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Dr. C.
Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 2537
Experience:  30 years of experience and an award-winning educator.
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Here's the facts: 32 y/o female. 5'2" 220lbs small frame,

Customer Question

Here's the facts: 32 y/o female. 5'2" 220lbs small frame, athletic. I'm 36 weeks 2 days pregnant with my first child. At my 36 week anatomy scan, the doctor estimated my baby to weigh 8lbs 9ounces (>90%) and recommended a prophylactic c-section between 39-40 weeks gestation. Here are the biometry numbers:
BPD 9.6cm >95%
HC 36.3cm
AC 35.9cm >95%
FL 7.5cm ~82%
Ratios: (all WNL)
FL/BPD .77
FL/AC .21
HC/AC 1.01
Ceph. Ind. .73
I am concerned that the US scans are not always accurate and I am going to be having an unnecessary surgery. I am also concerned that because it is planned, I will not go into natural labor, and I will be at greater risk of PPD. My medical and surgical history is below.
PMH: Negative for GD, was obese prior to conception due to hypothyroidism- multinodular goiter/Hashimoto's (on .75mcg levothyroxine daily) but gained only 5 lbs since pregnancy began. BP and cholesterol WNL. I have psychiatric Hx of bipolar type I, GAD, and PTSD, un-medicated throughout pregnancy, but stable.
PSH includes laproscopic appendectomy 2014, D&C 2007 (termination at 8 weeks), and 5 orthopedic surgeries to (R) shoulder.
Some of that is probably irrelevant but I want you to have all the info.
My question is whether or not the c-section is indicated and if it would be better to wait until labor begins rather than have a scheduled surgery at 39 weeks. My priority is safety before and after and controlling my risk for PPD.
Any info you can give me would be appreciated.
Submitted: 10 months ago.
Category: OB GYN
Expert:  Dr David replied 10 months ago.

This is Dr. David

it sounds like you have a healthy baby.

but even with a small frame that you have, you can deliver a vaginal delivery.

it is really your choice if you want to have a vaginal delivery or a C section. it is your right to choose.

many ob/gyn doctors recommend c sections because it is a faster procedure for them, they get paid more, there is less labor for you and less work for them

but you do have to recover longer in the hospital after a c section.

there may be some slightly increase rates of depression after a c section, but the data is not 100% clear on this. are you getting treatment for your bipolar and anxiety symptoms currently? that is good your symptoms are stable currently.