24 answers

Baby Measuring Smaller than Gestational Age

Hello, I am 39 weeks pregnant (per my Docs estimation from my last period) and my baby is measuring at 37 weeks, two weeks behind. Has this happened to anyone and is there reason for concern? In the beginning my doctor said my due date was April 12, then he switched to April 18, then he went back to the 12th and has been using that the entire time. The baby is moving great, has a good heartbeat and plenty of amniotic fluid. But my doc seems to think that if he hasnt progressed at my next appointment on Monday that they should take him out. I feel like may be he is off on the due date and the baby is just not ready yet. This is my first so I am a very worried. Please let me know if anyone has had this happen and if I should be concerned! Thanks!

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Congrats on the Baby!
If there are no other reasons for the baby to come out then I would not worry about it. Babies are on their own schedule.
My daughter was right on schedule until my last ultrasound at 36 weeks. Her head was only a 32 week and the rest of her did not go past 34 weeks. Then she was born and her head was still small - they say - and now at almost 3 months her head is in the 25% and the rest of her is 50%. She is fine. she can roll and babble and everything she is suppose to do. I would ask for more information about why they think the baby needs to come out. If they think the cord is being crushed or something with how the baby is laying, ask for exercises or alternative to help move the baby around. Good luck!

With my son, almost 10 years now. He had 3 due date at the beginning of Sept. So I really didnt keep track on my weeks but Dr. did. My water broke in Aug. I went in they induced me and when he came out there like Oh He's only 35 weeks. He was born Aug. 22 Meaning beginning of Sept wasn't his due date but more closer to the end. He is almost 10 and Healthy.

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Let me preface this by saying that I'm not a doctor by any means, but in my personal opinion, your baby will come out when it is good and ready. Some babies just need to cook longer.

I think you're right in your assessment. Ultrasounds are notorious for being not accurate when it comes to measurement, fluid levels, etc. If everything is okay with your baby, heart rate, movement, and you're doing okay, I'd say wait until your little one is ready. Unless you know EXACTLY when conception happened, due dates are merely estimates and I'd do research and follow your gut. Doctors are trained to view everything as a potential emergency...the problem with that is they can cause a lot more problems then help in some cases. I'd say wait.

K., hi, I am a doula here in Phoenix and have a niece who experienced the same thing. As long as your baby is healthy, heart rate is strong, movements are good, etc. I would think that you have nothing to worry about. One thing I have found in this area is that doctors are very quick to 'take' the baby when it hits forty weeks. In some cases the baby is just not quite ready yet. If you are anxious about waiting much beyond your due date there are some things that you can try at home to encourage your labor to start on its own without the help of the hospitals or doctors. The most important thing right now is to relax and enjoy the last few weeks of pregnancy. In just a short while you will be holding this amazing child that you have waited so long for. Treasure these last few days and let your body do what it was created for. T..

Hello K.,

This stuff is not an exact art. They can be off on the due date. The measurements can be off for fetal age. When I was 38 weeks pregnant with my second son, I measured 47cm. That just meant I had a lot of amniotic fluid and a big baby. I say you should go with how you feel. If the baby is small and wants to stay in longer and you are ok with that, then tell your doctor that you don't want to be induced or have the baby taken out yet. I would say as long as the baby isn't under stress and the heartbeat is strong and he/she is still growing ok, it should be fine staying in. Go with your gut feeling on this. Your doctor works for you. I would not be too concerned. I was 31 when I had my first son as well. I was 37 when I had my second son. Listen to the reasons your doctor has for taking the baby out, and then tell him your reasons for not wanting him/her to do so. I would say that if the baby isn't under any stress to let him/her stay in as you don't want to go through induction or a C-Section if possible.

I was induced with both of my boys because they were getting too big to fit through and I did not want to go through a C-Section if at all possible. The induction process is not pleasant and makes the contractions more intense and painful then they would otherwise be if you went into labor on your own.

Take care,
D. P.

Your doctor sounds like he is in a bit of a hurry. If everything about your baby (other than size) is normal and there are no other issues, I say keep that baby in as long as it needs to be! Of course, not going past your due date. In my experience, the doctors are usually wrong about the size. My first was 7 weeks early and 4.9 lbs - the doctor told me before the c-sect that he'd only be 3 lbs. My second was 1 week late and 8.3 lbs - again, the doc was wrong - said he was around 7 lbs. These were different doctors. Their measurements are only estimates and I don't know anyone whose baby's measurements came out as the doc said.
Good luck either way!

I would not be too worried. That is not good for the baby at all. I was enduced at 36 weeks due to having high blood pressure. My little girl was just fine. She was 6 pounds and 18 inches long. She is now a year and half and doing just wonderful. She is a little tiny still, but both my husband and I are short, so she probably will be too.

But, they say that as long as you can go past 32 weeks, everything is usually fine. No need to worry.

And good luck - Cheers,
S.

some of us have little peanuts.. my gestational measure was 46 at 37 weeks - hello?? I am like 5' nothing - so - dont stress, just have good communication with your doctor, and express your concerns.. :0) congrats on the little one.. they are such a blessing!!!

The gestational age is always two weeks behind. You obviously got pregnant two weeks after your period, though they call the age from the period. At any rate, there are small babies and big ones and some come early and some late, so the two weeks wouldn't make much difference unless he threatened to deliver VERY early, which time has already passed for you. Doctors are not infallible, either. I told my doctor that my fourth child was due on Feb. 8th, but he said it was too big and would be born Jan. 8th. My son was born, finally, on Feb. 23rd! And he was my biggest son - 9 lb, 7 oz. (my others were in the 6 to 8 lb range). Of course, this was back in the 70s and I had one of the 1st sonograms of the day and they didn't have as much experience with them then as they do now. Still, they are not infallible, and you will be okay.

The only way to change your dates, if you are accurate on you last menstrual period, is by ultra sound. Did you have one? You didn't mention it? Is the measurement that shows that you are 2 weeks behind, just the fundal height? You mentioned amniotic fluid level which can only really be evaluated by an ultra sound. There are other tests to evaluate your baby's well being that you may be able to ask for. NST, BPP. If your doctor agrees to do these tests and your baby is fine, then he may agree to let you go until yu go into labor naturally.

Hi K.,

First of all congratulations on your upcoming bundle of joy. This situation happened with me as well with my first baby. From 20 weeks, they kept telling me that my baby was measuring small but everything else was fine. I think I had 5 ultrasounds done and everything was fine. My doctor kept changing my due date back and then finally putting it back on my original due date. I also thought maybe my due date was not correct At the last ultrasound they determined that the baby's stomach was not growing so they decided to induce me at 40 weeks so the baby can grow better outside the womb. Everything came out to be fine and we had a healthy baby boy with no health problems. My second child weighed the same as my son and we never had any problems with her. So there is probably no reason to worry especially at this stage of pregnancy. You want to get ready for your new arrival. The doctors are probably taking every precautions they can with the information they have, which might not always be right. Good Luck with everything.

Was this measurement by ultrasound or by measuring fundal height?

If it was ultrasound, it can be off by as much as 2-3 lbs in either direction, so it's really not that spot-on for estimating fetal age/weight.

If it's by measuring how how your uterus has grown ("fundal height"), that is also a non-specific science. The textbooks tell us that the uterus will be the same number of centimeters high in the abdomen as the number of weeks since the last period after the pregnancy has reached 20 weeks. That means that if you are 39 weeks they expect that you'll measure 39 cm. HOWEVER, the things that can change that are the position of the baby, whether or not the baby has begun to dip into the pelvis, and a baby who's not as big as the average birth weight at that age. The textbooks also tell us that the fundal height measurement can be off by as much as 4 cm from the week of pregnancy and still be in the range of normal.

If the baby dipped into the pelvis since your last visit with the doctor, you'll measure smaller. That's completely normal. In fact, at 39 weeks I might be a little worried if my clients' babies WEREN'T moving into the pelvis! (I'm a midwife) Follow your instincts. If the baby is doing fine, I wouldn't recommend inducing to my own clients.

I was measuring small through my whole pregnancy with my daughter. I even had an ultrasound a week before she was born. I was fully expecting a 4 to 5 pound baby, when I had her the first thing I wanted to know was how big she was. When the nurse weighed her and said she was 7lbs 5oz. I was shocked. That wasn't the small baby I was expecting! My dr. said that sometimes they push themselves further into your back and that makes you measure small. Its all about where they are and how they are positioned, and that's hard to tell, even from an ultrasound. Are there any other problems? It's best for babies to stay in as long as possible.

My daughter measured small throughout the whole pregnancy. I had an ultra sound at 36 weeks showing that she was about 4 lbs. A lot smaller than she should have been. I went back in the next week and she was still the same. My doctor suggested for me to be induced since she was not growing inside of me so she was not getting what she needed from me. She came out at 4 lbs. 10 oz., 19 inches and was healthy. She went home after 2 days and has stayed small. She is a very active 15 month old and is still small for her weight but average for her height.

With my son, almost 10 years now. He had 3 due date at the beginning of Sept. So I really didnt keep track on my weeks but Dr. did. My water broke in Aug. I went in they induced me and when he came out there like Oh He's only 35 weeks. He was born Aug. 22 Meaning beginning of Sept wasn't his due date but more closer to the end. He is almost 10 and Healthy.

Already a lot of great answers, but I thought I would add that my daughters estimate was 4 lbs at 36 wks 5 days. We were induced for other reasons & she was born 5 lb 6.9 oz...
Way off!
She measured behind the entire pregnancy, in fact only in the 1st percentile & we new the exact due date. She's small but completely healthy at 14 mo.
Good luck!

Congratulations!
I'm sure that it could go either way - your due date is off or the baby is small for the due date, neither of which is a disaster.
Either way, I think the doctor is right on - if the baby isn't progressing, you need to get it out. I'm sure if the baby GROWS, but continues to be on the small side, the doctor won't be concerned. But if the baby doesn't grow, that really isn't a due date issue - the baby should be gaining .5 pounds each week (approx) at this point.
No matter what the due date, it should be safe to induce you at this point and the baby should be developed enough to minimize the risk, so I would follow your doctor's advice. Good luck.

Doctors are always so quick to induce. Personally, I don't agree with inducing. I think your body knows exactly when that baby is ready! If you feel in your gut that the baby needs more time, tell your doctor you want to wait. As long as the amniotic fluid is fine, there is no reason that you shouldn't wait for your body to go into labor naturally! If your baby is smaller,that's another reason not to induce. From my experience, doctors usually are worried about babies being late is when they're too big or if the fluid is low. Sounds like neither is an issue. Follow your gut and let that baby come out naturally! Good luck.

First of, congrats!

Sounds like you've gotten some good advice in here. I did want to point out that although most docs say that after 36 weeks it's safe to have your baby, that only means that the lungs are fully developed. There is so much brain development that happens at the end of your pregnancy. And rather recently the March of Dimes gave the US a D for a childbirth grade in part because we take babies out too early.

I would suggest asking for a nonstress test to evaluate the baby. Like others have said, these measurements are guesses. Go with your gut. Although most docs don't like it; normal gestation is 38 to 42 weeks. And as long as the heart and fluids look good, then what's the rush? If your gut says your baby needs more time, then go with that.

The cynic in me also suggest you ask your doc if he has a pending vacation coming up. I'm a childbirth educator and i can't tell you how many times I've seen docs push women into inductions because they've got something coming up in their schedule.

Always remember you're the momma and you do know best. Listen for any real risk and decided from there. And you can always get a second opinion.

Hi K.-

I measured just perfectly up to 37 weeks. Then at 37, 38, 39 & 40 weeks, I do believe that I continued to measure 37cm. I had a day or two when I thought that my baby was moving less, so the combination of measuring small and lack of movement was a little alarming to my doc. I had to go to the hospital every 3-4 days to have my baby monitored. All was just fine. At 41 weeks they ended up inducing me. You'll be fine. I wanted to wait as long as possible to let my body start the childbirthing process, but the doc said that the risks to waiting were much higher (the placenta can stop functioning at 100%- hence your baby doesn't get the oxygen, blood, nutrients that it needs) than waiting another week. You'll be fine. Hang in there...trust yourself, but listen to your doctors.

K., Congrats on becoming a Mom! You are in for some exciting, difficult, but absolutely wonderful days ahead. I was also 31 with my first child and my baby measured small on both abdominal and ultrasound measurements but everything turned out fine in the end. My due date was never absolutely sure either as I had irregular cycles. My tummy never measured more than 37 week size even at 41 weeks and my ultrasound at 34 weeks indicated that at term the baby would likely be no more than 5-6 lbs. She was born 10 days late and was a whopping 8# 13oz. So, even though your doctor has to be careful that your baby is growing properly (sometimes the placenta fails to function adequately towards the end and the baby stops growing due to less nutrition being transferred through it)don't give in to the pressure to induce labor before due date if there isn't clear evidence that the baby is in danger. Inductions of labor are often long, painful and more risky for both mom and baby. I've gone through an induction (30 hours of contractions every 2-3 minutes which ended with a bad vaginal tear, excessive bleeding, and slow recovery--but a healthy baby none the less--thank God) and a natural 5 hour labor with my second child and hands down I'd choose natural labor any day given the choice. Natural labor was so much less painful and uncomplicated.
If you are not comfortable with what your doctor is suggesting, seek a second opinion. In the mean time, try not to worry. As long as there is no clear reason to take him out, he's better off inside of you. Best wishes and prayers! R. nurse-midwife mom of 2

My daughter measured two weeks behind during the last few weeks of my pregnancy. She was absolutely perfect. The measurements they do are an estimation. As long as they measure withhin a few weeks, it is perfectly fine. Don't worry about it at all.

Congrats on the Baby!
If there are no other reasons for the baby to come out then I would not worry about it. Babies are on their own schedule.
My daughter was right on schedule until my last ultrasound at 36 weeks. Her head was only a 32 week and the rest of her did not go past 34 weeks. Then she was born and her head was still small - they say - and now at almost 3 months her head is in the 25% and the rest of her is 50%. She is fine. she can roll and babble and everything she is suppose to do. I would ask for more information about why they think the baby needs to come out. If they think the cord is being crushed or something with how the baby is laying, ask for exercises or alternative to help move the baby around. Good luck!

Dear K.; My advice is to listen to your doctor, if you trust him. There are so many ways to check on baby these days and the doctors have so much more experience than one mother. However, my own experience was that I had one child almost right on the due date (7lbs 7oz), one due in January that came on Dec. 7 (6lbs, 6oz) and one due on February 13 that came on March 13. (8lbs 15oz) Without all that scientific equipment to rely on we had to wait for the baby to decide! The babies made good choices I guess as they all survived to middle age, so far. Try not to worry. The baby will be fine either way.
D.

First of all relax. At 37 weeks if your son is born he will do just fine. Anything over 36 weeks is safe he may be little but he will have few if no issues. His due date issues are within a week so if anything he is 38 weeks instead of 39 so that is even better. If they take him next monday he will be at the least 39 weeks if not a day over due. Sounds like your Doc might be unwittingly pushing a panick button that doesn't need to be pushed. Take the next 5 or 6 days to enjoy the last days of your pregnancy and look forward to seeing your sons beautiful face. Worrying will do absolutely nothing helpful in bringing your son into this world. Enjoy your baby.

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