We’ve all heard about women who were told they needed to consider an artificial induction of labor or even Cesarean surgery, because their babies “looked big” toward the end of pregnancy. Many of these women were unpleasantly surprised when their babies were born at completely average weights, after they’d undergone a drastic intervention in a healthy pregnancy.

The latest article from our brilliant Rebecca Dekker on her site EvidenceBasedBirth.com is “What is the evidence for induction or C-section for a big baby?”  She confirms some sad news: 1 in 3 women in the U.S. are being told that their babies are too big, even though weight can’t be reliably predicted. Women are NOT being told that procedures such as artificial induction and Cesarean surgery for big babies have not been shown to improve outcomes, and, in fact, may be harmful. Induction for big baby likely increases the C-section rate.

Her article addresses the four “big” assumptions on which this approach is based:

  1. Big babies are at higher risk for problems.
  2. We can accurately tell if a baby will be big.
  3. Induction keeps the baby from getting any bigger, which lowers the risk of C-section.
  4. Elective C-sections for big baby are beneficial and don’t have any major risks.

In maternity care, treating assumption like fact can have devastating consequences.  In this case, we see that the “suspicion” of a big baby is more harmful than an actual big baby!

When it comes to big babies, there is a clear disconnect here between what research says is best and what is commonly practiced all over the country. Please read Rebecca’s article and share far and wide.

(The infographics below about “The Myth of the Big Baby” are available for sharing from our Facebook page!)

Big Baby Prediction

BIg Baby Dystocia

Big Baby Nerve

 

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  1. A says:

    I know every doctor and midwife is different and they should not be lumped together into nefarious “sides.” My personal anecdotal experience is that I went with a midwife group with my first child and found them to be very pleasant, and surprisingly more liberal with prescribing medications than my current OB (this isn’t a criticism, I feel it was appropriate and immensely helpful). However, none of them predicted how large my daughter would be (10lbs 3oz, 22″). I only went 4 days past my due date, but an induction was never suggested as an option. Labor was very long, and I agreed to pitocin after stalling in the second stage- a CS wasn’t mentioned as a possibility. I didn’t have any issues, but my daughter was stuck after her head was out and we were moments away from having to break her collar bone. It was terrifying to see how blue she was, and her first two Apgar scores were low.

    This time, I’m 34.5 weeks with an estimated 8.2 lb baby. Ultrasounds have a healthy margin of error, but given my history and the fact that I have new and extended stretch marks, I think it’s safe to assume this is a large baby. I’m getting much more information from my OB than I did last time, and she actually refuses to recommend any intervention until I have another ultrasound at 37 weeks. When I pushed for some guidance, I got her to say the earliest she would induce would be 38 weeks and the earliest CS she’d do would be 39 weeks. She is extremely insistent that this is my decision and that her role is to provide information, given size is the only issue at present.

    I just think it is important to not assume that there is some secret cabal of doctors trying to push women into inductions and c-sections. I’m scouring Internet articles and medical journal articles *because* my doctor refuses to push me. In her case, I think she would only recommend an intervention if truly necessary. It worries me to see a trend of women refusing to consider doctor recommendations almost out of principle. Surely there is a middle ground between blind faith and blanket distrust?

  2. oliviaB says:

    Hi I am expecting my second baby and am 40 weeks and 1 day today. 1 week ago my baby measured to be 9 lbs 2 oz. I have so far refused induction although my doctor highly recommends it because my first baby was born with shoulder dystosia at 38 weeks 4 days and she weighed 7 lbs 13 oz. I believe she had shoulder dystosia because she was not in the correct position and I was not in an optimal position when pushing. I also think that my body was not ready for labor and that my water only broke because I laughed too hard (contractions started after a slow leak after I learned ridiculously hard). However, I still have not gained as much as I did with my first child (currently 30 lbs over starting weight whereas I gained 35 with my first). I’m not sure how long I should wait before being induced. I personally believe that my body will not produce a baby I cannot birth but I am still nervous to put the baby in danger. I have been very active and using primrose oil in order to prepare my cervix and I have contractions every day. What would you advise someone in my situation?

  3. Marybeth says:

    Ultimately you are responsible for your birth. Since this is not your first baby, you are probably more in touch with what your body is doing. But also trust in yourself and you body to get the job done. I have had babies (5) from 6 lbs. to 9 1/2 lbs. All my babies except one were five days late. Just tell yourself this is only for one day, and you will be able to “stand it”. Remember too, that you are chasing a toddler around and not getting much rest. Good luck to you

  4. Ellie P. says:

    So I’m due in two weeks, and I’ve had two ultrasounds in the past two weeks. The first one measured my little one (number 2 for me) as 8lbs. They wanted to be very sure so they had me come in two days ago for another ultrasound and the baby is 9.5lbs!!! The thing is, the ultrasound tech I really trust. She has a reputation for never being wrong. I’ve got a two year old who was born at 7.7lbs and I feel very different with this one. I’m a million times more uncomfortable, with SPD and the worst sciatica. I’m so big even the nurse practitioner asked me if this baby has the same father as my first. So they are waiting until Monday to look me over again and then we will make a decision. I am 38 weeks today and I honestly do not know how much longer I can handle this. My health is actually starting to deteriorate. I’m so worried about the shoulder dystocia because my oldest was also stuck because he was a compound delivery. I tried switching positions during delivery and ended up with a laundry list of problems that took me 2 straight months of healing. I had to have nurses come to my house every single day. So I know what it’s like. To beg for a C-section after 2 1/2 hours of pushing and seeing that look of panic in my doctor’s eyes… I feel like I’ll be considered a coward after being told this news about my baby being so big, and I agree to the scheduled C-section, which according to my friend who is a nurse is actually better than an emergency c-section because the situation is more controlled, the incision is smaller, etc. What are your opinions on this?

  5. Cristen says:

    Mary, that is awful what happened with your friend. I wonder what was done to prevent the damage to your friend – it is the *positioning* and not the *size* that is the real culprit in many instances of physical trauma like that. Was your friend kept on her back – which is associated with more trauma and instrumental deliveries? Or was she encouraged to move around in labor to allow the baby to descend and position correctly? (http://evidencebasedbirth.com/what-is-the-evidence-for-pushing-positions/) Was her perineum supported? Was her pushing directed, or was she able to push as her body prompted? (If she had an epidural, that might not have been an option.) I’m not saying that these things would have prevented what happened, but they may have had an impact. I am always sad to hear of women being denied care they request, like a c-section. This is a great article about managing and preventing shoulder dystocia: midwifethinking.com/2010/12/03/shoulder-dystocia-the-real-story/

  6. Mary says:

    My best friend was told her 1st baby was going to be big. She was always measuring 2 weeks ahead. She was induced on her due date. Everything went well until it was time to push. She pushed for 3 hours but nothing was happening. She asked for a section but the doc refused. She ended up pushing him out. His shoulder was broken and he had a laceration on his forehead from being pushed up against her pelvic bone for so long. He was 9lb 9oz. After the birth my friend started hemorraging and almost died from the trauma her body went thru to have her baby. So yes the big baby is not a myth. Her second baby was a c section at 39 weeks and she was already 8lb 10oz. I love how everyone is always making it sound like the healthcare community is “out to get women”

    1. Marybeth says:

      Your story in unfortunate, but I have a feeling there was more involved. Inductions are not only painful, they are dangerous. The best advice I ever received was to be educated, have a birth plan in writing, do everything possible during your pregnancy to have a healthy baby and be healthy yourself. Mental preparedness is as important as much as physical preparedness.

  7. Yes, I was told to go get induced last week, 39 weeks, because of CONTROLLED gestational diabetes. I haven’t gone in. I refuse to go in. I’m having a home birth and then will go to the hospital to make sure the baby is ok.

    1. Mary says:

      So the hospital is ok to take your baby to to make sure it’s ok but not ok to have your baby in??

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