You go to your normal prenatal appointment and you are measuring just a little big, so your care provider decides to do an ultrasound. A big baby is confirmed so the doctor recommends an induction or even a cesarean birth because looking at your hips there’s just no way you can birth this baby vaginally.
Your doctor tells you all about the potential complications, and with this information studies show you are definitely more likely to choose a planned cesarean birth.
The reality is…big babies are normal! Healthy well-nourished mamas grow healthy well-nourished babies. Healthy babies are often eight pounds or more. Keep in mind there are genetic factors that may influence the size of your baby and often the second baby weighs more than the first and the third weighs more than the second.
Mamas with gestational diabetes tend to have larger babies also.
That being said, the best way I’ve found to guesstimate baby’s weight is to actually palpate with my hands, but even then, it’s only a guess. I have also seen ultrasounds be off by two pounds plus or minus the actual weight of baby.
I’ve had many mamas call with questions because their doctor is recommending an induction or cesarean birth because their baby is “too big”.
In fact I came across a study that said two out of three moms were told their baby was ‘too big’ based on ultrasound (Cheng et al. 2015). However, the average size of these babies when they were born was only 7lb 13oz which in my book really isn’t that big.
The question comes down to the safety of birth and what complications may occur.
One of the biggest concerns that comes with a “big baby” is shoulder dystocia. This is where the shoulder gets hung up on the pubic bone and requires tricky movements on the care providers part to assist baby in coming out. I’m not going to lie; I hate a shoulder dystocia, but a true dystocia is not very common. For example, it’s about 5–9% of babies weighing between 9lb 9oz that may experience a true dystocia. These numbers come from a study in the journal of prenatal medicine. (Politi et al. 2010)
Other unhappy outcomes are the chances of a perineum tear or even a postpartum hemorrhage. Again, these are really very rare, like .6-1.7%.
It really comes down to how comfortable your care provider is in trusting birth and being patient as labor may take a bit more time with a larger baby. They are more likely to diagnose failure to progress during labor and recommend a cesarean birth if they suspect the baby is on the larger side of normal. (Blackwell et al. 2009).
When you get the word that your baby is big you have an increased chance of interventions at your birth, it’s those interventions that often lead to complications even if the baby is not actually big.
What I’m trying to say is the very thought of your baby’s size can influence outcome more than the actual size of your baby.
An ultrasound only “estimates” fetal weight and are often inaccurate so many inductions may not even be necessary.
I get it, you’ve waited nine months to hold your baby in your arms. You are miserable, you can’t get comfortable, you can’t sleep. When the idea of an induction is given, you want to jump on it. The thought of knowing the exact date that you can put all this discomfort behind you sounds amazing. BUT…keep in mind there are many risks that come with labor induction that outweigh the risks of giving birth to a big baby.
This is a great study World Health Organisation guidelines states that labor induction shouldn’t be considered just because baby is suspected large due to an ultrasound, “estimation of fetal weight by clinical assessment or ultrasounds can have significant margins of error”.
So, in the end, using the results of an ultrasound to determine baby’s weight and size is inaccurate. Here in the US, complications that are generally associated with big babies may be a reflection of your provider’s fear and practice guidelines. However International guidelines do not necessarily recommend an automatic induction for a suspected big baby.
I feel strongly that you as mamas need to be given this information before you even agree to an ultrasound when you are measuring large for dates. I say this because once you are labeled as having a “big baby” it can’t be reversed, and it may alter your birth experience and outcome.
Labor Support Blend
This blend smells amazing and can be helpful for labor pain with fear and anxiety.
Put in a 10 mL roller bottle and fill to top with FCO.
Simply massage into low back and feet as often as needed during early or active labor