Ask Yo Mama: Does Size really matter?

askyomamaOkay, so before you delete this and think it’s a crazy porn site, let me extrapolate. I got an email from a mama this week and wanted to respond more fully on this site so that all can be served from this nonsense.

Dear Yo mama,

I’m hoping you might have some thoughts/advice as it’s looking like I’m turning out to be a statistic… Yesterday, they did a special ultrasound to figure out how my baby is. She weighed in at 8lb 10oz (at 38 weeks 1 day). I’m dilated ½ centimeter and not hardly effaced although baby has dropped pretty well. I’ve had my membranes swiped twice now and have been aggressive with acupuncture and chiropractic to bring on an earlier labor…. All that said, it has been pretty strongly recommended I go for a c-section based on the size of the baby. Because I’m not very effaced and hardly dilated, they are not even recommending medical induction as it seems it could well lead to unscheduled c-section, considering how not ready my body seems to be, despite baby’s size. (Baby is very healthy with healthy placenta and amniotic fluid levels and it seems she’d be happy to float around for 2-3 weeks more, gaining ½ to 1lb/week, so I’m told….)

As it stands now, I’m scheduled for a c-section next Monday and of course my hope is I go into labor before then… I was just wondering if you have any specific thoughts or ideas and/or if based on your experience you agree with this view.                        Signed, Big Baby

Dear sweet Mama (and Big Baby),

WTF.  Sorry, but this is one of the most crazy-making parts of the birth industry right now.   I will highlight what you yourself wrote:  “Baby is very healthy with healthy placenta and amniotic fluid levels and is seems she’d be happy to float around for 2-3 weeks…”  SO LET HER!  I’m going to take a few moments on my virtual soap box here, but I am so frustrated with this ‘cesarean or induction based on size’ thing that I gotta have some words.

here are a few quick facts:

1.  BIG BABIES ROCK.  They nurse better, sleep better, and basically come out like big bouncy buddhas.  They are fully cooked, lovely munchkins and are a delight to be around (in general).

2.  Big babies navigate the pelvis beautifully!  Sometimes even better than a smaller baby, because of reason #1.  ANY baby of any size can get stuck in the pelvis, and very tiny women can rock a vaginal birth of a big baby with no problem. (my delicious daughter was almost 10 pounds, and I am on the smaller side of mamas)

3.  Ultrasounds have no idea how big your baby is.  Ultrasounds have been known to be multiple pounds off.   So, to say we have to induce or do a cesarean birth based on this ultrasound is nonsense.  It’s like making a map with GPS points in Wyoming while you’re in Colorado.

4.  Babies do better who have labor.  Even if it ends in a cesarean birth.  Apgar scores are higher in babies that had a trial of labor before a cesarean birth.  The contractions are essential for helping baby transition into this new world.

So, Big Baby, Here’s the conclusion.  I don’t know if your doc has a little hawaii vaca planned or is having his/her in-laws to visit, but this recommendation is not in the favor of you or your wonderful (and potentially small) baby.  Take your time.  Say no thank you.  Hold steady.   Your baby will pick a perfect birthday, and on that day, you’ll both see how you can navigate getting baby through your pelvis.  Stay active (see Happy, Healthy Pregnancy) so you can walk and do a lot of stairs in labor.  And potentially, if you and your doctor keep not meeting eye to eye, consider making a switch.  I know it’s super late in the game, but as long as you’re not in labor, it is still possible.  (See Three Steps to A Great Birth).

And if you can, avoid empty calories like refined sugar.  These do tend to make babies a little fluffier.  Eat five colors of veggies a day, eat good proteins (vegetarian or meat).  Think of each day as the potential day that your great birthing adventure will begin.

Sending you all my love and patience, to you and your gloriously big baby.

Yo Mama

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2 Comments (+add yours?)

  1. Cindy Peyton
    Nov 08, 2014 @ 13:30:33

    This post is also part, unfortunately, of the baby industry, but from an anecdotal and un-researched perspective. Do other moms out there a favor (and save a few lives!) by citing studies to support your claims. Why large-for-gestational age babies are a heavy risk for moms to bare: http://www.hindawi.com/journals/isrn/2012/353791/

    Reply

    • Katie
      Nov 11, 2014 @ 15:49:21

      Hi there Cindy! I’m honored that you read this- and I’m happy to cite some articles that may help. Again- with extremely large babies, or mothers with diabetes, induction may be a good option. But with a ‘suspected’ large baby only based on the imperfect measurements of ultrasound- to induce as a practice does not make sense, and is not recommended by ACOG-

      This is from Pregnancy and Baby.com:

      “Should you induce labor?
      Inducing labor utilizes pitocin, the synthetic form of oxytocin, the hormone your body naturally releases when it’s time for your body to go into labor. While there are medical reasons for induction, a suspected large baby is not one of them.

      In fact, the American College of Obstetricians and Gynecologists (ACOG) does not recommend induction for a suspected macrosomic baby, and studies show that induction for this reason does not lead to better outcomes for the baby, but also nearly doubles the risk of having a cesarean section.”

      here’s the whole article:
      http://www.pregnancyandbaby.com/pregnancy/articles/945311/birthing-big-babies-labor-and-delivery-facts

      and here are the guidelines from ACOG:
      http://www.aafp.org/afp/2001/0701/p169.html

      The main risk here is also that induction can double the risk of cesarean birth- which is much riskier for mothers:
      (http://www.acog.org/About-ACOG/News-Room/News-Releases/2013/Vaginal-Delivery-Recommended-Over-Maternal-Request-Cesarean)

      so to take on a known risk for an ‘unknown’ size of baby- to me doesn’t make much sense. I’d love to have a continued conversation. And thank you for the reminder to put some links in- it’s a good practice.

      Reply

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