# Induction to AVOID cesarean for large baby



## danotoyou2 (Jan 19, 2007)

I keep hearing this on mainstream forums, and in my family. It's driving me nuts, so I decided I had to compile some studies and try to educate some women. Too bad it's too late for a family member.

She was induced at 39 weeks because her baby measured 8 lbs 10 oz on ultrasound, with her first baby. After a day and a half of "failure to progress," she had a c-section.

It breaks my heart. I just hope that if enough of us shout this information from the rooftops, it might reach enough women.

http://www.truebirth.com/2008/02/25/...-large-babies/


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## mytwogirls (Jan 3, 2008)

Yeah, I was induced BOTH times with my girls because the first baby was measuring 8 lbs 12 oz and since I am (gasp) only 98lbs pre-pregnancy my doc thought it would be too big for me. SOOO, I was induced at 39 weeks and squeezed out a 9.8lb baby. Same way with the second baby, only she was 9.2oz. I wish I would have found MDC BEFORE I had my babies...I would have been so much better off..but I did avoid a c-section both times


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## sapphire_chan (May 2, 2005)

I never know how one goes about proving something like this. I'd just be tempted to answer "how does that make any sense? that's totally illogical." which is less than helpful.

Henci Goer addresses inductions as leading to c-sections among other risk factors, check out the bibliography in "A Thinking Woman's Guide..." for some citations about that.


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## vespertine (Mar 24, 2006)

Yep, this is so ridiculous. Babies grow to the perfect size for their mother's body. There is no such thing as a ''too small pelvis'', unless you have ricketts! Inducing a baby heightens the risk of caesarean so dramatically, as the contractions come unnaturally hard and fast and the body is often unable to cope/dilate ''enough'' for the hospital staff's satisfaction within their given time frame. So poor Mum ends up with a caesarean anyway. Their justification for it is absurd. And their estimate of baby's size is often waaaay off. I was told I was having an average sized baby, but he ended up being quite a bigun (10 lb 1 oz). My best friend was told her baby was going to be HUGE and was therefore scheduled for a c-sec but baby came out weighing under 7 lbs! Cut a baby out at all, let alone prematurely, and you're bound to get problems for both mother and child. I get so angry at this stuff.


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## CourtneyATW (Sep 13, 2007)

I was induced with DS due to concern about his size, but not until just before my due date, and I had already been in early labor off and on for 6 weeks. I had started dilating, he was engaged, etc. Having had a prior c-section, my OB didn't want his size to be cause for that 2nd one (meaning no hospital around here would allow me to deliver vaginally). I made clear that I wouldn't be rushed, and that inductions take TIME. 16 hours after the induction started cervidil (just to get me dilated a bit more so they could break my water... and he was engaged already, thus my OB was not concerned about the cord slipping through), and just 8 hours after the amniotomy my son was born (and that sounds funny the way I worded it, but 16 hours TOTAL labor). Yes, I DID end up getting an epidural (my choice) at 7cm because the stacked contractions from the amniotomy sucked, but it didn't slow anything down, probably because we waited till the very end to do it.

As for his size though... to support the argument here, he was 8lbs 3oz (predicted 10lbs based on MY measurements... but I just have a TON of fluid, I do again this time and this time we checked it!) with a 14.5" head. I pushed just over 6 times and had no stitches. Size was TOTALLY not an issue in the end, but I don't regret the decision either. I knew that I wasn't going to let anyone talk me into a c-section unless it was for a VERY good reason, and my OB is quite anti-c-section, so I trusted him as well. But it is so easy for an OB to talk you into a section with an induction because you spend a LOT more time in labor IN the hospital compared to going naturally. I mean, if my labor had gone the same, but without the induction, I probably would have been in the hospital just 5-6 hours if that.

I was also induced with my DD, and my doctor at the time fit the bill perfectly (pretty much told me I was HAVING a c-section when I was "only" 3cm after 8 hours of induction, and I was too young and stupid to question him). So, having had both instances, I feel the key is making sure you are educated and informed, and don't let some doctor force you to give up without a good fight!!

I guess the bigger battle is so many women being told they need to go straight to c-section because of baby's size. Induction seems a better option to me than not even getting the chance of trying to deliver vaginally.


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## DBZ (Aug 9, 2005)

I was induced because I was practically 42 weeks and the baby was getting big. I'll always wonder if I had labored without drugs if I would have avoided the c-section. My DD was 10 lbs 2 oz.

With my last pregnancy I posted on a mainstream board and I would scream "don't induce for big babies" and it was so frustrating. They'd all listen to their docs and end up with sections, except for one mama. She was a first timer and pushed out an almost 12 lb baby!


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## erin_brycesmom (Nov 5, 2005)

Great article! Thanks for writing and sharing with us! Whenever anyone asks about this online, I always say the same thing:

from ACOG (The American College of Obstetricians and Gynecologists):

*"Suspected fetal macrosomia is not an indication for induction of labor, because induction does not improve maternal or fetal outcomes."*

btw "The term fetal macrosomia implies fetal growth beyond a specific weight, usually 4,000 g (8 lb, 13 oz) or 4,500 g (9 lb, 4 oz), regardless of the fetal gestational age."

http://www.aafp.org/afp/20010701/practice.html

and a blurb from a more recent article from ACOG:

*"Although post-term infants are larger than term infants and have an increased incidence of fetal macrosomia, there is no evidence to support induction of labor as a preventive measure in these cases."*

http://www.aafp.org/afp/20041201/practice.html

*"Suspecting a large or very large baby is not a medical reason for induction. In a November 2002 press release, ACOG reported that induction of labor for macrosomia (large baby) almost doubled the cesarean rate without improving perinatal outcomes (the health of the baby).2 This statement was based on a study published in Obstetrics & Gynecology.3 Several earlier studies also showed that induction for macrosomia increases, rather than decreases, cesarean section rates without improving the health of the baby.4,5,6 In the professional publication Evaluation of Cesarean Delivery, published by the American College of Obstetricians and Gynecologists, the authors recommend against induction for large babies in healthy women, concluding that ?Induction of labor for suspected macrosomia [large baby] does not improve outcome, expends considerable resources and may increase the cesarean delivery rate.?7"*

http://www.lamaze.org/institute/care...aborBegins.asp


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## Mommal (Dec 16, 2007)

I just want to add this link from the Coalition for Improving Maternity Services. According to CIMS, "Inducing labor for suspected big baby produces no benefits but increases the likelihood of cesarean section" and it gives 2 peer-reviewed journal articles as references to back up that statement.


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## BetsyS (Nov 8, 2004)

My midwife did not induce for macrosomia as a standard.

I'm glad. I went into labor on my own, and when it became obvious that he wasn't going to fit (and he was truely macrosomic), I knew that artificially inducing him wasn't even a small part of the reason for my c-section.


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