Expert: Dorothy H, LCCE - 6/11/2010

Question
I am 39 weeks pregnant and 5'0 tall on a good day. My baby measured at least 8lbs today and I have no dilation, or thinning and he still hasnt dropped. I havent felt any BH's either. My doctor asked how i feel about being induced if I havent gone into labor or shown any progress by my next visit, which would make me 40 weeks. If i am dilated then she will strip my membranes on my visit, but if i'm not dilated she is leaning towards inducing me pretty soon after that.
My concern is inducing in general, and receiving a csection when it could have been avoided just by letting my body go into labor naturally. But with my size I am worried that he could get too big for me to have vaginally, resulting in a csection.
I would like your opinion on my specific situation since I am a small person. I'm not skinny and never have been. I'm a normally built, small woman.
Any advice would be greatly appreciated!

Thank you!

Answer
Hi Adriana,

Although many doctors will suggest induction for a suspected big baby, ACOG (American College of Obstetrics and Gynocologists), which is the organization which sets obstetric policy in the United States, has said this about suspected fetal macrosomia, when the baby is predicted to weigh over 9 lbs.4 oz (much bigger than your baby!):

"Induction of Labor. In cases of term patients with suspected fetal macrosomia, current evidence does not support early induction of labor. Results from recent reports indicate that induction of labor at least doubles the risk of cesarean delivery without reducing the risk of shoulder dystocia or newborn morbidity."  From ACOG Bulletin #22

Inducing labor when your body isn't ready can double your chance of having a cesarean.  You are twice as likely to need a c-section if you induce at 40 weeks than if you go into labor on your own after 40 weeks (even though the baby will be a little bigger)

Also, ultrasounds at the end of pregnancy are not that accurate - they are frequently up to 1 lb off and occasionally up to 2 lbs off.  

If you do not want an induction, you do have the right to decline it and wait for labor to start on its own.

Here is some more information from Lamaze about letting labor start on its own:

http://www.lamaze.org/ChildbirthEducators/ResourcesforEducators/CarePracticePape...

I hope that you go into labor on your own very soon!

Sincerely,

Dorothy H, LCCE