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@Mrs. Lemon-Lime: Im glad you've made your decision!
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@Mrs. Lemon-Lime: great decision. We are all l rooting for you and even if it doesn't turn out ideal you'll have a sweet baby in your arms.
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@Mrs. Lemon-Lime: I think you made a good decision. I'm rooting for you!
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I am also petite and they were guessing T was 9/9.5 lbs. I had a 42 hour medicated induction and she was born at almost 8 lbs with minimal tearing. Anything can happen.
I've never heard of a bishop score till this post.
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Good luck! With my lo we had borderline low fluid so we didn't want to go pat 40w at all. I reread my comment and realized it kind of sounded like we just felt like doing an induction, oops.
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I did not have a medical induction, but was very close to one. At my 40 week appointment, baby was showing no signs of being ready, I wasn't even dialated 1 cm, and the midwife said it could very well be another 2 weeks until baby was ready. Not sure what my bishop score was, but I'm guessing not great. My midwife wanted me to call and schedule an induction for 41 weeks. I didn't see a reason, since baby and I were doing fine, and wanted my best chance at a natural labor.
I ended up going into labor naturally 2 days later, had an intense but short 7 hour labor, and baby and I both did great. I'm only 5'1, baby was 8 lbs, and I did tear badly, but that was due to baby coming fast.
Anything can happen, and it sounds like you're in a good place mentally with your decision. Good luck!
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Update: SHORT my doctor told me to find a hospital that will vaginally deliver a 9 lb baby because she will not. I am totally at a loss!
LONG
The day started with us getting an ultrasound and my fluids are fine. Then we called insurance to see if we can switch care providers this late and they had no problem. Then, we called a midwife and a doctor's office that my doula recommended and they won't take me this late- past EDD. Then we called Planned Parenthood to see if they can do the monitoring, but they can't.Then it was time for the doctor's appointment. Two hours later they put us in a room with heart rate and movement monitoring. It was crazy getting it set up. Then the doctor walked in to say the cesearean was scheduled for the next day at 12:30 pm. I told her we didn't want that. Then, she said no one in her practice will vaginally deliver a 9 lb baby. Even if I come in 7 cm dilated I'm getting a cesearean. She told me to find a hospital that will and said we would need to sign a waiver. Then she left for the hospital.
She didn't leave any instructions for the nurses. So it took more questions and explaining to finally get to leave the office. We didn't sign the waiver because they were taking forever and will have to go back at sometime to do it. Right now our doula is trying to help us figure out care for the last few- several days.
DH cried in the car on the way home. This is the second time I have ever seen him cry.
I know women have ceseareans everyday, but I truly don't feel I should be bullied into having one when at the moment it is not medically necessary. Nothing the doctor said (9lb baby) or nurse said (past EDD) indicates this cesearean is in my best interest or baby's.
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@Mrs. Lemon-Lime: Wait, what?!? They won't deliver a 9 lb baby??? First of all, they don't know exactly what size the baby will be, they CANNOT tell with ultrasounds, no matter what they say. Second, they cannot force you to get a C-section, obviously, but I cannot believe they're telling you to find a new hospital. You ABSOLUTELY should not be bullied into a c-section, it's your decision. If that's what you want to do - great, but if not, it's your right. My baby was 9lbs 6oz and we had a successful delivery with just a minor tear.
I feel like this is not real - this doctor/hospital should be reported or something. I'm so sorry you're dealing with this at the very end of your pregnancy
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@Mrs. Lemon-Lime: If I remember correctly, at least one concern for (you) and your LO was shoulder dystocia and all the related complications. It seems there are several factors at issue here that give your provider cause for concern.
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@Mrs. Lemon-Lime: that sounds crazy to me! I'm assuming the baby looked good on the non stress test. Did they even offer to check you or sweep your membranes?
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@pwnstar: that is true, but looking at the research of a) estimated weight accuracy and b) likelihood of shoulder dystocia I am okay with going forward with a vaginal.
In my doula's search to find a different care provider for me she came across another doula that had a client with the same doctors. The woman delivered a 9lb 8oz baby VBAC. Who knows maybe the baby's estimated weight was under 8lb 13 oz, but VBAC is way more risky than anything going on with me. If the baby was estimated much less then that just goes to show they may be wrong on the weight. If the baby was estimated to be over 9lbs then it's just bull what they are doing to me.
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@Mrs. Lemon-Lime: I have litigated multiple cases involving shoulder dystocia; the outcomes were far from favorable, even in cases where risk was, truly, minimal. I don't say that to scare you. I say that because you seem to be assessing your risk in a vacuum, without including all of the variables (some of which you have mentioned in this thread); estimated size is not the only variable here.
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@Mrs. Lemon-Lime: WTF??! This is making me rage-y!!! My sister and cousin have each delivered 2 >9lb babies vaginally. That is ridiculous that they won't even let you try? I would be so angry.
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@Mrs. Lemon-Lime: WHAT!
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@Mrs. Lemon-Lime:
Many people I know have delivered babies over 9lbs naturally, your doctor sounds really mean. Sorry you are going through this. I know its kind of late now but I wish there was some way you could switch doctors. I had a c-section and hated it and wouldnt have it unless it was actually necessary and in your case it doesnt sound necessary yetUpdated to add, the size of the baby isnt even a definite thing until the baby is born. they told me my baby was nearly 8lbs but she was born 6lb 90z
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I'm kind of appalled by this. As a doula and midwife in training I've NEVER heard of a doctor or hospital refusing to deliver a 9 lb+ baby. It makes absolutely 0 sense. They obviously WILL deliver 9 lb babies to moms who haven't had growth ultrasounds and therefore don't know the size of the baby before comes out. That is just ridiculous. Is that even legal?
Growth ultrasounds have a huge margin of error and there's no guarantee your baby will even be 9 lbs.
And do you know how many women have easily vaginally delivered 9 lb babies? Not to mention that, as someone said before, there's not really such a thing as "running out of room." It's also not that common for your pelvis to be too narrow to deliver a large baby. Your pelvis stretches like crazy during birth and it's extremel hard to tell before labor if something will prevent it from stretching.
You have every right to refuse or skip the c-section for tomorrow but I hope you can find a doctor or midwife ASAP to take over your care!
ETA: What's the evidence for the risk of shoulder dystocia?
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@Mrs. Lemon-Lime: I am just APPALLED. There are no words. The cesarean may end up being in your best interest, but right now it just looks like it's in the best interest of your doctors. I hope you can find a hospital/doctor who will deliver you. I'd definitely report that office though. They cannot force you to have a c-section.
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@pwnstar: you would go conservative and get a cesarean? The panic of this all is not having a doctor to monitor me every 2-3 days.
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@Mrs. Lemon-Lime: First, I would like to say how truly sorry I am that you are going through this. My short answer is yes, I would have the c/s.
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@Mrs. Lemon-Lime: Is there another practice that delivers at your hospital that would take you on this late? Is there a certain hospital in your area that is known for having a lower cesarean rate?
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@pwnstar: I forgot to mention in all of this my doctor's office doesn't carry malpractice insurance. DH thinks this is motivaging the hard line more than anything else.
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@pwnstar: please wall me with the long answer. I don't want people to have birth fear.
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@Mrs. Lemon-Lime: I work in the finance industry and 90% of my clients are doctors. This is fairly common (not having malpractice insurance). They most likely are able to self-insure. There are deductions, etc associated with this and it's completely legitimate.
I am going to be the other outlier and say I would probably side with @pwnstar. I think on HelloBee we tend to sometimes go past the line of being informed patients vs. wanting to dictate our care. You selected your doctor because you trusted the practice. Based on your other posts, I would say that you probably put a lot of research into this decision (selecting your doctor). I know that your baby has been measuring large for awhile now. Has this never come up before? I dunno it feels like more is going on, especially since ACOG only recommends automatic c-section with babies over 5000 grams (11 lbs).
ETA: It also sounds like your doctors are fairly "by the book," considering they wouldn't induce you due to low bishop score and, until Hellobee, I'd never even heard of bishop score and know many people who have been induced with no dilation at all. This statement seems very un by the book, which is what is confusing me to think there are other factors at play.
I'm sincerely sorry you are going through this.
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@avivoca: so far 0-4 on an alternative doctor. There is one more doctor that I was referred to that isn't in today, but her admin said to bring my records to review. We're dropping off the records there as well as the on-call practice that delivers at a nearby hospitals. There's another hospital that is further away, but my doula recommends. IDK about cesearean rates at the hospitals. I really want a doctor to monitor me now.
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@Mrs. Lemon-Lime: I am sorry you are going through this, it just makes me ragey.
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@Mrs. Lemon-Lime: So, I'm someone who chooses to deliver at a hospital that is further away but is more aligned to the type of birth that I would prefer. Don't get me wrong, if I need a c-section, I can get one there and will gladly take it. So I wouldn't worry so much about having to go to a further hospital. I'm so sorry you are going through this and I'm so angry at your doctor for you. I hope you can find a doctor to monitor you.
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I am sorry. I agree with you based on the information you've given. If the only factor is suspected baby of 9lbs, then there is no need for an automatic C- section. A friend of mine was told the same by her doctor, got a C-section, and the baby was barely 7lbs. My doctor on the other hand said my baby was going to be around or a little under 8lbs and he was almost 9 lbs. They just cant tell from the ultrasound. With my first they didn't even do a measurement u/s so what if he'd been 9lbs? Ugh. Very frustrating.
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@LBee: @pwnstar: I'm going to agree with you guys here. the thought of being overdue and not having a doctor to monitor the baby is absolutely terrifying. More terrifying than an unnecessary c-section for sure. It sucks you're in this position, but based on the circumstances - c-section or no doctor - I'd have to choose a c-section.
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Oh honey, no advice, just thinking of you and sending positive juju.
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@Mrs. Lemon-Lime: I'm just LIVID for you. That is beyond absurd. You should have the choice to give birth as you desire since you have been presented with all of the risks and information necessary - it's your body and your baby. Why can't they have you sign a waver that they preemptively offered you a c-section but you wouldn't accept it? Anyways, I have VERY small hips, a slight build (despite being tall) and I've delivered two babies, one at nine lbs and one at just over. It was fine. There was never a hint of concern from my practice that there was a concern despite the fact the babies measured large and we had no complications whatsoever - I didn't even require an episiotomy. I barely tore with my first and didn't at all with my second. All that to say, I am so sorry that they are leaving you in a lurch like this. It truly feels unfair. I'm not sure what I would do in your shoes. I didn't go with a practice for my first baby (it was a home birth that had to transfer to the hospital to get an epidural after 30 hours of labor and I was exhausted and needed rest) and was able to get in to the hospital with the doctor that was on call but I was well into labor. That's probably the decision I'd make in your case but I know that's not going to be everyone's first choice (and I know there are likely people reading this and judging me for that
). At any rate - so sorry this is happening. How stressful.
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@LBee: My belly has been measuring big, but any time I have gone for an additional ultrasound to see if baby is really that big he measures smaller, by at least 1-2 weeks. The only time one of the 5 providers hinted that a vaginal birth may not be something I would be able to have is right after the holidays when I gained 6lbs in four weeks. At the time, the doctor said if I got too heavy that puts me in jeopardy. She did not mention anything about the practice having a limit on the baby's weight. By the time I went back the next month I lost 3 lbs.
Also, I reviewed my birth preferences with all 5 providers and no one mentioned an automatic cesarean when it came to baby's size. The doctor that brought up shoulder dystocia is the one doctor that gave us a worse case scenario during the birth preferences review that my birth partners could not provide fluids in case of an emergency c-section.
I hear what you're saying about dictating care, but let me give you more detail on why this cesarean, as of now, just seems unreasonable.
Last Friday @ 40 wks, baby measured 8 lbs 13 oz. Dr S. suggests cesarean because I'm nearing 9 lbs baby + I'm short + Bishop 0 (only way to get him out is c-section) + FTM so no way of knowing if I can handle large baby + shoulder dystocia. BUT Dr S. gives an FYI she's running a marathon this weekend and the on call doctor's at the hospital are another practice covering for them, SO we can either schedule a C-section for Mon or Tues OR just come back for baby monitoring.
We opted for baby monitoring for that Monday. We had monitoring in the morning and an appointment with Dr. U in the afternoon to review results. Everything was fine, but she wanted to schedule the cesarean for later in the week, BUT not Friday because that day is hectic.
We settled on Thursday, and by Tuesday when the cesarean coordinator called I told her we changed our mind and she said when we come in for our scheduled monitoring and doctor visit on Wednesday to discuss it with the doctor. Apparently, the cesarean was still scheduled.
With everything pointing to baby being okay, why did the cesarean have to be based on their wants not mine?
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@Madison43: yes it's absolutely terrifying not having a doctor. A mid-wife team is willing to take me on, but that means a home birth and waiting for spontaneous labor. All, I wanted was more time. Just thinking about what Dr. U said (a woman btw) if I don't have a cesarean this week it's too late makes me feel so unsupported. Too late for what? If her plan is to remove him from my belly why does it matter if it's tomorrow or next week as long as baby is fine?
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@Mrs. Lemon-Lime: I imagine that she's pushing to do the c-section now, as opposed to waiting a few days, because she doesn't want you to go into spontaneous labor and risk a vaginal delivery or an emergency c-section. It's unlikely that an OB will take you on this late in the game, but I wonder if there is someone who will at least take a look and give you a second opinion?
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@Madison43: I have an appointment with a midwife tomorrow. On my Monday visit, Dr. U said once a patient agrees to a cesarean that's what she's giving them. She said her practice will not vaginally deliver baby's estimated at 9 lbs. Period. Besides a big baby being uncomfortable Dr. U did not give me risks to support her recommendation, which turned out to be a requirement.
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@Mrs. Lemon-Lime: why does a midwife team mean a home birth? No one can force you into a medical procedure without your consent. If you go to a hospital in labor, an OB will assist you (or midwives would). Given how absolutely detail driven you are (from your other posts), it seems just so odd that this is suddenly coming up now, so strongly. It seems like something that would have come up weeks before now - I know my OB and I started serious talks weeks before 40 weeks, and I think we're pretty norm.
I can't imagine your choices are a forced c-section or home birth. Women deliver all the time without having an OB (or prenatal care or anything). There are OBs at hospitals and once you are admitted, you will be assisted.
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@Mrs. Lemon-Lime: I would be so extremely frustrated in your situation. I hope the midwife works out for you. Just keep in mind that you can transfer to the hospital AT ANY TIME. At least if you see the midwife you can get the monitoring you need and then make the decision as labor progresses. And I'm sure if labor does not start on its own you can schedule a c-section in a couple days or a week.
I hope you get a good resolution and the best birth possible!ETA: one of my friends planned a home birth with a midwife and ended up in the hospital. And I personally delivered my second at a different hospital than I was supposed to because we couldn't make it to the other one on time - which meant a random OB caught the baby. A hospital will not turn away a woman in labor!
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I'm so sorry you're going through this - nothing that's been said here would seem to indicate that you need a c-section at this point. Of course, in many cases c-sections are necessary, but the U.S. has a much higher rate than other industrialized countries and there's a lot of evidence that financial incentives of doctors play an important role in explaining this. There's a great and well-published paper on this here: http://econ.sites.olt.ubc.ca/files/2015/01/pdf_paper_marit-rehavi-physicians.pdf
In short, for non-physician patients, whether or not they get a c-section is strongly influenced by the doctors' financial incentives to perform one. This effect is not there for otherwise medically-identical physician patients, who have better knowledge of whether a c-section is medically necessary so are harder to bully into (our out of) one. The medical outcomes are worse for the non-physician patients, in both directions. When they need a c-section but don't get one due to financial incentives, there's worse outcomes for their babies, but same when they don't need a c-section and get one due, as c-sections aren't without risk for the babies and should only be used when medically necessary.
Anyways, I'm really sorry this is happening - I would be completely livid.
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@Mrs. Lemon-Lime: what happens if you skip the C-section tomorrow? I thought after a certain point, OBs weren't allowed to drop your care.
Also, this situation makes me so frustrated for you. I had a similar situation with my first (estimated >90% percentile at 38 weeks, doc wanted to induce, I ended up delivering 40+4 vaginally. It was an incredibly stressful two weeks.)
I know there are risks involved with delivering a large baby, but to not even let you try is so crazy to me. I think it's pretty rare that a woman's body will grow a baby it can't birth.
Anyway, you seem to be a good advocate for yourself. Best of luck with anything, you definitely have a lot of support here!
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@yoursilverlining: the midwife team is opening up a birth center, but it's not open yet and that is why it has to be a home birth. The reason they are taking me on at this point is because of the relationship with my doula, I found her through them, and partially me because of I am using them for the placenta encapsulation. Another midwife group that employs a doctor on staff and has hospital priveleges already told me no.
The reason why I want a care provider now and not just at the hospital if I go into spontaneous labor is for the monitoring. I don't know if I'm legit high risk, my doctor's never used that to describe me, but they said I should be monitored every 2-3 days until baby arrives since I'm now past EDD. ETA: it isn't too late for me to decide not to go the midwife/ home birth route. I just have to decide what's more important to me- monitoring or hospital birth.
Please trust me when I tell you this 9 lb baby thing did not come up. For the last couple of months I was concerned about automatically being induced for not giving birth by 39 weeks, which came up with Dr. B during my birth preferences review. To my surprise Dr. B saw me at my 39week appointment and didn't even do a cervical check.
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@coopsmama: those are my options at this point.
@sotofamilia: The doctor said if I didn't do the cesarean tomorrow I would need to find another hospital. Her practice only has privileges at one hospital and no one at her practice on call would give me anything but a cesarean even if I come in with active labor- she actually said 7cm. Now, of course there are other doctors at the hospital, but to me it sounded like a threat- no one is going to go against her at the hospital. In fact, the nurses even asked the other partner doctor, Dr. G to speak to us because after Dr. U spoke to us she left for the hospital. Dr. G wouldn't come out of her office.
Many people I know have delivered babies over 9lbs naturally, your doctor sounds really mean. Sorry you are going through this. I know its kind of late now but I wish there was some way you could switch doctors. I had a c-section and hated it and wouldnt have it unless it was actually necessary and in your case it doesnt sound necessary yet
). 
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