Birthing Bigger Babies

Wow oh wow. This baby pictured here weighed over 12 pounds and was born at home!

Who says women can’t birth big babies? Do we not tend to grow babies that are the right size for us to birth?

This is a hot topic as many women are being advised to have their labour induced at 40 weeks or even before because the doctor suspects their baby is big.

Over 10% of women in the UK give birth to babies weighing 4kg (8lb 13oz) or more. This is largely because many women are well-nourished and so have well-nourished babies. Certain families are also more likely to have bigger babies too.

The main concern about having a big baby is that there is an increased chance of shoulder dystocia. The chance is 1% for babies weighing up to 3.9kg and 5-9% for babies weighing 3.9-4.5kg.

Gestational diabetes might play a role here. If women’s blood glucose levels are higher than normal in pregnancy then their babies can grow more than normal and in abnormal ways – more fat across the chest and shoulders, increasing their chance of shoulder dystocia. This is where head is born but the shoulder then gets stuck under the pubic bone, preventing the baby's body emerging. This is an obstetric emergency and potentially life-threatening for baby.

However, studies often don’t differentiate between bigger babies born to mums with diabetes and to mums without, so we cannot truly know the chance of shoulder dystocia for bigger babies for mums without diabetes.

What we DO know is that when babies are suspected to be on the bigger side, women are more likely to opt for an elective caesarean and more likely to experience interventions such as induction, caesarean for ‘slow progress’, severe perineal tearing and postpartum haemorrhage. And these increased rates of intervention remain true even when babies are found NOT to be so big after all – they were just suspected to be!

So, beware of that big baby label, particularly in the absence of gestational diabetes. It appears the label increases your chance of intervention more than having a big baby in itself!

Please see www.midwifethinking.com for a great blog on this subject and lots of references.

Thanks to @midwifejohunter for access to this photo :)

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