Induction vs. c-section
I talked to my doctor yesterday evening about my options following the distressing ultrasound. She confirmed that she thought the baby might be large (medical term: “macrosomia”) when she had palpated my abdomen. She says she supports my desire to go forward with induction, but I can tell that she probably thinks a c-section is a wiser choice. And when I say “my desire to go forward with induction,” I don’t mean that I actually want to do that. I would prefer to go naturally above all else. But confronted with the potentially large size of this baby, if I wait any longer the hospital will take the induction option off the table and require a c-section. My doctors says that c-sections are mandatory when the baby’s size is estimated at 4,500 grams (about 10 pounds), and my baby’s estimate is 4,300 grams (9 pounds, 10 ounces). In the event I go for induction, I’ll be closely monitored and they will not attempt delivery with the vacuum or forceps if the pushing stage is prolonged due to the risk of “shoulder dystocia,” where the shoulders get stuck in the birth canal. They’d require a c-section at that point.
Tomorrow morning I’ll call my doctor and ask about a second ultrasound - I just want another one for confirmation. The baby was pretty active during it, and I’m wondering if those little snapshots they take for measurements might have been too blurry - perhaps it threw the measurements off. I really don’t know if that’s possible, but it’s worth asking about.
So back to my original problem - no progress as far as station or dilation, I found some information about how obstetricians determine the likelihood of a successful labor induction. Induction is particularly likely to lead to c-sections in nulliparous (never given birth before) women. They use a method called the “Bishop Score”:
Bishop Score
| CONDITION | 0 | 1 | 2 | 3 |
| Dilation (cm) | Closed | 2 | 4 | 5 |
| Effacement (%) | 30 | 40-50 | 60–70 | 80 |
| Station | -3 | -2 | -1,0 | +1,+2 |
| Consistency | Firm | Medium | Soft | — |
| Position | Posterior | Midposition | Anterior | — |
I’ve highlighted my current situation in the table above. A score of less than 5 is considered unfavorable, and my score is a whopping 3. So when I take that into account along with the potential size of the baby, it seems my odds for a c-section are pretty darned high. So I’m juggling the idea of inducing with a small chance of success and a large chance of emergency c-section, or just going for the c-section where at least I know what I’m going into and the recovery will probably be slightly easier than if I’d gone through hours of labor beforehand.
Here I am in the examination room right before yesterday’s doctor’s appointment:
Feeling just a bit uneasy!
Who am I?
CRAP! What a toughie. I’m sending you good vibes from Kansas City!
Thanks, Chelsea. How are YOU doing?
I am doing well - going into the hospital tonight to spend the night with Cervidil on my cervix and then the induction starts first thing tomorrow morning. Fortunately, my Bishop score is a 7, so I’m hoping that it’ll go smoothly. Fingers crossed! I’m nervous, but really excited, too. This is just such a BIG DEAL, it’s overwhelming. I don’t know how people stay so calm.
One of my best friends was in EXACTLY your same boat - she went past her due date, wasn’t dilated at all, was really big and they did an ultrasound and they had her baby weighing in at 10 and 1/2 lbs so they scheduled a c-section. Turns out the baby was 11lbs 2 oz! She was really happy with the whole experience despite it not going the way she’d hoped. She said that there are definite advantages to the scheduled c-section. I don’t know if that makes you feel any better or if it makes you feel worse…but I thought I’d throw it out there. Moral of the story being that you can have a happy birth story even if you have to have a c-section!
Hm. Honestly? I think you might want to seriously consider a c-section. I know it’s terrifying to think about, BUT, do you really want to go through a long, hard labor just to find out that the baby is too big to deliver vaginally? Of course there is no way of knowing that would happen, but still… at least if you get a c-section you know it’ll be over very quickly. You probably don’t want to go through 16 hours of labor like I did.
It sucked!
Anyway, good luck and keep us posted!
Hi ! I just thought I would check in tonight before going to bed to see how you were doing?
Any decision yet on Julianne.
Take care, hope you and hubby and are well and waiting (or already have) Julianne.
Jill
Hey Jen, Congratulations on Julianne. Hope the delivery went well
and that you’re recovering well. I hope that if you had a c-section that you were spared a long labor first, as you said it will be a bit easier to recover.
Warm wishes for you, hubby and baby
Elizabeth