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Is there REALLY Such a Thing as A Too-Big-To-Birth Baby? - Page 2

post #21 of 51
Quote:
Originally Posted by Storm Bride
I have no actual knowledge about this. I would guess that it does occsaionally happen, due to mixing of races. My daughter was much larger than my son and was from a different father, who was himself a big baby, so I believe that the paternal genes contribute to the baby's size. So, it would make sense to me if sometimes a woman from a generally small ethnic group (eg. some Asians, some of the Celts, etc.) had baby with a father from a larger group (some of the Scandinavians, some of the Africans, etc.).
Regardless of the language used (because we all say stuff quickly on here wihtout the benefit of tone and body language...), I think there may be something to this. My brother's professor was a teeny, tiny Asian woman whose husband was a gigantic blonde man. They had a really big baby. Don't know the labor and birth specifics but I do know it was a c-section.

Not race related, but what about that 17 pound South American baby from the news a few months ago? That's awfully big for any woman...

but I generally agree that's it's a woman-baby-day-position-health specific answer.
post #22 of 51
maybe yes maybe no, I could probably list off dozens of very small women having babies with large men and no sections.
when I have seen a baby not come for size it is rare- most of the time everything molds --
as said before by someone else- it is a baby born to a mother at a particular time--
post #23 of 51


NO. NO. NO.

That is... yes, possibly, in a teeny-tiny % of cases. But let's have all women birth upright, squatting, on all fours, etc. THEN we'll see how many babies are "too big."

Let's have them go to term, instead of being induced, as long as the baby is showing no true signs of distress. THEN we'll see how many babies are "too big." Or women's pelvises "too small."

"Some women are just too small to birth?"

No. Not really. That's cultural indoctrination and non-evidence-based medicine.

"*Very* rarely, women/babies have some form of CPD and vaginal birth isn't gonna happen easily?"

Yeah, maybe.

But really... The whole idea that "some women can't do it" or "babies can be too big and tear you up/it's easier to deliver a small baby."

Nuh. Uh.

For *most*-- virtually all-- intents and purposes, no.

Of course, lay a woman out in the stranded beetle position (or help her into that position with unreliable FMs or paralyzing drugs), give her meds to nudge out a baby that isn't ready yet, have her birth UPHILL, and then...

...blame it on her body, of course! Or the baby!



I just...
post #24 of 51
Quote:
Originally Posted by Bleu
[bold added]

Uh... I really don't think you meant this to come out as racist as it reads to me. Maybe you meant "mixing of genes from different ethnicities"? Something? I don't want to be accusatory, but I can't let this pass unremarked.
What seemed racist? "Mixing of races"?? I didn't mean it in any racist way whatsoever, and I think the rest of the post is pretty clear about that. What's the difference between saying "mixing of races" and "mixing of genes from different ethnicities"? Is "races" not allowed these days? I have trouble keeping track...

(Just for the record, I'm part Scandinavian, part Celt, part Cree and I don't know or care what else..."race" to me is just a shorthand term for genetic similarities - hair colour, size, eye colour, skin colour, facial shape or whatever - within a particular group or "ethnicity", if you prefer that term.)
post #25 of 51
Yes, but it's *really* hard to assign physical characteristics to race, or race to genetics. It really *does not* exist biologically-- race is *purely* a social construct. I mean, who decided who was black, white, Asian, Latino? In the US, mainly legislators. Seriously.

We take it for granted that race is "obvious," but it is learned.

One can obviously see that someone's skin is darker, someone's hair is lighter, etc. But being able to assign people into specific "races" with any degree of accuracy is learned.

Anyhoo... Your hypothesis is fine-- not necessarily "racist," IMO. I just think it's inaccurate. Interracial couples make up a tiny % of the population, and many of them include partners (like the majority of African Americans) who are already racially mixed. So, ya know... Those tiny Asian women and their 6'3" Norwegian husbands... Not really a factor. And even in THOSE cases, we know height has little to do w/pelvis size during birth. Without a major illness or injury, CPD doesn't really exist.

It's a matter of using intuition to "explain" what is, in fact, counterintuitive in our society: obstetrics for low-risk women is the culprit, not women's/babies' bodies.
post #26 of 51
Quote:
Originally Posted by Rach
There was an article about how a woman gave birth to conjoined twins [of course in thoes days, they were called siamese] at home, delivered by her mother.
Wow! Good point! I had never thought of that!

Quote:
Originally Posted by mmaramba
Your hypothesis is fine-- not necessarily "racist," IMO. I just think it's inaccurate.
I learned from my ped that a person's head size is a paternal trait. And whenever I think about "big babies" being born, I ignore the fat stats, and am more interested in the size of the fetal head, or the size of DAD'S head.

Maybe it is more accurate to pay attention to dad's head size when making CPD guesses about that 1%? I've always wondered about this...it doesn't impress me that a newborn was 11 lbs and had fat thighs...tell me how much that fetal head molded, tell me dad's hat size. And of course baby's shoulders.

Quote:
Originally Posted by mmaramba
It's a matter of using intuition to "explain" what is, in fact, counterintuitive in our society: obstetrics for low-risk women is the culprit, not women's/babies' bodies.
Right on!

I think CPD is a real problem. It is a real fact that a laboring woman in a hospital today has a tremendous chance of falling victim to the environment and interventions that will "make" a head-fitting-in-her-pelvis problem.

I seem to have a similar problem, called "can't take a dump at my in-laws" when I'm visiting there. But once I'm home, in my own calm surroundings with privacy in my own bathroom, ta da, nature can do it's thing. (And hey--my in-laws aren't checking my progress or inserting IVs or any number of the "routine" elements of a hospital birth.)

How many times does a baby's hand by the face slow down decent during labor? That's not the baby's head being too big; that's a hand by the head. What about mom's full bladder arresting decent? I'd like to see a guess at how many c-secs for CPD go thru, and really, it was just a full bladder (from all those IV fluids to keep blood volume high enough to compensate for the epidural blood pressure drop.)

LASTLY, this thought: perhaps this current generation of birthing mamas contains a good handful of women who were born via c-section circa 1975-1980. That's entirely possible.

HOWEVER.....most every woman birthing today, still, was born vaginally, which would imply that the women birthing today are the result of hundreds and hundreds of years of adequate pelvises. The math is simple; if your great-great grandmother's pelvis wasn't big enough two generations ago, you probably aren't here. And neither is your "too small" pelvis, so your c-section is truly unnessary.

When my dd is having babies, and if we hear this "CPD" nonsense spewed from the OBs of tomorrow, that diagnosis would at least have a shred of science to it, since 15% of birthing women will have been born via c-section themselves (I'm taking today [2005's] stat of 28% c-secs and dividing by 2, half for boys, half for girls.)
post #27 of 51

A Couple of Empowering "Big Baby" Stories

Hi,

My first baby was 10 lbs, 6 oz. Of course, you only get these facts AFTER the baby is out.

However, because of the fetal monitors during the night of labor, my baby kept "wiggling out of the way", because they annoyed him - in utero. By morning he had "wiggled" all the way into breech position! The doc said I'd have to get a c-section, but my mid-wife standing beside him said with a laugh and a smile, "No she doesn't!"

She went and found a friend-doctor who was luckily on the premises and he came in and pushed on my belly until the baby was again head down. This was done with relative ease and no pain or forcing... remember this turned out to be a 10 lb, 6 oz baby...

Then my midwife broke my waters and we walked around for hours (so the baby couldn't flip again.) Like I said, a few hours later, my first baby was born, Samuel Flint, weighing in at 10 lbs, 6oz. Perfectly healthy.

My second baby, a girl, weighed 9lbs, 10 oz. (I am convinced the only reason she weighed less is because I barfed the whole first trimester!) The same doc came in and said I'd need a c-section because I had been actively laboring for ten hours and I was not at the pushing phase yet. My midwife again laughed at him and said "Oh, pooh--she's fine!" with a smile and a sense of humor. He smiled, too, and left us to it.

Virginia Grace was born ten minutes later - I had a strong urge to push right after the doc left (imagine that) and she came out with ease. I needed no episiotomy or stitches, and the baby and I are in good shape.

Now we are pregnant with number three...

Beansavi
post #28 of 51
Urgh, I want to cry everytime I hear that the baby was too big. I hate how it makes woman not trust their body. I have a good friend who has been told by doctor's that her pelvis is too small and she never attempted a vaginal birth. She had two c-sections with 7lb babies.
post #29 of 51
I have not yet had in my practice a case of what I thought was true CPD. I have had 2 women have cesarean sections after not being able to push out their babies, but both were poorly positioned, one straight posterior with the head extended (and he was 9 lbs 6 oz to boot) and one was an even odder position, occiput transverse, with the head also cocked to the side so it was almost presenting sideways (baby was 7 lbs 10 oz). Both of these moms pushed for 4 hours, in every position imaginable and did not descend at all. To different OB back up doctors did these cesareans, and the one with the smaller baby has "CPD" listed on her operative report, even though I argued and argued the point with the OB. The doc who did the bigger baby's cesarean agreed with me that the whole problem was positioning, and her operative report says "malposition."
I'd happily VBAC with either one of them, if they so choose and have told them so.
I had one other woman who may have had CPD, but I'm not sure. Her water broke spontaneously, and she labored spontaneously for 24 hours, progressing to 4 cms within the first 12 hours then no further dilation after that. She received pitocin augmentation for another 12 hours with no further dilation, and was exhausted and discouraged by then and elected for cesarean birth. Baby's head had a 4 cm bump on it, an inch tall, from where his head was against the cervix all that time, and he never descended into the pelvis. The mom was 4 ft 10 inches tall, and the baby was 9 lbs. CPD? Maybe. Or maybe bad luck that her membranes ruptured prior to labor and wedged the baby's head funny. As someone said in a PP, this particular baby on this particular day, didn't seem to fit, but I don't know that it was true CPD.
I don't have the high volume many OBs have, but that's 181 births without a true case of CPD, so I don't think it's that common.
post #30 of 51
Quote:
Originally Posted by mmaramba
Yes, but it's *really* hard to assign physical characteristics to race, or race to genetics. It really *does not* exist biologically-- race is *purely* a social construct. I mean, who decided who was black, white, Asian, Latino? In the US, mainly legislators. Seriously.

We take it for granted that race is "obvious," but it is learned.
I don't find race obvious, even in the sense it's used most often. I couldn't begin to tell you what race most people I meet are...I completely agree that "race" is a very vague term.

Quote:
Anyhoo... Your hypothesis is fine-- not necessarily "racist," IMO. I just think it's inaccurate. Interracial couples make up a tiny % of the population, and many of them include partners (like the majority of African Americans) who are already racially mixed. So, ya know... Those tiny Asian women and their 6'3" Norwegian husbands... Not really a factor. And even in THOSE cases, we know height has little to do w/pelvis size during birth.
I'm not really talking about height, though - I'm talking about size. Asian women aren't really a great example (I know I'm the one who brought them up in the first place), as most of them seem to have very wide pelvises for their height. But, I've known quite a few small women of west European background who have very small builds...not just short, but very slight. I really have to think that when they do hook up with the 6'3" (that's not that big, imo...most men in my family are over 6') Norweigan, there is potential for problems with a big baby. But, I did say in my original post that I think this is an occasional issue.

One of the things that got me thinking about it was that my first baby was 7lb., 12oz. - right around the "average" mark. His father was within a couple of ounces of the same birth weight. My second baby was 10lb., 2oz...and her father was 9lb., 13oz at birth. This suggests to me that the father has a lot to do with the baby's size, and it does make sense to me that a woman who comes from a genetic heritage of generations of 6lb. babies could possibly run into problems if she has a baby with a man who comes from a genetic heritage of generations of 10lb. babies. I'm not saying she will have problems - just that if her pelvis could be too small to accommodate a baby that size. (In fact, substitute head size everywhere I mention weight...it's more relevant, imo.) That's really all I meant.
post #31 of 51
I know of a few cases my midwives have had that both led to hospital transfer of the baby and stays in the nicu on a ventilator. The one was a big mom who kept stalling on getting an ultasound.She was measuring large so they thought maybe twins?Nope,just a big baby and a really tight squeeze through the pelvis.This happened in the last two deliveries to this mom.
The other case was borderline gestational diabetes,and the mom wasn't real good about going along with the nutritional guidelines offered by the midwives.this baby also ended up on a ventilator and a shoulder injury.
I'd say yes it can happen,but i don't think it's all that common.
post #32 of 51
Quote:
one was an even odder position, occiput transverse, with the head also cocked to the side so it was almost presenting sideways (baby was 7 lbs 10 oz).
This was why I ended up with a section, no one even thought that it was CPD...she was positioned badly and didn't want out...silly girl...the doc who did the section told me I have a perfect pelvis for birthing, wide and everything in there is textbook...I DARE someone try to tell me that I can't deliver a baby vaginally, when even the c/sec doc (who is not the most natural minded doc in the world) told me that I would have no problem birthing any baby in proper positioning...
post #33 of 51
Quote:
Originally Posted by doctorjen
...one was an even odder position, occiput transverse, with the head also cocked to the side so it was almost presenting sideways (baby was 7 lbs 10 oz)...
Out of (morbid) curiosity, what would be the probable outcome if a mom ended up delivering such a baby vaginally? That was the cause of my mom's primary c-section in '63 (my brother). If they hadn't done the surgery, I'd guess he wouldn't have made it...but what about my mom?
post #34 of 51
Well, there are 3 possibilities, I think.
1. Eventually, if we waited long enough the baby would have lined itself up better and been born vaginally, with no other issue.
2. The baby would have eventually, with good pushing efforts been pushed out in the same position, either with no problems, or perhaps with some injury to baby or mom, such as skull fracture, or bad vaginal tearing or something.
3. The baby truly would not fit like this, and eventually the stress of prolonged labor would have been fatal for the baby, and perhaps the mom, too.
No way now to know what would have happened, since we elected to intervene surgically instead.
post #35 of 51

Cpd

I just add this: my sister had a c section with her first, and the baby was about 8 lbs. 3 oz.; doctor said CPD. Next she had twins (smaller), VBAC; second twin was breech. Third she had a big baby, 9 lbs. 12 oz., last she had an almost 9 lb. baby. All girls. I don't believe that CPD happens very often.
post #36 of 51
Quote:
Originally Posted by boongirl
I've known two cases. In one case, a woman I know had her first child die in utero late term and the process of trying to delivery the baby revealed her pelvis is shaped such that she will never be able to get a child through it. So, with her second pregnancy, which she carried to term, she scheduled a c-section.

In case #2, I had a neighbor growing up who was 5 feet tall at best and slender. She had two babies, both over 10 pounds each and big and tried but could not vaginally deliver either one.
Problem is that people look at little women and automatically equate big baby with c/s. I'm 5'0 on a good day, when the planets are all in alignment and the wind is blowing in the right direction, yadda yadda .... yet I gave birth to a kid over 10 lbs. And I'm a fairly slender gal. About 105-110 lbs when not pregnant. I always tell women this story because it tends to affirm the belief that small pelvises can birth big ol' babies.

I think it is more about fetal positioning than size.
post #37 of 51
I have to agree that in most cases it is a "this mom, this baby, this day" issue. My MIL who is a short but sturdily built woman birthed three kids just fine vaginally, but when it came time to birth dh (last and biggest) he just wouldn't come out. They did a c-sec and told her baby was "too big" (he was 10.5 lbs) but I wonder if he just wasn't poorly positioned. My friend is a tiny girl. She is maybe 5 foot and weighed 93lbs soaking wet before she got pregnant with her first. Her boyfried was a big guy (6' 5") and she gained 90lbs during her pregnancy. She was able to birth her 10.5lb baby vaginally. She did need quite a few stitches, but i think that is because they had her coached pushing while lying down and when the baby didn't come fast enough she wound up with a big episiotomy. She probably wouldn't have needed as many if they would have just let her tear.
post #38 of 51
It can happen. An acquaintance of mine who is a midwife in New Zealand got very upset when someone told her CPD simply doesn't exist, she said they see it sometimes with Asian women married to Caucasian men. Although not a small woman herself, in fact, she has flirted with the issue, having had problems with shoulder dystocia with several of her children (she's on I think her 7th or 8th pregnancy), which led to one having its clavicle broken during birth. And as others have pointed out, there are occasional deformities of the pelvis to deal with. I don't think anyone is arguing that the overwhelming majority of cases of CPD translate out to things like poor positioning, much as the overwhelming majority of cases of "failure to progress" translate out to impatient doctors. However, to say that such things are a complete myth is also a misunderstanding of the issue.
post #39 of 51
About the malpositioning factor...

Experienced midwives, when they were the NORM, not the EXCEPTION, could manipulate babies so they could safely be delivered vaginally. So, for example, if the baby's skull was wedged against the mom's pelvis and couldn't pass through, she would maybe put one hand in and manipulate gently internally while the other hand helped externally, that sort of thing. Simple body mechanics. This sort of thing is a lost art, now that we can just hop into the ER for surgery, tho
post #40 of 51
Quote:
LASTLY, this thought: perhaps this current generation of birthing mamas contains a good handful of women who were born via c-section circa 1975-1980. That's entirely possible.
What do you mean by this?

If it's that they'd be more likely to think they need a C-sec, I can see that.

But if it is some sort of evolutionary argument (about head size, whatever), I don't think so... That would imply that all or most of these women would have died if they hadn't been delivered by C-sec. We know that's not true, so they shouldn't have any genetic problem (e.g.: huge heads) that makes them more likely to have babies with the same problem and need C-secs.

Unless choice of interventive OBs is a heritable trait!
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