practice? or are they only offered to VBAC / other high risk pg's? (Just curious, sorry to crash your thread hun).

DD's growth scan done at 31 + 3 was accurate-ish (given a figure of 1200 - 1600 grams - she came out 1180 grams); but yeah, I've heard many inaccuracies with almost full term bubba's scans.

I'd respectfully decline as it could put doubt in your head, your Ob's head etc - never doubt your abilities hun.

[Ozziehoffy]

Out of my 3, I've only had a growth scan once and that was for Elijah and that was because my fundal height was measuring weeks ahead. I had muscle separation so I looked big cos he wasn't held in snugly! He was smaller than predicted at 8 pound 8. He was also a VBAC. I think from memory at 35 wks they wree telling me he was already around 3 1/2 kg or something? I can't remember now but I just went pfft whatever rofl. I "knew" he wasn't going to be enormous!

[Shanti]

Like the pp's have said, please don't stress about the size of your baby..... They are designed to be birthed vaginally ignore remarks they make about hubs size as it is not relevant. Even if bub ends up 12 pds; you can birth that

[Yeddi]

My VBAC bubba was 9lb4 and posterior. I think baby's and mother's position is more important than size unless they're like 15lb or have a 40cm head.

[OceanPrincess]

Another anecdote... At 32wks my DD was estimated at 3kg, they told me she would continue to put on about 250g a week until delivery... She was born at just before 40wks at 3.8kg. 800g in almost 8wks?? I don't think so.

My second bub I didn't have a late term scan, there was no mention of size at all, no one thought I looked big, fundal height was spot on - DS was 4.8kg, or almost 11lbs.

I think Heaven makes a good point - ask for the evidence!

But it sounds like your Ob is right on board, which is great!

[wysiwyg]

I am also hoping for a VBAC am only 17 weeks but I know size is going to come up because it already has been mentioned - because DD was 4.1kg with a big head and got completely stuck (was posterior and during the C-Section forceps were required to pull her out and the pop she made when got her free told me she was well and truly stuck) and at 17 weeks was measuring 2 weeks ahead (I know I can't be 2 weeks ahead). I think her position was more of a factor than her size (her head was arched back leading with her forehead - she still likes to sleep that way now) but the midwives and doctors found it impossible to be sure of her position during labor because my belly was so hard so we didn't know was posterior till she got stuck.

I know that it is said your body won't grow a baby that is too big for you to deliver, but have also read and believe that if something like combination of size and position means you will struggle then your body knows this and labor stops (this is what I believe happened with DD - ctx stopped at 5 cms), so whatever the expected size and position I am hoping to be able to allow to try for the VBAC, as I would like to start labor on my own but then make the decision if labor stalls again in a similar fashion to go for the c/section much earlier than last time so am able to keep my eyes open when this one is born. So I am not completely set on achieving a VBAC, do you think you have to be to achieve it? Or can you just go with the flow and still get one?

A question about the body won't grow a baby that is too big for you to deliver - does anyone think that this has an evolutionary component in that, we are designed that way but because over time generations have been born via c-section it means that natural selection hasn't been acting and therefore possibly that statement is getting less true as time goes on? I would think c-sections haven't been around long enough to have a had an evolutionary effect? Also read recently that older women are likely to have bigger babies, but they don't have a clue why.

[Yeddi]

I think that you do have to be determined to have a VBAC and have some set ideas. I found even in a supposedly VBAC friendly hospital that the education etc. was all geared to fear mongering and I wouldn't be surprised if half the women walked out of it and went and booked an elective C-section. Many hospitals have a lot of hoops that they expect you to jump through that stack the odds against achieving a VBAC unless you either run to or ahead of schedule etc.

I also do think that these days occasionally women can grow babies that are too big for them based upon the diet they eat. A lot of the cheaper hormone/antibiotic reared meat (mainly an issue in other western countries like America) may have an effect on how big baby grows. If it can make a chicken at 30 days the same size as an organic chicken is at 150 days, it wouldn't be a stretch to think eating said chicken could effect a baby that is developing. There are all sorts of additives in food these days that we don't really know the long term effects of. This isn't an act of evolution though, but greed. One case comes to mind was the baby that was 16lb and his mother was having burgers for lunch and dinner from a local take away who used cheap (aka more than likely hormone laden) meat. I think though, in general, that if you eat a healthy diet from good whole foods baby will be as big or little as baby needs to be.

[Fleur]

I think sometimes that a more relaxed attitude can actually help. Stressing out too much can be counter-productive, which is one reason it can be so devastating to have a negative OB putting worst case scenarios in your head.

You will need a certain amount of determination I guess though, to even get to the point of attempting a VBAC. You could across a doctor who will only let you go to your 'due date' or who looks at the size of your belly & says 'oh, you'll need a c-section' - especially given that size has been mentioned already for you, at 17 weeks.

I understand what you are getting at, and I actually think it's really reasonable. I think it's great that you are accepting of the possibility of a CS & might just put your mind in a better spot. If you let labour start naturally & attempt a VBAC then there will be benefits for your baby also.
But you will still want to have some determination about how far post-dates they let you go, and how you labour; things like continual monitoring, and being stuck to the bed, will not do you any favours, you know? Give yourself the best possible shot at it.

I would be also looking at optimal foetal positioning , to try and encourage this bub into a better spot

Good luck

[wysiwyg]

Thanks for the opinions Yeddi and Fleur - I am hopeful that being relaxed will help because isn't really in my nature to get stressed out but I am pretty determined to be allowed to start labor naturally - am going public and so far my rather "go with the flow" attitude seems to work in my favor as have said are happy for me to just keep seeing midwives until 36 weeks when will need to see an Ob. The positioning I am definitely going to look into - last time they always thought was in a good position but wasn't until later was admitted that it was difficult for them to tell so I don't remember doing much prior to labor.

Sorry to crash your thread Jakabella - hope all goes well on Monday

[~mamaspice~]

Hi Jakabella,

Just wanted to add my story into the mix. I was really wanting a VBAC with DS. But I got gestational diabetes and when I had growth scans at 33 and 38 weeks I freaked. He measured ahead by about 3 weeks and they told me that bub was going to dfinately be over 4 kilo's. Even when the middies felt my tummy they said he was big. In the end this was why I chose a CS. I had this vision of having a bigger than normal diabetes bub that I couldn't push out.
Well guess what! He was 3.7kilos and had quite a small head. I remember looking at him after he was born and thinking I could have easily pushed him out.

Moral of the story - please please don't let bubs "guestimated" size scare you. I wish I didn't. . .

[Ozziehoffy]

Well guess what! He was 3.7kilos and had quite a small head. I remember looking at him after he was born and thinking I could have easily pushed him out.

Moral of the story - please please don't let bubs "guestimated" size scare you. I wish I didn't. . .

Yep I agree with that... I remember them saying about how they thought Elijah was going to be HUGE and I told them I didn't think so, that yes, he was going to be bigger than Oskar but not THAT much... he was 1200gms more.... bigger yup but NOT huge, 3.8 kilos. (I think I already mentioned my scan before... but yeah, just tacking this on here though cos they can "scare" you when there's no need to feel that way)... I just wish they'd be more encouraging than a lot of them are.