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Dear Childbirth Educator:
I am 32 weeks pregnant with my second child. My first child was born vaginally after a 20 hour labor and she was a whopping 9 pounds. We have moved and I have a new doctor who said this baby is probably going to be even bigger and he has already begun talking c-section.
I don’t want to deliver by c-section, at least not without trying for a vaginal delivery first and I don’t know what to do. I chose this doctor because my insurance plan recommended him and am now regretting listening to them. Everyone at work who has used him has had a c-section, so it looks like this is his M-O.
Do you have any suggestions?
Holly Fogelson
Portland, OR
Dear Holly:
At 32 weeks you may be in a sticky situation, because there are doctors who will not take on new patients after 32 weeks, so you really need to get on the ball.
Since you are still working and you obviously have talked to women at work, see if you can find other doctors through the women at work who are less scalpel-happy and make appointments to meet with as many of them as possible, even if you need to pay out of pocket for the appointments.
Make sure you get an ultrasound from your current doctor to get help determine the size of the baby. Even though they are not always accurate, it will give you somewhat of an idea of the baby’s weight. When you visit the potential new doctors, make sure you have a copy of the ultrasound with you so you can get truer evaluations from the situation. Be sure to explain to each doctor that you are new to the area, that you delivered vaginally the first time (make sure each knows the weight of your daughter) with no complications, and that your goal is for a repeat performance this time.
Remember that although second labors are usually shorter that first labors, second babies are usually bigger than first babies. Most doctors should point this out to you and most good doctors should never make promises they cannot keep.
Discuss time limitations with each doctor. If a doctor agrees to attempt a vaginal birth but insists upon inducing you at 38 or 39 weeks, you must either totally understand his or her rationalization for such (which will probably be weight-related but may also be c/s motivated.) Although too many inductions lead to cesarean deliveries, if a doctors’ explanation is justified based upon what a later ultrasound shows, it may indeed be wise to consider, particularly if you are already effaced or dilated and the baby has begun to descend.
One option I have not yet mentioned is that of using a midwife. Some hospitals have midwives available with back-up doctors, which might be a great option for you.
Delivering in a birthing center or at home is another way to go, although considering the size possibility of the baby, this may not be advisable.
I would definitely consider hiring a labor doula who has experience with birthing large babies. She may be exactly what you need to make it through this delivery. You can find one through the doctors you interview, through co-workers or by going on line.
Have a safe and healthy labor and baby,
Leslye
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