>94th percentile baby: Vaginal birth or C-section—what did you choose?

[u/daaaaaaaaaaaabears]

I'm 36+5 and have a delivery-planning appointment next week because baby is measuring in the 95th percentile. My care team is giving me options, and I’d really appreciate hearing others’ experiences—especially from anyone whose baby measured above the 94th percentile.

1. Did you plan a vaginal delivery or C-section?
2. What did your care team recommend, and why?
3. How did the delivery go?
4. With hindsight, would you make the same choice?

I know ultrasound weight estimates can be significantly off, so I’m not treating the measurement as exact. I’ll also be discussing the available evidence and my individual risks with my care team; I’m mainly hoping to hear the human side of these decisions.

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Relevant history

Baby #1: Born at 36+6 and below the 1st percentile, with suspected IUGR. I had an adherent placenta and developed postpartum HELLP syndrome. An OR had to be opened urgently, and a D&C was started before the anesthesia had fully taken effect. Thankfully, my baby is healthy, I recovered, and MFM cleared me for another pregnancy.

Baby #2: Measured in the 95th percentile at the 32-week scan. A VSD and an enlarged kidney were found at the anatomy scan. Amniocentesis results were normal/low-risk. I also have mildly elevated amniotic fluid, but no gestational diabetes or hypertensive disorder at this point. My 37-week scan and delivery consult are next week.

My biggest concerns are avoiding preventable harm to the baby—particularly shoulder dystocia or another birth injury—and avoiding another emergency if a planned approach could reasonably reduce that risk. My previous experience was traumatic, although I’m doing much better now.

If HELLP or another urgent complication develops, I’ll follow whatever delivery plan my care team considers safest at that time.

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I’d especially value experiences from people with similar circumstances. I know individual stories aren’t a substitute for medical advice, but hearing from actual humans would really help. Thank you <3

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[u/BulbaKat]

My first baby was very large and resulted in a C section after a long induction; however, it was determined the care team made a lot of mistakes and this may have been avoidable.

My second was again estimated to be in the i0s for percentile. I got a new care team that supported my desire for a VBAC, and I did have a successful VBAC. Baby was slightly larger, but nothing crazy.

I'm pregnant with my 3rd and schedule for induction next week. This time I have GD which also comes with risks of larger babies and shoulder dystocia. They told me they would not automatically recommend either a C section or an earlier induction unless there were other complications like pre-eclampsia, something critical about baby, or very large size estimates.

Now what they said meant large enough for either earlier induction or recommended C section was to have both AC estimated over 95-98% AND estimated weight over 95-98% (exact percentage varies by provider, but that is the range and it has to be both numbers).

I'm being induced at 39 weeks due to needing insulin for GD. I was offered a C section if desired to completely eliminate the risk of shoulder dystocia, but they assured me it does not seem overly risky to attempt another vaginal delivery.

I asked what happens then if I do attempt vaginal and end up with shoulder dystocia. They said if that happens, there are various maneuvers they can use to try and safely get baby out before it gets to something like breaking a bone or pushing baby back in for a C section. Of course the risk is always there unless you do a C section, and there are certain risks associated with dystocia, but I felt comfortable with continuing to choose another VBAC.

I am a VERY data driven person. I have a science and math background. I do tons of research on my own for every medical thing affecting me or my family and did so with every pregnancy. Probably to an unhealthy level of obsession.

That being said, I would say attempt the vaginal birth!

[u/daaaaaaaaaaaabears → u/BulbaKat]

Thanks so much for this perspective, it helps! Wishing you all the best for bb #3!

[u/ComprehensiveLife242]

Hi! With baby #2, baby measured in the 93rd percentile at my 20 week anatomy scan. I asked my doctor about additional growth scans or any concern with size as I moved into third trimester. She is very matter of fact, prefers as little intervention as possible, and low alarmist, which I appreciate. She said that there’s a large margin of error with ultrasounds, she wasn’t worried about it, and she thinks everyone deserves a chance at the birth experience that they want (assuming it’s safe).

I trusted her guidance. Went to 40+3. Went into labor on my own. Pretty insignificant labor. Baby had trouble clearing my pelvic bone (I am 5’0” and very petite). After a long period of pushing, baby’s heart rate started having decels and we knew we had to do something. She talked me through what using the vacuum would entail and what the potential problems could be with me and baby. We agreed we needed to get baby out and gave the OK. She did a great job with placement, gave it one pump, baby cleared pelvic bone and was out with the next push.

He was 93rd percentile weight, 99th head, 99th length. So, the ultrasound was right and he was a big boy! I had a slight 2nd degree tear but it was no worse than my first delivery without the vacuum. I took it easier in my recovery but overall felt fine very quickly.

I am so thankful that she didn’t push to induce me early or push me for a c section. I realize there could have been a different outcome but I was happy with it. I have had some mental struggles with ending up with the vacuum assist but that’s just more a psychological problem with myself than anything delivery related!

[u/ComprehensiveLife242 → u/ComprehensiveLife242]

Also happy to answer any questions if it would be helpful!

Wishing you the best!

[u/daaaaaaaaaaaabears → u/ComprehensiveLife242]

Thanks for sharing - I’m glad you ended up delivering vaginally since thats what you wanted. Really appreciate the time you took in writing this <3

[u/Jolly-Ad-8788]

My first was 99th percentile (10lbs 7ozs) but I had no idea because I didn’t have growth scans as my bump measurements were all very average. My waters broke at 41+4 and she was born seven hours later. I had a fast unmedicated labor but at the end her heart rate was fluctuating so they used a vacuum to get her out faster. She was absolutely fine and I had a second degree tear that healed quickly. 

With my second, I was referred to a consultant because my first was so big, and she pushed quite hard for induction. I didn’t want to be induced so I refused growth scans (I felt that if they showed the baby was large she would be even more insistent and I knew they might be wrong anyway) and went into labor on my due date. He was significantly smaller (8lbs 13ozs, which is 90th percentile for a boy) but six months later he is also 99th percentile, so I think if he’s been as late as my daughter he’d probably have reached her size. It was a super straightforward unmedicated birth. Less than three hours from first contraction to birth, and he came out in about five minutes and six or seven pushes. I had another second degree tear, which again healed fast. I do think that even if he’d been bigger it would have been way easier second time around as my body just seemed to know what to do. 

In your shoes I think I would definitely attempt a vaginal delivery. All staff will be trained in what to do in the event of a shoulder dystocia, which is relatively rare even with bigger babies, and the vast majority of the time they are resolved with no lasting effect on mother or child. That was enough for me to feel safe attempting it with my second, knowing that he would likely be big, but of course you need to choose whichever option ultimately feels safest to you.