Macrosomia?

About 4 weeks ago, at one of my routine midwife appointments, my midwife started hinting around about me having a large baby.  She said measuring fundal height on "larger" individuals isn't very accurate, and therefore they like to obtain other data.  She went on to say that she would like me to get an ultrasound at 31 weeks, and another at 36 weeks.  This annoyed me.  I didn't plan on any ultrasounds past 20 weeks, and its been shown numerous times that ultrasounds that late in pregnancy are not accurate for determining size.  So, why was I being ordered an ultrasound?!

 

I dutifully scheduled my 31 week u/s, and during the u/s found out that according to their measurements, baby was measuring 2 weeks ahead, and in the 95% percentile.  Ok.  So?  If, (and that's a big if) the measurement was accurate, there could still be several factors involved.  First, my husband is a 7 foot tall freak of genetic nature.  Second, maybe my due date is off.  But, most likely, the ultrasound is off. 

 

At my next midwife appointment last week where we discussed the results of the u/s, my midwife still seemed to think the size of my baby is a big deal.  She told me she was obligated to discuss C-section and offer me one if that's the route I wanted to take (really?  This discussion at 34 weeks?  Before I'd even tried?)  She felt around my stomach and thought at 34 weeks my baby was already 7lbs.  WHAT?!  I know she is a professional and all, and I've never been pregnant before, but I was like "there is no way my baby is 7lbs yet."  Sure, my belly has reached epic proportions.  I'm 34 (now 35) weeks pregnant!  I could give birth anywhere in the next 2-5 weeks.  Of course I'm huge.  So she had me schedule a 36 week u/s.  I left the appointment slightly irritated. 

 

Why, why, why, would anyone in the OB/midwife field tell a woman that they think she is having a huge baby.  I mean, even if that were true, and there was a way to know exactly for sure how big a baby is in-utero (there isn't by they way, but let's pretend) that is not something you should put into a mom to be's head.  Let her body do what it's going to do.  Just the idea that a woman is home to a "larger" baby might make the difference in labor between giving it a good try and having an unecessary C-section.  (disclaimer- there is nothing wrong with an individual choosing a c-section.  What I have a problem with is the high number of uneccesary c-sections that are performed in the U.S.  Personally, I'd like to use the opening I have, and not create any new ones with major surgery. That's just me, I definitely don't look down on people that have had them, just the doctors who are too quick to choose that route.  K?)

 

The whole reason why I was so set on getting care from a midwife is because I never wanted to be scared into things that had no basis.  I didn't want to get talked into induction if I went past 40 weeks.  I didn't want to get talked into excessive testing.  And I certainly didn't want to get talked into a C-section due to "suspected large baby."  So I peppered my midwife with questions: "will there be a time in labor when its obvious my baby is too big for my frame?"  Yes.  "if I'm eating too many calories for my needs, does that mean the baby packs on extra weight as well?"  No.  "aren't late ultrasounds notoriously inaccurate at predicting size?"  Yes.  "I could just deliver earlier, right?"  Yes.   

 

It was like an exercise in futility.  What was the big "worry?"  If there is no real way to tell exactly how big my baby is until it comes out and is placed on a scale, WHY ARE WE EVEN TALKING ABOUT THIS?  Just to give me something to stress about for the next 4 weeks?  Just to give my insurance something extra to bill?  True macrosomia (baby larger than 8lbs 13oz) isn't diagnosed until after a baby is born.  It also only affects about 9% of babies. 

 

My plan is to continue doing what I'm doing and let my body do what it is going to do.  I trust my body.  I HAVE to trust my body in order to ensure nothing happens to it that I don't want or don't need- this is true during pregnancy and during non-pregnancy.  I just have to wait and see what is in store for me (us).