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If you VBAC'd a baby with a large head

5K views 17 replies 17 participants last post by  audsma 
#1 ·
What was the size of your baby's head and how long did you push? Did you tear (what degree)? Was it a hospital vbac, birth center vbac, or a homebirth?

I am two weeks from my due date and two weeks ago at 36w5d I had an u/s that showed his head measuring 38w6d. I know that late u/s aren't always accurate, and that his positioning could play a big role in the measurements that were obtained that day, but DD has always had a big head (above 90% since she was born) so I'm thinking it's correct.

I have a mw appt today and I'm going to ask about how long I will be "allowed" to push before they consider a repeat c/s. I'm a small-framed person (not even 5') so I'm a bit concerned that it might take me longer to push out a baby with a bigger head.

I guess I'm just looking for your experiences. Thanks!
 
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#2 ·
I'm planning a VBA2C in mid-April so I haven't pulled it off yet. But I've done lOTS and LOTS of reading about childbirth and here's what I've learned.

U/S are notoriously INaccurate in the last trimester. I know you said your daughter had a large head but keep in mind that every baby and every pregnancy is different. I wouldn't put tons and tons of stock into it. Kind of take it with a grain of salt, ya know? Like be aware of it as a possibility but don't get overly freaked out by the thought of it.

Also, the pelvic bones expand a great deal during labor. Maybe I've read like 26% or something....or maybe it's more. I can't recall exact figures. But your body can accomodate the baby it grew.

I would recommend doing yoga squats to help open up your pelvic area. Stand with your feet a slight bit more than shoulder-width apart. Put a pillow underneath you, between your legs. And squat down, resting your bottom on the pillow so that your poor legs don't have to support all of your weight. Do this often.

Sitting on a birthing ball will also help open up the pelvic region. Sit on it to type on the computer, to watch tv, to read a magazine, to do your nails.....as much as you can.

Also, keep in mind that pushing while lying down significantly inhibits the expansion of your pelvic bones. Try to plan to push in a squatting position or on all 4's. On your back is the WORST position to be in for pushing.

Finally, in Ina May Gaskin's second book (can't remember what it's called), there's a move in there used to help expand the woman's pelvic bones during labor and pushing. One person stands on each side of hte mother and pushes in at her hips (you'll have to read it b/c htere may be more to it than that). This simultaneously widens the pelvic bones to allow a bigger baby to descend. Your local library probably has this book. Or, one of these posters probably owns it (I checked it out at the library and have given it back already) and they could quote it verbatim for you.

I would say to try not to get overly concerned about this. Many, MANY a woman has birthed a baby bigger than the one that was sectioned out of them with the diagnosis of "baby too big--won't fit." When they VBAC, they birth babies that are a pound or a pound and a half BIGGER than the one that was sectioned. I think a lot of it depends on the skill of the person helping you deliver, and since you're with a midwife, hopefully that will help versus being with an ob!

ALL THE BEST!!!!!!!
 
#3 ·
Definitely be aware of how your position will affect your pelvis. More squatting, less laying down, etc. My VBAC's head was in the 90th percentile too. Just remember that the bones flex, your pelvic flexes, you soft tissue will stretch.....I did get a 2nd degree tear,but blame that mostly on the doctor. My baby had an arm up and the OB was very rough about it. Not very supportive of my squatting position or insistence on pushing with my urges instead of his promptings.

All you can do is the best you can do! Take care!
 
#4 ·
Hopefully it'll make you feel better, DS1 born via c/s had a 14.5 inch head(his head was in the 95% all pregnancy), pushed for 2 hours. DS2 born via HBAC turned hospital VBAC had a 14.75 inch head(no ultrasound measuring him no idea what %) and came out in less than 10 minutes of pushing. I had 2 second degree tears but that was because of the explosive birth and lack of labial support.
 
#5 ·
Let's see... my VBAC baby's head was in the 80th percentile at birth (can't remember what her actual measurement was), and I pushed for a little over two hours. (I had an epidural, and they overdosed me, so I wound up pushing flat on my back -- uphill. Even so, if I had been less afraid of pushing, it would definitely have gone faster.) I tore just a little -- 4 or 5 stitches, I think. I'm 5'2" and not overly big-boned, though not excessively tiny either. I don't think it matters too much what size your pelvis is. It can stretch a lot! It's made to do it. It's why we waddle at the end of pregnancy.

Nealy
 
#7 ·
My VBAC baby had a huge head (over 14 cm. I think). She crowned for 45 minutes while my midwife did perineal massage and told me to push SLOWLY. In the end, I only had a small tear on the inside from her shoulder that required 2 stitches.

And after my daughter came out, her head had different size "rings" on it from crowning and being pushed out so slowly. lol!

Oh yeah, this was in a hospital.
 
#8 ·
I worry about this too. I'm planning a VBAC, and my DS was huge - 10lbs 12oz, head was waaaay above the 97th percentile. I'm already measuring 2 weeks ahead, at only 16 weeks, and whilst I take measurements with a large grain of salt, I am pretty sure I am having another big baby.
 
#9 ·
15.5cm!!! Home in the water, pushing on all fours. My CS baby had a smaller head, but was acynclitic (bad fetal position probably from bad mother position/induction- not given a chance to move around). Had a small tear, we opted not to suture- but probably could have used 3-4. Healed fine.
 
#10 ·
I think everyone saying cm means inches


Quote:
Normal term newborn head circumference: 33 to 38 cm
Ds2's head was 35cm or about 13.8inches. However, he came out widest part of his head first (he was born facing my hip) & I think his head was still pretty moulded when we measured. I maybe had a couple skid marks. The internal bruising was worse.

It was UBAC & I pushed for a very long time, but he was stuck for quite a bit of that time & my pushing was very ineffective for most of it, too.
 
#11 ·
I had a hospital VBAC with a midwife. Baby's head was 14inches (that's not overly big though, is it?) with no moulding of her head. She came out officially in an 18 minute "pushing stage", though I only consciously pushed once, which was unfortunately when she was crowning. She shot straight out. Which meant I had a 2nd degree tear. The midwife, my husband, and my doula didn't actually witness her birth, as no one was actually expecting her to come out so fast. I was on all 4s on the floor, and I think she may have been posterior.

I went to a chiropractor and I'm convinced that it helped ensure my pelvis was roomier, plus I was listening to a hypnosis CD during labor (though the hypnosis didn't really work too well on me, it did relax me and focus me a lot).

My first baby had the same sized head, and was "failure to progress", also a posterior baby. We have a video just after she came out by C section of the pediatrician examining her and saying, "That head was just a bit too big. C section was the right way to go"! So I did have my doubts, and was pleasantly surprised that my pelvis birthed the same sized head the second time around!
 
#12 ·
YES! Inches. oops! I agree that though I didn't have a big tear, I felt the internal bruising was the most painful. I pushed his head out slowly, and he had several "rings" you could see. lots of moulding.
 
#13 ·
I don't know if mine were considered "large", but they were both 14" and POSTERIOR so it is the largest circumference of the head coming through. I pushed for 1 hour45 minutes w/ first and 1 hour 30 minutes w/ the second. I tore big time w/ first (inside, I had a episiotomy, which was my choice bc I wanted to cut off any time I could---I was breaking in two) and hardly at all the second time (no epis either).

They both came out sunny-side up.

The key for me was no epidural. I could never feel to push w/ an epidural. It was really tough w/out one. I had an epi the first time and got cut. I don't know for sure if I would have had a c/s w/out an epidural, but my odds would have been better.

My ob said I could push as long as I needed to, as long as heart tones were good.
 
#14 ·
Mine have got bigger lol my c/s bubba was 34.5 cms, 1st VBAC 35.5cms and 2nd VBAC 36cms. My last baby was my biggest head at 36.5cms (14.4 inches) he was born at home after a couple of pushes but his shoulders got stuck, so took a little while longer. I only had a slight tear.
 
#15 ·
Quote:

Originally Posted by raek622 View Post

I have a mw appt today and I'm going to ask about how long I will be "allowed" to push before they consider a repeat c/s. I'm a small-framed person (not even 5') so I'm a bit concerned that it might take me longer to push out a baby with a bigger head.

I guess I'm just looking for your experiences. Thanks!

I personally know women who have pushed out 10+ lb babies, with no help from anyone else. And the women were 5 feet to 5feet two. What is more important than an ultrasound of the baby's head, is the ability of the mother to move freely, be upright, use water or other non-chemical means of pain relief, and have the freedom to move however she needs to get the baby in an optimal position(stay away from reclining or laying on your back) and let her pelvis open freely and the baby's head to mold like it normally would. That would help the babies be born to even very small moms, cuz the pelvis is not solid rock, and the head plates fold over one another, making it easier to dive under the pubic bone. That helps the success of VBACs, the most, as well as a supportive labor crew.
 
#16 ·
I have had three big-headed babies. The first was 10 lbs 6 oz with a 15" head. My midwife had me purple-pushing on my back before I felt the urge, and I pushed for 5 hours total before agreeing to a c/s. The second was 8 lbs 10 oz, but also with a 15" head. This time I waited for the urge to push, pushed only with the urge, and stayed in an upright (modified hands and knees) position. I pushed for 30 minutes before he was born, and had only one 1st-degree tear that needed no repairs. My last baby was 10 lbs 8 oz and had a 15.5" head. Again, I waited to push, pushed only when I needed to, and only pushed for 30 minutes (less, actually), and this time I had no tears, not even skid marks.

It's all about positioning, patience, and listening to your body.
 
#18 ·
I can't find the stats at the moment, but my HBAC baby had a 14" head, and I pushed for 42 minutes or less. I had several second degree tears, but we did not actively try to avoid them-- no perineal massage or blowing through the pushing contractions, etc. You can do this!
 
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