Is a baby (really) ever too big? - Page 3

[Dov'sMom]

Originally Posted by ~*~MamaJava~*~

I wear a size 11 but my biggest babe was 7lbs 3oz. I wish I could find a way to grow a nice plump one and test that out!

How does that work for European mamas?

I'm a size 13 (11 mens) so I guess I don't have to worry, right?

But I did worry, quite a bit, because my mother had 5 c-sections. Her first she was in hard labor for 24 hours, no epidural, no progress for hours (stuck around 7 or 8 centimeters, baby's head still -) when the baby went into distress and they did an emergency c-section. They had suspected CPD earlier and done some X-rays that left the doctor sure it wouldn't work, but she was determined to try. With her second (me) she tried a VBAC. Her doctor told her to labor for more than 3 hours could be a risk of rupture, so the plan was that after 3 hours of hard labor they would switch to a c-section...well, they made the decision after 3 hours, but her doctor didn't show up for ANOTHER 9 HOURS so a total of 12 hours, in which there was no progress. Also no epidural. The next they did the c-section as soon as she told them she was in labor, and the next two were scheduled. So, was it real CPD?

Now, I had no trouble birthing my 7 lb 1 oz son (other than 50+ hours of labor because he was face up...), and my sister has had no trouble with her two (7 lbs 8 oz and 7 lb 2 oz), but I don't know that I'm eager to try 14 lbs!

[Turquesa]

Originally Posted by mwherbs

I wanted to pass along this journal abstract-- a bit to the point to some degree

J Midwifery Womens Health. 2007 May-Jun;52(3):216-28.

A review of factors associated with dystocia and cesarean section in nulliparous women.
Lowe NK.

Oregon Health & Science University, Portland, OR 97239-2941, USA. [e-mail]

The primary indication for cesarean section in nulliparous women continues to be clinical diagnoses that fall under the rubric of dystocia. These diagnoses account for approximately two-thirds of all cesareans experienced by otherwise healthy nulliparous women. Contemporary research evidence suggests that this clinical phenomenon is complex and multifactorial. This review explores factors associated with the phenomenon of dystocia in the context of a conceptual model that considers women's physical and psychological characteristics, fetal factors, intrapartum care and interventions, assessments and clinical decision-making of health care providers, the sociopolitical environment, and the social and physical environment of childbirth. Clinical recommendations include emphasis on
the maintenance of normal weight and weight gain during pregnancy, delaying the admission of nulliparous women to the hospital until active labor is established, avoiding elective induction for nulliparous women, keeping women well-hydrated and well-fed during labor, providing high-quality supportive care during labor, staying the course with effective treatment when dystocia is encountered, and a renewed emphasis on the psychobehavioral preparation of nulliparous women for the realities of labor.

PMID: 17467588 [PubMed - indexed for MEDLINE]

Thanks for the abstract! If I were at the campus library, I could post some abstracts about the Gaskin maneuver (i.e. birthing on all fours), an evidence-based alternative to cesarean for cases of shoulder dystocia. Appallingly few doctors have heard of the Gaskin maneuver.

In "Born in the U.S.A.," Marsden Wagner cites research indicating that shoulder dystocia is likely to happen REGARDLESS of a baby's size. I can get my hands on the citation if anybody is interested.

In response to the OP, a doula's role is to enhance the father's participation, not inhibit it. Our doula assumed the role of memorizing my birth wishes and guiding me through labor. My husband, relieved of all of that pressure, was still able to provide moral support while wholly experiencing the birth.

Doulas often compel women to question the most questionable of obstetric practices, so it's no surprise that the OB in question was anti-doula. Even my crunchy midwives lifted brows when I told them I'd be bringing one along. (Fortunately, they ended up liking her!)

[mwherbs]

the only thing I am a bit troubled about in the abstract (that is a review) I sent along is the info on weigh gain-- and what I think about that is like another poster wrote a "healthy" whole foods diet that has a good deal of veggies and fruits- as well as some whole grains- and plenty of protein -- little to no processed sugars not so much for size of baby but for mom's health--- so the studies do stack up against over weight moms but if you think about it many providers would be treating/over treating a perceived condition and actually not ending up with good results like more c-sections which ends up making for a statistic that you have to work at understanding--

[WillowBrook]

Originally Posted by PoisonousBlonde

As for the OP, my cousin had a baby and her Dr. said her pelvis was way to small for her daughter to pass through and her baby started to go into distress, so she had to have a C section. Her baby was 7lbs 3oz.

From what I understan (from a laypersons point of view) it's not necessarily the size of the baby alone which determines CPD, but the size of the baby relative to the size of the pelvic opening. For someone with true CPD giving birth to a 5 pound baby may be just as impossible as giving birth to a 10 pound baby simply because it depends on the size of the pelvic outlet.

Originally Posted by dflanag2

Also, don't doctors know that your pubic bone pulls apart when birthing? I know mine did in both cases, and ached a bit for months while knitting back togetherbut feels fine now.

They only stretch/pull apart so far though, just to use myself as an example because of the malformation of my pelvis I would literally have to dislocate both my hips and tear myself in half in order to give birth vaginally. For women with true CPD caused by pelvic malformations it makes no difference whether or not the pelvic area stretches or opens up, it still won't make it big enough for a baby of any size to pass through.

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To the OP - If you're cousin has accepted and is happy with how she gave birth then, and I don't mean for this to sound as rude or blunt as what it's going to come out, what business is it of yours to insist she feels differently? It sounds as if you have far more of an issue with this than she does, perhaps you are projecting your own feelings about birth onto her? Not all women are traumatised by a C-Section and not all women feel they were robbed of a certain experience by undergoing a birth process that was highly medicalised. Your cousin may have liked the idea of a "natural" birth and looked at it as her ultimate ideal of birth, but at the end of the day understood that sometimes our ideals are out of reach for whatever reason and been perfectly accepting of that fact.

Before I found out about my particular pelvic formation issue I had always wanted to have a waterbirth, preferably at home with a midwife attending. Once I discovered that was going to be impossible however; that indeed vaginal delivery fullstop was impossible for me, I was fine with it. I didn't mourn the loss of a particular birth experience at all. To me it was like well ok I'd really ideally like to live in a 2 storey bluestone mansion overlooking the ocean, but that doesn't mean I won't be just as happy and satisfied to live in a 2 bedroom house in the suburbs.

[UrbanCrunchyMama]

Originally Posted by WillowBrook

If you're cousin has accepted and is happy with how she gave birth then, and I don't mean for this to sound as rude or blunt as what it's going to come out, what business is it of yours to insist she feels differently?

Three months have passed since my original post, and I haven't seen my friend since, so I don't know "where" she is right now.

Why does this effect me so deeply? Because she may represent many of the 31% of women in this country who did not need a c-section. I'm not against c-sections altogether, just the unncessary ones.

It's heart-wrenching to know that...
- she dreamed of a gentle, candlelit birth amongst loved ones and was dissuaded from getting the support she needed to make that happen.
- in all likelihood, her OB does not know how to truly support a healthy pregnant woman and her baby.
- that her situation sounded like the domino-effect that so many of us on this forum try to avoid and help others to avoid.
- on some level (whether conscious or not) she thinks that her body isn't meant to birth babies the way God had created it.
- when she is pregnant again, she will likely be convinced that a c-section is her only option (when she's twice a likely to die on the operating table during a second surgery). We do have another friend who nearly died during her second surgery because she lost so much blood. This woman has squelched her heart's desire to have a third child because she's afraid of really dying during a third surgery.

My friend may fall into the 1% of women who have CPD. My friend's baby may have never come out vaginally after any amount of pushing (after the epidural). But 68% of our friends and family (in various parts of this country) have given birth via c-section. This is insane!

Yes, the feelings around our births are as unique as the individual and at the same time, equally valid.

But how much longer do we "let" this happen to the people we care about?

[flapjack]

The sad fact is that the political is personal. At some point, women will start challenging their own birthing history and rewriting their own stories, but as long as maternity care is determined by a third body (the insurance company, or in our case the NHS) then "let" will not take its true place as the nasty little swearword that it truly is.