UPDATE: Help me with big decision after 40 week apt...long

Had my 40 week apt today - Here is the breakdown:

Cervix is soft
Baby not in pelvis
Not dilated
Baby measuring 9lb 1 oz

Dr said the baby is not coming due to my weight gain (60 lbs ).

(I'm going to vent a little here: the only thiing I heard from this Dr's office during my entire 9 months is not to worry about how much weight I gained. Never once during my bi monthly - then bi-weekly- visits did they say I should cut back on the calories after being weighed each visit. Now its too late to do anything, I'm being lectured to. I know the reccomendations in the books said 30 lbs, but my dr (whom I should trust) said don't worry about what the books say)

Anyway: Decision Time:

a) Scheduled c -section over the next couple of days.

b) Let me wait for natural labor, but he won't let me wait past 41 weeks. And probably won't happen due to the massive amount of fat I've put on putting too much pressure on vaginal walls for baby to progress...

c) doesn't reccomend inducing labor due to fact I'll probably need a c-section anyway and it can cause complications.

Here our my concerns with the choices:

a) I'm wary of the scheduled c-section, b/c I've heard that hospitals prefer this method - more predictable, more insurance $$$. Besides, I truly don't want a c-sec due to recovery time. However, if baby really is that big, how big of a episiotomy am I going to need???? and what kind of recovery time is there for that.

b) On the other hand - if I go into labor naturally, isn't there a chance that I'll need a c-sec anyway? And if so, will it be crazy emergency, where there will be rushed and therefore could cause complications and even longer recovery time?

c) I've heard that inducing can lead to c-secs anyway, but has it worked for anyone in my situation? I don't want to rule it out completely... any success stories?

WWYD?

ETA: I am 5'2" and people say I have a medium frame... I've also been having lots of Braxton Hicks contractions for the past week or so...

UPDATE
Thanks so much everyone for helping me with this. I've been very emotional - feeling like this is all my fault for not controlling my weight gain better and very angry at my Drs for not warning me sooner - I really thought that the weight gain would just add cellulite to my butt, not prevent my baby from a natural delivery...

I just spoke with a diff doc at the practice I go to (she is my reg gyno and the only doc there that I really like) She said that she didn't feel that the baby couldn't come naturally and that she is fine with waiting until next week. She said she is even willing to try inducement if that is what I really want (not that I do) and that the baby could be smaller than sono says.

I'm going to acupuncture today to try to induce. It helped while I was TTC and I've read some success stories on other boards. Wish me luck!

Message edited 3/20/2008 3:09:26 PM.

Re: Help me with big decision after 40 week apt...long

The baby weight is just an estimate so personally I would never plan a c-section just because of that. The baby's weight has very little to do with if you will wind up with a c-section. It's all about placement. A woman in my office had two 10 1/2 pound babies and did not have a section with either. IMO it's just an excuse that doctors use to go for the section. I would wait and see what happens. I do agree about being induced though. Many people who are induced wind up with a c-section anyway.

If you go into labor and you have failure to progress because of how big the baby is then I would say go for the section. Otherwise I would wait another week and see what happens.

Re: Help me with big decision after 40 week apt...long

Wow this is a rough one. First I wanna give you some hugs because I would be so upset that they didn't say anything until it was too late to change.


I am honestly not sure what I would do. I would probably want to still try to go natural.

The Sono estimate of weight could be off. I hear that happens quite a bit.
Inductions do tend to lead to C-Sections in a lot of cases but no always.

I'm sorry that probably was not very helpful. You might want to try posting on parenting as well. I am sure at least a few of the ladies there have had similar experiences.

Re: Help me with big decision after 40 week apt...long

I would go with a c-section! The baby may be bigger then the sono is telling you, I had Julia 2 weeks early (c-section) and she was already 8lbs 5oz, if I had her late she would of been over 10lbs, so I probably would of needed a c-section anyway.

Message edited 3/19/2008 6:53:10 PM.

Re: Help me with big decision after 40 week apt...long

First of all, the sono could be off. Besides, you're not overdue until 42 weeks. I would personally wait it out.

I would rather try everything in my power to have a vaginal delivery than to just schedule a c-section.

And Easter is coming up, not to be mean but maybe that's why your doc is pushing so hard for an induction/c-section, he doesn't want to miss the holiday because you suddenly went into labor.

Re: Help me with big decision after 40 week apt...long

Thanks to everyone who responded so far...keep em coming!

BTW - Dr is jewish, so I don't think that is why - and anyway it is a practice -so I'm sure someone is already scheduled to be on call that day. However, I do believe most docs prefer sceduled c-sec b/c there is less risk with a scheduled c-sec.

Sono tech said she was pretty confidant in her reading - that sometimes she has a difficult time measuring, but she felt good about these measurements..

Re: Help me with big decision after 40 week apt...long

I would wait another week. My friend just had a 9 lb 11 oz baby completely naturally.

Re: Help me with big decision after 40 week apt...long

i would wait it out if you can. if your still not dialated and the baby hasnt moved down i understand why they would push for a csection but its not medically necessary. i was late with my daughter by 2 days and i gained 55lbs and am 5 '2. my daughter was 9lbs 13oz ws told she would be 8 lbs. if it were me and i had to opt for natural or c i would go with natural.

Re: Help me with big decision after 40 week apt...long

I just found this. ACOG's reccommendations for suspected fetal macrosomia (big baby).

Summary of Recommendations

The ACOG committee provides the following recommendations for the management of fetal macrosomia:

Recommendations based on good and consistent scientific evidence (Level A):

The diagnosis of fetal macrosomia is imprecise. For suspected fetal macrosomia, the accuracy of estimated fetal weight using ultrasound biometry is no better than that obtained with clinical palpation (Leopold's maneuvers).
Recommendations based on limited or inconsistent scientific evidence (Level B):

Suspected fetal macrosomia is not an indication for induction of labor, because induction does not improve maternal or fetal outcomes.
Labor and vaginal delivery are not contraindicated for women with estimated fetal weights up to 5,000 g in the absence of maternal diabetes.
With an estimated fetal weight more than 4,500 g, a prolonged second stage of labor or arrest of descent in the second stage is an indication for cesarean delivery.
Recommendations based primarily on consensus and expert opinion (Level C):

Although the diagnosis of fetal macrosomia is imprecise, prophylactic cesarean delivery may be considered for suspected fetal macrosomia with estimated fetal weights of more than 5,000 g in pregnant women without diabetes and more than 4,500 g in pregnant women with diabetes.
Suspected fetal macrosomia is not a contraindication to attempted vaginal birth after a previous cesarean delivery.

Re: Help me with big decision after 40 week apt...long

TBH if it were me I'd wait about a week and prob. sch. to be induced.
What kind of complications did your Dr. mention?

Re: Help me with big decision after 40 week apt...long

how tall are you?

I know that sounds like an irrelavent question, but a tall woman would have a bigger pelvis and would have less difficulty having a vaginal delivery with a large baby. If you are 5' tall, I'd probably be a bit more cautious....

the post above with the official recommendations is very helpful. I've heard numerous posters say their baby's weight estimates were rather off.... since the official recommendations also caution that, I'd avoid scheduling the c-section until later. (I have a similar suspicion to you that hospitals and Dr's give many uneccessary C-sections just to avoid the potential of lawsuits and keep the birthing process simple)

try to walk around, climb stairs.... sort of encourage the baby to drop down a bit.

Re: Help me with big decision after 40 week apt...long

Re: Help me with big decision after 40 week apt...long

I was in a similar situation. I gained 42 lbs, and am not a large person. Baby measured over 8lbs from growth sono.

I was induced at 41 weeks. I was in horrible labor for 2 days, got an infection and a fever and never dilated past 3 cm. I finally had a c-section. Ava was 9lbs. The recovery was painful, but it is also painful with a natural delivery-just in different places.

I am having #2 in September, and it will be a repeat c-section.

Re: Help me with big decision after 40 week apt...long

I would go for the c-section. I know someone who had a scheduled C and she did great with it and even highly recommends it. At this point, it may be safer for the baby and easier on you. Trust me, I know first hand what it is like to "plan" to have the whole natural thing only to find out that it may not be what is best. I have to be induced early so as to stop my blood thinner that I take every day, it was hard to hear until the doctor explained that it was safer for both baby and I. It took some time for me to cope with the fact that I wasn't going the completely natural way, but I'll tell you, after reading some of the inducing stories, I've been asking my doctor if we can just schedule a C-section. Despite that people think doctors are "overdoing" C-sections, my doctor actually told me he doesn't see a reason to do that at this point therefore, we won't be scheduling it unless something changes and believe me if it does, I will be totally fine with a C-section. Recovery time seems to be quite minimal these days and I know someone who had a "diagonal" epiziotomy during natural delivery- it wasn't a good time and the recovery was much longer than a C-section would have been.

Regardless of which advice you take, I'd say lean more toward what your doctor says - if you trust your doctor then go with what he/she says is best. Also, I hope that whichever decision you make that everything works out well.

Message edited 3/19/2008 9:27:01 PM.

Re: Help me with big decision after 40 week apt...long

FYI-if you have a c-section you will not have an epesiotomy. The cuts are in two different places. The c-section cut is usually at the bikini line. The epesiotomy is two cuts used if you are having a regular delivery to ease the baby out of the birth canal.

Re: Help me with big decision after 40 week apt...long

I had a c-section and the recovery was fine. I had a sono due to toxemia and DD was estimated to be 8lb 8 oz and sure enough she was 8 8 two weeks early. I honestly do not beleive Dr's would perfer to due a "c" ... It is MAJOR surgery and a lot is involved...

I am of medium - large build and 5 foot 7.. When my Dr said "c" i wasn't gioing to argue. It may be whats best for you and your baby..

Re: Help me with big decision after 40 week apt...long

I had a similar situation as you. I was 1 week late, no progress, and baby was measuring 9lbs 11oz, plus I am also 5'2, with a small frame.

I opted for a c-sect the next day.

I had no desire to be pregnant any longer and truly did not care how the baby got out of me, as long as he was out and healthy. He ended up being 9lbs 4oz, and I don't think I would have been able to push him out because of his size.

You have to decide what is best, but that is what happened with me. BTW, a c-sect recovery is not always bad, some recover faster than a v-birth. It all depends on the person.

Re: Help me with big decision after 40 week apt...long

Re: Help me with big decision after 40 week apt...long

Re: Help me with big decision after 40 week apt...long

I would wait and see if your body goes into labor naturally.

At 2 days past my due date, I was not at all dilated, no progress what so ever in moving towards labor. I had a sonogram and the woman said DS measured 9 lbs 6 oz.

3 days after that doctor visit I went into labor naturally and DS was 8 lbs 7 oz.

The sonogram measurements can be wrong and I prefer to let nature take its course if you can! Good luck to you!

Re: Help me with big decision after 40 week apt...long

At 39w1d I was not dilated, not effaced and the baby had not dropped. However, my BP was high, I had protein in my urine, and my feet, ankles and calves were swollen. I had full blown preeclampsia. Because I was not dilated, effaced and the baby hadn't dropped my OB said I was not a candidate for induction and would not consider it an option for me at all. Given the preeclampsia waiting also wasn't an option. I had a c-section at 39w2d.

Before that I had multiple growth sonos and they all showed Braxton-Hicks contractions (some I felt some I didn't) starting at 32 weeks.

I remember driving home from the OB's office trying to figure out how to tell DH the baby was coming the very next day. I also remember being terrified. I just kept thinking it was my worst nightmare come true. Then while at the hospital there were a few emergency c-sections that delayed mine for 3 hours!!!

In the end though, the recovery was soooooo much less onerous than what I anticipated. I was out of bed the next day. I took a shower on day 2 (and dried my hair with my hair dryer). I was walking the halls multiple times pushing the baby each day. When I got home I was able to go up and down the stairs without being in excruciating pain several times each day.

I hope that helps.

Re: Help me with big decision after 40 week apt...long

There's always a chance of c-sec, early, on-time or late.

I would go with your heart. If you want to wait then wait.

Re: Help me with big decision after 40 week apt...long

personally I would wait and see if you go naturally and if not, induce. there is still a chance you can not have a c-sec.

I am in a similar situation. I just went to my 39week appointment. I finally dialated to 2cm and the baby head is right there, so the dr is hopeful tlhat I will go before next weeks appointment. If I don't then they will schedule me to be induced by the end of next week.

My dr told me that they prefer to induce before 41w because there is less chance of c-sec.

ETA: I am taller than you and there is not a concern of a larger baby.

Did you ask your dr why now they are mentioning your weight gain, but never did before???

Message edited 3/20/2008 8:53:07 AM.

Re: Help me with big decision after 40 week apt...long

Wow, you sound like my mother 18 years ago with my sister. My sister was born at 42 weeks, she was 9lbs 3 oz, and my mother was induced because she wasn't progressing. She had my sister vaginally. My mom gained 52 pounds with my sister. My mom is 5'10", so a little taller than you.

It can be done vaginally....assuming no other complications. I wish you the very best in your choice.

Re: Help me with big decision after 40 week apt...long

Personally I would go with the C section. With my first I did not gain that much, I gained 25 pounds. I am 55 and my prepregnancy weight was around 120 so I am of average size. All my growth sonograms estimated that she would be big. My doctor did not feel that I would need a c. He told me over and over that he had smaller women than me deliver big babies.
I went past my due date and he wanted me to wait it out. I was miserable -more emotionally than physically I think I justed wanted her out so bad.
I finally convinced him to schedule an induction. It didnt work. I never got past 2cm. They then gave me the option to continue with dilation for about 36 hours or have a c. I chose the c and then she was 9 10! Once the doctors and nurses saw her size they said there was no way I would have been able to deliver her vaginally.
I know my experience is unique in that the growth sonos were right but I feel it he would have scheduled the c sooner I could have avoided alot of pain and misery and she would not have been so big.
My recovery was not bad at all.
Good Luck whatever you decide.