Big Headed Baby. Will I have to have a C-section?

[kozachka]

Hi,

I am 36 weeks pregnant and at my last doctor's visit this Wednesday an ultrasound showed that my baby has a head of a 40 week old. Does it mean I'll have to have a C-section? My doctor has only said that it increases my chances for one and that there is nothing they can do for me before I am 38 weeks anyway. For now, he's adopted the wait and see attitude.

The funny thing is that the reason why my doctor decided to scan me is that my stomach measured too small and he was concerned that the baby is not growing enough. My overall weight gain although at the high end of the recommended range (33-34 lbs.) seems to be within limits and I exercise regularly, walking for 30 mins two times a day and taking yoga class twice a week. So I don't feel like I did something wrong.

I went through all my pregancy books and did not find much information on the subject. Did anybody have a child with big head born vaginally? Or would I have to be induced early so that the baby's head does not get to grow much anymore.

And if you know that there is a high chance of mismatch between the baby's head size and mom's birth canal is it better to go through the trial of labor or schedule the C-section and avoid the suffering?

Can't sleep and am driving myself crazy. Any advice would be appreciated.

Elena
Due 12/11/03

[flagger]

First off late term ultrasounds are terribly innaccurate for measuring weight and size of the baby. A c-section would be performed only if medically necessary and/or you choose to have one done.

[kristine_elen]

Hi there. I will tell you what happened to me (briefly) and you can take it for what it's worth. Ultrasounds all along had shown that my baby was going to be big, and my docs didn't want me to go past my due date b/c of that. Two days before my due date they did another ultrasound (which are actually pretty accurate) and it showed that my baby was slightly more than 10 lbs. I was freaking out so my doctor scheduled a C-section, something she hates to do b/c the natural method is preferred. Turns out my son was positioned in such a way that he would have gotten stuck in the birth canal and they would have had to do an emergency C-section anyway.

And I must say, the most painful part of the entire C-section, for me, was getting the IV stuck in my hand before the operation. Of course, the next day it was painful to get out of bed, but the recovery really wasn't that bad (my husband took a month off of work -- as he'd planned to do anyway -- which is good, b/c you will need a lot of help with lifting things), and I was SO happy I hadn't gone through multiple hours of labor just to have a C-section in the end. (Jack was 9 lb. 15 oz. at birth.)

Hope that helps.

[houseof3boys]

I had a similar discussion with my specialist before Ryan was born. When we went for our 34 week Level 2, they said his head was measuring at 38 weeks and scared us have to death since I was planning a natural delivery. Ouch was all I could think about. Well as Flagger mentioned, ultrasounds are not as amazingly accurate as they lead you to believe. Ryan was born at 38 weeks and his head was 13.5" (normal size) and I delivered fine. For weeks I kept calling him fat head (in a nice way) or the bowling ball when I was pregnant. Funny thing is at his one month check up, they had us scared because his head was small. He then became peanut head!

Don't go crazy over this Elena. Ultrasounds are not 100%, not to mention growth changes week to week. I didn't sleep a lot to when I kept thinking about them saying he had a big head but you really aren't going to know until you are in the throes of labor! You'll do great. :)

[egoldber]

As Flagger pointed out, late term ultrasounds are notoriously inaccurate and can be off by as much as a pound. But just because a baby has a large head does not necessarily mean that you need a C-section or that you will have a difficult birth. The head comes first and so the birth canal conforms to the head. If its any comfort, a mom in my playgroup just gave birth to a 9 lb, 14 oz baby. She had a relatively easy, no complications vaginal delivery with only 3 pushes. So you just never know!

[amp]

My experience is much like Kristine's. I was not planning on a C-Section, but my baby was pretty big. They did ultrasounds all along the pregnancy to monitor another issue and found the baby to be growing relatively normally. Toward the end I was so big that my OB said we definitely needed an US at 38wks (it ended up being at the end of 38 wks) to estimate fetal weight. That ultrasound predicted Jacob's weight at just under 11 lbs. Then she *highly* recommended a CS and told me I could labor if I wanted to, but she thought it might be more risky (in terms of tearing and the possibility of the head and shoulders getting stuck!) and that she recommended I not even labor and go right for the CS. I trusted her judgement and although I cried, I went ahead and had a CS scheduled for several days later (3 days before my due date).

The CS went smoothly and so did my recovery. It was very scary for me, but in the end, it really turned out just fine. And Jacob? He was 10lbs 9oz, so *very* close to the estimate the US gave. My OB, my husband, and even I was glad we went the CS route in the end. And if the same thing happens with my 2nd baby, I will gladly do the same.

Good luck! And if it comes down to a CS, you can feel free to email or pm me if you have any questions.

[COElizabeth]

Even if the ultrasound is accurate, it doesn't mean you will have to have a c-section. My niece was full-term and over 9 pounds with a HUGE head (I think it's always been at the very top of the charts), and my sister pushed her out in about 15 minutes!

Elizabeth, Mom to James, 9-20-02

[dogmom]

This missing piece of this is how big is your internal pelvic space and how much will it change during labor. So although they can talk in general statistics (bigger babies require more c-section), but that doesn't tell you much about your specific situation. I would try to talk to you doctor, or a nurse in his office if he has one, that can tell you a little more about what he will plan and when he will make a decision. Most OBs I know would not want you driving yourself crazy with uncertainty. It might be easier if you had a better idea or what a "trial labor" means to your OB.

Jeanne
Mom to Harvey
1/16/03

[mamahill]

A good friend of mine just delivered (vaginally) a 10 lb 6 oz baby - and she has a body like Jennifer Aniston. If I didn't know her, I would have thought she was carrying a beachball under her shirt. Anyway, the OB said the baby was measuring normally, and after delivery she said that had they known, they would have recommended a c-section. My friend says she's glad they didn't know, since obviously it could be done. My point isn't that you're going to have a big baby, but to do like your OB says and just wait. Like Flagger and Beth said, late-term measurements are not reliable. In labor they told me I'd have a 7.5-8 pounder, and when my 5-14 girl arrived, everyone was surprised. Just relax for now, and repeat after me: I didn't do anything wrong!

[KMommie]

I agree with dogmom, your internal pelvic space is important. I was induced at 41 weeks, and DD was estimated to be 9 pounds via ultrasound the day before delivery. She was 7 pounds, 3 ounces and her head size at her 2 week check up was at the 50 percentile. She wasn't a HUGE baby, but for my pelvic space she was too large. The dr had to really work, and DD ended up with a fractured collarbone on the way out. The dr was about to recommend an emergency c-section when she finally made her way out. After delivery (while he was sewing me up), the dr said that if he had known how big/small my pelvic space was (he was in my ob's practice, but only saw me once, my ob didn't deliver me), he would have recommended earlier induction or a c-section. He said something about my pelvic bone being in the way? I can't remember specifically, since I wasn't paying a whole lot of attention to him, I was more interested in craning my neck to see my DD getting attended to!

Good luck! Try to get some rest, just remember no matter which way you go, the reward at the end is your baby in your arms! It's the best feeling in the world!

Jeannie
mommy to Kiki 4/18/03

[alleyoop]

Elena,

Like you, I knew going into labor that DS was big (though no where near as big as some of the brave ladies who have given birth on these boards) and heard all the warnings that you did! DH and I decided that we would have a unified stance...to weigh every decision against what is best for the baby first, and the mom closely behind.

That meant, for us, choosing an OB group that has one of the lowest CS rates in the country, that I refused to induce (for fear that baby wouldn't be cooked properly), tried my hardest to refuse pain meds (gave in to an epidural when my pain was too much for me to bear), accepted baby monitoring, pushed for a hellish amount of time in every conceivable position, gave in to C-section when OB said that is was absolutely necessary for health of baby.

I think that it is difficult for any person to put themselves entirely in another person's shoes... and that goes double when it comes to the C-section issue. We all have so many expectations around the birth of our kids, the strength of our bodies, and the power of nature! When those expectations aren't fulfilled, there is nothing worse than holding your wonderful newborn in your arms and feeling like a failure. I stand behind all the decision we made, and still felt like that. Sometimes, when I read these boards, I still feel that way. Though, 99.9% of the time I look at my son, and realize what a stupid waste of time regret is when I still got the prize!

So, my big advice is to do whatever you need to do; research, preparation, questioning, talking, role playing, anything it takes so that you are happy with the decisions you make. Surround yourself with those you trust, and then trust them. Be proud of yourself with any road you take, because the destination is the same! You are Woman, You are a Mom, hear you roar!!

[starrynight]

It really depends more on your pelvic size/shape than anything. I deliverd all of my kids vaginally and my son was 8lbs 11oz and had the biggest head/shoulders of all my kids and bigger than alot of newborns I have seen. I have semiwide hips though, always have even when I was snaller pre-kids so maybe that is why I had no problems. I wouldn't worry too much about it. It's really your choice, if you personally want to do a trial labor or not. Good luck!

[kaismom]

Yes to everything everyone else said :). For my first baby they thought he was going to be almost 9 pounds from the 38 week sono and he was 7 pounds. Also I am very petite, but he did have a big head at birth and it was not a problem (or with the other 2). I guess you just don't know, the first time around, until the time comes. Best of luck and try not to worry,

[karin4]

Hi Elena--

Wow, I could have written your post 3 years ago! I also had an ultrasound at 36 weeks because I was measuring small (as I did with every one of my babies). The ultrasound showed the baby's head was the size of a 40-week-old fetus. Just like you, I worried that this baby would be too big to deliver-- *especially* as my due date came and went...and went...and went. Nobody but me seemed concerned that I was 42 weeks along with a baby whose head measured at 40 weeks FOUR WEEKS EARLIER. I thought I was going to give birth to a toddler. But-- it turned out they were right and I was wrong. Yes, Sam was my biggest baby-- 9 lbs 4 oz, and he did indeed have a big head (still does!). But I delivered him with no problem, and my guess is that if he hadn't had those extra 2 weeks to cook, he would have been a pound or so lighter.

Anyway-- like everyone else here, I just wanted to reassure you that there's no reason to panic. The ultrasound measurements may well not be accurate, and even if they are, you may well have no problem delivering vaginally. Your doctor's wait and see attitude sounds just right- responsible and non-alarmist.

Good luck! Not too much longer til you get to meet that little sweetie!

[kozachka]

Thank you, ladies! I am very gratefull for all your advice and sharing your birth experiences with me. It makes me feel SO much better knowing that I do have options.

My doctor has pretty low c-section rate, only 13-14%, and I have always had wide hips (don't know about the birth canal, which can be small) so maybe I'll be able to avoid a c-section. And you are right, it does not matter HOW you deliver, as long as the baby and mom are healthy. And my husband promised to be home for as long as necessary, luckily he is self-employed and can do a lot from home.

Once again, thank you for your kind words.

Elena
Due 12/11/03