A young family in British Columbia recently welcomed a new baby into their family. He was a big baby . . . over 13lbs.
He was not born by cesarean and his mother did not have any drugs during labor. It actually reminded me of many women I’ve known who have successfully given birth to large babies.
Big babies have a bad reputation with pregnant women. Intuitively, big babies sound very scary. We think, the bigger the baby, the more difficult the birth, however, I have found that size of baby is only one factor determining how difficult labor is. There are other factors, such as relative positioning of the baby in the pelvis that impact the birth much more than size of baby. On a personal note, my biggest baby was my easiest birth.
Often, women who suspect a large baby choose an induction. The idea is to give birth before the baby can get any bigger, which seems logical, but there are a few problems with this thinking. First, the measures used to estimate the size of a baby are notoriously inaccurate. Predictions are easily off by a pound or more in either direction, and combined with the margin of error for due dates, one could risk prematurity for their babies by early induction. Another concern is that studies have shown that inducing labor for macrosomia (large baby) almost doubles the risk of having cesarean surgery without improving the outcome for the baby (Horrigan, 2001; Leaphart, Meyer, & Capeless, 1997; Sadeh-Mestechkin et al., 2008; Sanchez-Ramos, Bernstein, & Kaunitz, 2002).
Even if a baby truly is large, the safest approach is to attempt a spontaneous labor with the mother having freedom of movement. Her walking and position changes can help the baby to descend and navigate his or her way into the world. With an induction, women will likely be immobilized by monitors, IVs, and epidurals (some data suggests that women who are induced are 12 times more likely to have an epidural). If the baby has a hard time squeezing through, a mom who can’t move is little help in getting him or her to shift into the best position, hence the increase in cesarean for those who choose induction for big baby.
Let’s not discriminate against these babies who might be big. Give them a chance to show how well women were designed to give birth.