Is a baby (really) ever too big?

[UrbanCrunchyMama]

Even before she was pregnant or thinking about getting pregnant, my friend said that she'd have to come to me (when it's her turn) for natural birth resources. Immediately after it was safe to share the good news, we had a nice afternoon together, and I sent resources to her (in the form of emails that contained local resources as well as a copy of Ina May's Guide to Childbirth and Birthing From Within). Her first "to do" on her list was to find a doula.

The next time I met with her, her OB had talked her out of a doula, saying that hiring one would take away from her supportive husband's experience. In my head, I screamed,"OH, NO!" She didn't seem ready to be "pushed", so I left it alone.

The next time I saw her was at her shower. She and her hubby had just taken a childbirth weekend intensive class. Of course, it was recommended by her OB and pretty standard information.

At this point, I'm growing more and more worried, but she still didn't seem to be in the right place to be "pushed".

Fast forward to her birth...
She labored at home for 8 hours, and arrived at the hospital at 1 cm dilation. Instead of telling her to go home, they told her to walk around the hospital until she was further along. She was admitted at 2cm. Shortly after, she asked for an epidural. Right before pushing, she experienced extreme pain. She pushed for 2 hours, unable to get the baby passed 0 station. A c-section was performed. She was told that her baby was too big and that her anatomy did not allow for the passage of the baby. (To my knowledge and her knowledge, she does not have Rickets.)

Her son is only 8 weeks old, so it's still a wacky time for her, I know. I asked her about writing her birth story, but she told me that she wanted to forget the bad parts. Of course, I told her it would be a good thing for any mom.

So what am I to do? From what I know of chilbirth, it seems that the "big baby" theory and the "you're too small" song and dance are a load of crap. (Her son was 8lb. 14 oz.) But maybe that's just my limited perspective?

When she gets pregnant again, do I say anything?

Any and all thoughts and questions are welcome.
Thanks,
Lydia

[Veritaserum]

It does happen, but it is extremely rare. More likely is that her baby wasn't in a great position (which is common with reclined, epidural moms) or the baby was largish for her body and she needed to squat to maximize the room in her pelvis and use the help of gravity.

[mother4good]

Yeah, I hear this alot too. I think it has more to do with the drugs and the birthing supine, etc than anything. Some of the moms who tell me this tell me their OBGYN says they will always have to have a C-section. How depressing! (knwing that it is probably not true, that is.) If it were so common wouldn't the human race have just died out by now? Or at least we'd all have to be brother and sister. Just kidding!

I think it depends on your relationship with her. Some people are more comfortable "washing their hands" of it and say thing "there was nothing else to be done" Than to try to take charge of their own lives. I see that alot more where I am now (rural area) than I did where I was before (a suburb).

[Belleweather]

I'm not one of those people who believes that your body will NEVER grow a baby that's too large for your pelvis, but unless that kid was somewhere between 12-15 pounds, she probably got hit with a combination of a lack of support and an impatient and ignorant doctor.

Unfortunately, there probably isn't much you can do unless she decides she wants to re-evaluate her birth choices before her next baby.

[BetsyS]

My son was big (11lbs, 14 ounces), he was in a bad position (persistant OP, despite weeks of trying spinning babies optimal fetal positioning stuff), and so that combination DID add up to him being too big for me.

With the next baby, I'll still do the optimal fetal positioning, but I'm also going to try to have a smaller baby.

[DoomaYula]

There's a story on the Birth Stories about a 12lb 4oz baby born vaginally at home. He did have dystocia, but he was fine...

[SublimeBirthGirl]

It's too bad our friends and family don't use us as a resource. I'm more than happy to share free information but nobody ever seems to want it. Very strange.

[UrbanCrunchyMama]

Veritaserum - Which makes me think, as eager as she seemed when I shared the resources, she didn't actually use them. Had she actually read either of the books (which I ear-marked for her because she was a busy, busy traveling corporate woman), she would have known to stay at home as long as possible, to explore positions, to refuse the epi for its likely domino effect, etc., etc., etc.

mother4good - Hilarious! I've been thinking and saying the same thing. If childbirth was REALLY that bad, our species would have died out long ago. (I'm not trying to trivialize labor here. I'm just looking at the big picture.)

Belleweather - That was my sense of her son's weight too. He's definitely bigger but not to the point that it would greatly hinder birth. I'm hoping she'll at least entertain the thought of reading posts similiar to, if not, MCD, so she can begin to heal.

YumaDoula - Those are the stories we like to hear! Where did you see this story? Do you mean MDC birth stories?

SublimeBirthGirl - It seems strange to me too, but from their perspective, I'm sure we're the ones that sound nutty. I've always been adamnant about telling the truth and seeking the truth. I just can't relate with living life any other way.

[dlm194]

I do believe it happens sometimes but I agree that it's very, very rare. Whenever I hear of a woman who had an epidural and couldn't push her baby out, I shake my head. That's drugs and usually directed purple pushing - not a baby that's too big to pass through the pelvic bones.

That's what I was told. My baby (8lbs 6oz) was too big. My midwife actually went through this big explanation about how my pelvis is more of an oval shape and I have a thick sacrum so my baby's head couldn't pass through. She went on to say that *maybe* I could vaginally birth a 6 lb or 6.5lb baby but not bigger than that. When a provider gives you a serious explanation like that, it sounds pretty legit. I remember thinking how strange it was that my anatomy was so "off" and thank heavens for the c-section. However, as time went on, I began hearing these stories over and over. I swear, obs must be learning this in school because sooooo many women are being told that their babies are too big now. Funny how in 2007, we can't birth out babies. All these years of evolution and we've evolved into women whose pelvises are too small to allow out babies to come out. My sister came over the other day and told me how her coworker had a c-s after many hours of labor. The doctor told her that he could tell after her c-s that "her pelvis really was too small." My good friend's doctor told her that she's a small person (5'1" maybe??) so she'll never birth vaginally. She did actually labor for a good 8 hours or so (induction, epidural, a week before her edd) before they determined that she wasn't going to dilate.

So I began researching several months after my dd’s birth. I found stories of women who were diagnosed with CPD (cephalopelvic disproportion) go on to have much bigger babies. It no longer made sense. Then I researched more about modern obstetrics. I think obs want to shift blame away from the mothers and make it more nebulous. "It's not something you can help. You were just born with a pelvis that was too small." So women believe they are defective through no fault of their own and dutifully schedule repeat c-sections with their subsequent babies. That's a perfect situation for doctors! No worrying about when a mom is going to present in labor if we schedule her 1 hour birth. Staffing and resource issues are alleviated since we know when a mom is going to come in to have her baby. It's a vicious cycle.

I wouldn't push your friend. She needs time to come to terms with her birth. I think it's okay to ask how she's feeling and how she feels that recovery is going but I wouldn't try to get too far into her feelings unless she brings it up (let her do that – she may really want to talk but needs an environment where she won’t feel judged or attacked for what happened). If she gets pg again, you can ask her about her delivery plans. If she plans on a repeat c-section you can mention vbac. Emphasize that she is not broken and every labor and delivery is different. ICAN would be a good resource for her (www.ican-online.org).

[Ironica]

The Sears Birth Book puts *true* CPD at less than 1% incidence.

Uncontrolled gestational diabetes can grow babies that are VERY large, and they *may* be too big to be born vaginally, as well. (That's not the head, but the entire thing, I guess.)

So yeah, it can happen. But it's much, much rarer than the OR reports make it out to be.

[MommaCrystal]

I was told this! After an ultrasound (that no one told me could be off by 2lbs or more) I was told my baby could be 8.5-9lbs. I was told that I should be induced before the baby got any bigger if I had any chance of deliverying vaginally.

No one told me you are more likely to have a c-section if you are induced. My induction was a NIGHTMARE! Posterior, NO ONE did one DARN THING to help me with that or to manage the pain. I laid in bed gripping the rail believing I was dieing and something must be HORRIBLY wrong because I wasn't have contractions I was having NEVER ENDING HORRIBLE PAIN. Yes I had an epidural, I knew no better.

Long story short... despite making it all the way to 10 cms we had fetal distress and I was rushed to the OR and delivered via c-section. I never had a chance to try to push. On the operating room table my OB declared my pelvis "incompetent" and declared that I'd always need c-sections.

My baby was 7lbs 3oz.

I feel like I was violated, lied to, and really assulted.

I've learned so much since then. I am DETERMINED to have a different experience this time.

[glendora]

I do know one mama who had a c/s for a baby that was "too big" which I feel was perfectly justified. But, it was specifically the HEAD that was too big. Baby had a chromosomal disorder. He's 5 now, and his head is still proportionally larger than his body. So, YEAH there are "too bigs" that are actually too big. But, certainly not as many as doctors seem to find...

[DoomaYula]

I found the story here on mdc. It was a 12lb 12oz baby (!) and they did have to break his arm , but he is fine now .

[thebarkingbird]

the kind of pelvic formation that make for an unlikely successful vaginal delivery can't be seen from the outside. it's not the hips it's the pelvic opening. if a woman's pelvic opening is truly odly shaped and the baby is truly quite large the woman can have problems. the thing is, that kind of mild deformity is extreemly rare!

i would NEVER go back to a doc who discouraged a doula. the OB i saw actually asked us if we had one! sounds to me like someone feels that someone else might get in the way!

[applejuice]

I have posted this a million times, but Frank Sinatra was 13-15 pounds and was born at home, 1915. One version of the story says the doctor used forceps and messed up his ear. The doctor thought he was stillborn so he set the baby aside and went to work on the hemorrhage his mother was experiencing. His grandmother, a midwife, worked on the very large but limp baby, putting Frances Albert under some cold water and got him going after a while. His mother did have diabetes and did not have any more children. Frank Sinatra was an only child of an Italian immigrant family in New Jersey, an unusual situation.

So a small Italian woman gave birth at home to a 13-15 pound baby and lived and so did the baby. No big deal. Happened every day.

There are also rumors, OT, that his mom and or grandmother performed illegal abortions in their community also. Just a rumor. Probably the only way a midwife could use her skills once women all went to the hospital to birth their babies and the state legislatures refused to license midwives.

[WillowBrook]

CPD does indeed exist, I happen to be one of the rare cases of true CPD myself. I have had an Eating Disorder for a very long time (since childhood) and the resultant years of malnutrition during my developing years has resulted in my pelvis being somewhat malformed. I was having MRI's, X-rays etc for an unrelated condition when the Pelvic Disproportion was discovered. When the Doctor showed me the images and explained what it meant it was really one of those situations where in all honestly you didn't need a medical degree to see that something was really wrong with the structure of my pelvis. So if (and hopefully when) I do have a child(ren) I will be having a C-section because for me it's pretty much a choice of labour for days, risk the babies life and risk serious damage to myself (Obstetric Fistula for one) with absolutely no chance of actually giving birth vaginally and ending up being rushed in for an emergency C-section or have a pre-planned C-section that is as comfortable, pleasant and positive as I, and the Doctors, can possibly make it

[Romana]

Of course! True CPD does exist. It's just quite rare (1% or less) and usually is the result of malnutrition or prior pelvic injury. It's really not possible to diagnose CPD prior to labor since the ligaments loosen and the bones move during birth to make room for the baby. However, in extremely unusual cases, it can be diagnosed if the pelvis is clearly malformed OR major prior pelvic injury makes it obvious.

I wouldn't be convinced in your friend's case . . . I suppose it's possible, but lots of babies won't come out when you're pushing with an epidural while lying on your back. I would find a CPD diagnosis to be suspect after anything but an unmedicated, uninhibited labor with a pretty long pushing phase (i.e., mom given plenty of time to change positions, choose what feels best, etc.).

I like this article: http://www.bellybelly.com.au/article...s-big-baby-cpd

[UrbanCrunchyMama]

Romana9+2 -- Great article! I've bookmarked it for future reference. Thanks!

[flapjack]

My eldest was born at home and was 14lb 2. No SD, unlike his brother who weighed in at 8lb 13oz.

If I can offer you advice, the best way of helping her heal is to put her in an environment with new mothers, womens whose births are recent and who share her philosophies on parenting (you know, people like us...). Over time, they tell their stories again and again and you can see the healing happen. You can see the passage from numbness to questioning to anger and then to "what if ?" It's really hard- in fact, it's heartbreaking, when you see a friend suffering with the realisation that with different caregivers, her baby's birth could have been much different and you watched all along, but this is your role. To support, to nurture, and to pick her up again when she stumbles and falls. It isn't possible to show someone the light. Be aware, also, that the story she tells of the day her son was born might not be the story that her heart tells- she may already be on the journey, but not yet sharing it publicly.

[Ahimsa]

I know a woman who is petite 5'2" or under, and on the trim side too, who birthed an 11lb+ baby in the hospital with no drugs. She said she got up and squatted on the delivery table. She said all the nurses were impressed and had to come and see. The boy must be at least 20 now.