Natural induction at 38 weeks - Mothering Forums
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#1 of 29 Old 12-27-2007, 07:43 PM - Thread Starter
 
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Hi, I am at 36 weeks as of tomorrow. I had my midwife visit today and asked how the baby was measuring. She said that she was a little big and at around 38 weeks they would decide whether to induce or not That being said, this practice is so kind and nice and are known for being gentle and not doing any unnecessary interventions.

I have read a lot about VBAC and talked about it until I exhaust myself with many doctors and the midwives. Except for this midwife, all have said that VBAC mamas cannot have induction with synthetic hormones. This, I am told, leads to another c-section because of the risk of too strong contractions and possible uterine rupture. I have been told by everyone else that I must go into labor naturally and progress naturally. Is this true?

My main question is this, would it be safe to do all the natural "get labor started" ideas at 38 weeks myself so that I will not be in the position to have to accept or reject medical advice? I know that many large babies are born naturally and at home and in birth centers. I really know this. I also know I will have a hard time saying "No" to these midwives and OB's because I am not confident with myself knowing all there is to know and am not assertive enough when "questioning authority." Please keep in mind that this practice is wonderful. I am treated with kindness and respect and their c-section rate is the lowest in my state, 2%

Cross-post on main Birth and Beyond page

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#2 of 29 Old 12-27-2007, 08:12 PM
 
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sorry but no one should "decide" to induce you! first of all that is your decision. second of all "big baby" is not a medical reason to induce!!

you say they aren't doing unnecessary interventions, but inducing at 38 weeks would certainly be one, and a big one at that.

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#3 of 29 Old 12-27-2007, 09:10 PM
 
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sorry but no one should "decide" to induce you! first of all that is your decision. second of all "big baby" is not a medical reason to induce!!

you say they aren't doing unnecessary interventions, but inducing at 38 weeks would certainly be one, and a big one at that.
:
:
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Honestly? I would RUN away from a midwife practice that said they would talk induction PERIOD at 38 weeks. Much less with a VBAC.

-Angela
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#4 of 29 Old 12-27-2007, 11:26 PM - Thread Starter
 
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Yes, I felt really weird when she said this. To give her the benefit of the doubt, she said this when Ivan was standing there crying because he wanted to leave and had hurt himself. I will clarify next week at my appt. Nobody there has ever given any indication that they would ever induce me, quite the opposite. There are 6 midwives and 4 OB's there. This is the first time I have met her and maybe I misunderstood, due to the noise of Ivan crying. Also, maybe she was referring to something "natural" that I did not have her clarify. I have read on these boards about all kinds of different things that I have never heard of.

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#5 of 29 Old 12-28-2007, 11:29 AM - Thread Starter
 
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I called the one midwife in the practice who specializes in maternal depression last night. She has helped me previously as well with my many issues. She assured me that I would never be pressured to induce. I did misunderstand the other midwife. She also assured me that all the midwives there "hate" induction. When I asked her why anyone would mention induction for a suspected large baby, she let me know that the risk is head getting out and shoulders being stuck and damaging the baby's arm.

She told me my best bet was to "go with the flow" and make my own heart-felt decisions as they arrive to be made.

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#6 of 29 Old 12-29-2007, 08:08 PM
 
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The risk of shoulder dystocia is increased by induction as are the myriad of other complications from interfering in the normal process of labour. It's not size of babies that matters since you can't grow a baby too big to birth. I hired a mw for a HBAC and she told me my baby was HUGE and I'd probably need another c/s. I freebirthed.
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#7 of 29 Old 12-29-2007, 08:18 PM
 
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Keep in mind that measurements of fundal height aren't accurate for determining fetal size. The position of the baby plays too great a roll in how far out they are. I've known women with 11 lb babies that measured small, and some with 7 lb babies that measured huge. What it DOES tell you is whether or not the baby is growing at a healthy rate... for instance, if you measure the same for two or more consecutive visits, it's worth checking into. So it should change, but it shouldn't be used to determine the actual size of the baby.

And induction shouldn't be considered for a 'large baby' unless the baby is estimated (by u/s) to be over 11 lbs. I'm not saying "that's when you induce," I'm just saying that's when you even CONSIDER inducing. Before that, it shouldn't even be an option.

But it sounds like your midwives know this... I just thought I'd throw it out there.

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#8 of 29 Old 01-03-2008, 12:30 AM
 
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Induction of labor is not natural. Anyway, for me personally, I would rather a repeat c/s at 41-42 weeks over an induced labor for vbac.
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#9 of 29 Old 01-05-2008, 06:52 PM
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this is a really interesting thread... I'm due in 6 weeks, and they said I could vbac as long as my baby wasn't 10+ lbs (via u/s)... My last vbac attempt ended in a c -- to our surprise, DS was 10lbs 3 oz, and wouldn't come down the pike. I had a beautiful natural labor (started at home, arrived at 6 cm, no drugs, ate, drank, moved around, fab. doula and DH...) - but we also didn't know that the big guy also posterior and chin-up. He was also 11 days late, and came thanks to castor oil (after loads of eve prim oil, a bunch of sweeps, eggplant parm, everything in the books...)

So I'm hoping for a vbac and on the same token, I'm concerned about intervening with nature incase I get things going before everything is really ready to go.

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#10 of 29 Old 01-07-2008, 07:33 PM
 
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I would never consent to a VBAC induction. I'm glad they told you that you would never be pressured. I hope your birth goes well!

FWIW, I always measured big. As in, over 40 weeks big and my babies came at 37 and 39 weeks. Neither were over 7 lbs. I don't think fundal height is very accurate for weight.

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#11 of 29 Old 01-08-2008, 07:11 PM
 
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I am due on Friday. My OB/midwife also told me there was no synthetic induction on a VBAC. My daughter to be (as of LAST WEEK) is already measureing over 8lbs...my son was 10. rather than get all caught up in size and delivery adn vbac..blah blah blah...I went for acupuncture. Last night I went to acupuncture and I'll know w/in 24hours if the "induction" worked. All the stress of talking about size of baby and vbac and everything made my mind very racy and nervous. the acupuncture if nothing else put me in a great frame of mind to start my visualization process and get this baby vagionally delivered.
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#12 of 29 Old 01-08-2008, 07:59 PM
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When I was in labor with DS, which was a vbac (ended in c...), after several hours of pushing, I felt like my contrax. just were not strong at all and were petering out so they did a minimal amount of pit drip which I tolerated very well. Still never got the "unbearable urge to bear down" - but looking back, I'm certain it was the baby's positioning...

My mw told me this time around (and it should have been last time) that they shouldn't even bother checking my dilation that frequently - but more so if I'm feeling the urge to push to make sure I'm at (or close) to 10 cm.

fwiw, I heard chiropractors and prenatal massage therapists do wonders for bringing the baby down and getting things ready.

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#13 of 29 Old 01-09-2008, 01:39 AM
 
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Gracefully avoiding the rest of the conversation to say:

FOLEY CATHETER

Non-chemical induction by means of a little balloon which opens up your cervix a wee little bit (or up to 4 cm depending how 'soft' it is) and hopefully starts to engage or promote or encourage the hormone cascade.

Worked like a charm for me at 39 weeks b/c I had been diagnosed with IUGR at 30 weeks and had a few red flags. And it was a VBAC induction.

Kate: fumbling through the best years with W, L, F & V...newest arrival coming Jan '11
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#14 of 29 Old 01-09-2008, 09:27 PM
 
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Your body cannot grow a baby that is too big to push out. If you squat while birthing, you will open up your pelvic bones about 3 cm larger than if you were sitting/reclining, and about 5 cm larger than if you were lying flat. This is the key to CPD--it is misdiagnosed because mom was not in the optimal position to give the baby the most room through the birth canal.

Here is a quote of my post in the (edit) Birth Professionals forum about natural induction for a VBAC mom.

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Although I have read extensively about herbs, this is my opinion as a doula, not a trained herbalist!

I personally feel that induction (except stuff like s*x, nipple stimulation, kissing, squatting, walking, pelvic rocking, eating spicy food, evening primrose oil on cervix + orally; all 100% harmless) should not be attempted on anyone pregnant until 42 weeks. However that is just me. I'm very low tech/non interfering.

At 42 weeks I might suggest castor oil packs on the belly or 2 Tbs. orally. If that didn't work, and the mom is soft, stretchy, and effaced (in other words very "ripe"), she could try using herbs. However, a mom with a former c-section is not a good candidate for black/blue cohosh. Every mom reacts differently with herbs and black/blue cohosh (an oxytocic herb) sometimes produces stronger-than-normal contractions, which is not good for a scarred uterus, especially one that only had 5 months of break between birth #1 and conception #2. Think of it as a natural and weaker form of Pitocin (fake oxytocin).

Other herbs such as pure Red Rasberry Leaf tea and pure Peppermint tea are non-oxytocic. You take 4 teabags or 2/3 oz. of dried herb in 8 oz. of boiling hot water; cover and steep for 30 minutes. Take Peppermint tea first thing in the morning, then three hours later take Red Rasberry Leaf tea prepared the same way. Alternate teas all day, walk and squat alot during the day, eat a spicy supper (with a raw pineapple for dessert), and end with Red Rasberry Leaf tea before bed...and then s*x! Might bump you right into labor! RRL tea works by toning and preparing the uterus for labor and P tea works by stimulating the uterus; spicy food with pepper, ginger, garlic, and chili powder work like this too.

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#15 of 29 Old 01-14-2008, 09:22 PM
 
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Your body cannot grow a baby that is too big to push out. If you squat while birthing, you will open up your pelvic bones about 3 cm larger than if you were sitting/reclining, and about 5 cm larger than if you were lying flat. This is the key to CPD--it is misdiagnosed because mom was not in the optimal position to give the baby the most room through the birth canal.

Here is a quote of my post in the (edit) Birth Professionals forum about natural induction for a VBAC mom.
I agree about your body positioning advice...but with such good nutriton available to us, babies are much bigger here than in other places, so it is reasonable pseudo-science with which to frighten mothers. The average baby born at a Camp in Uganda (where a dear friend volunteered for 2 months) was less than 5.5 lbs. I think most babies under 6 lbs around my neighbourhood are monitored closely as low-birth-weight babies.

But, having said that, I have also been told by my midwife that a 5lb baby and a 10 lb baby have the same top-of-head circumference ie 10cm. However, the shoulder measurement would be different.

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#16 of 29 Old 01-14-2008, 10:23 PM
 
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That's interesting information! I agree that babies are being born larger now than, say 100 years ago (or nowadays with malnutrition)---but we as adults are also larger! The average height of adult men in the 1600-1700's was about 5'3"-5'5"; now such a small man is an exception, not the rule. Women also, were 4'-5' tall and often less than 100 pounds. Check out the colonial or civil war dresses and shoes on display in museums; they look so small! I do know that corsets contributed to this (I am a civil war reenactor and history buff), but most women did not corset tightly for everyday wear; that was more of a special occasion thing when they were wearing a ballgown.

Sooooo--- for right now, I'm sticking with my theory that women, barring rickets or some kind of disease or deformity, cannot grow a baby that they are not capable of birthing.

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#17 of 29 Old 01-15-2008, 02:10 PM
 
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Induction of labor is not natural. Anyway, for me personally, I would rather a repeat c/s at 41-42 weeks over an induced labor for vbac.
Sorry to hijack the thread Ivan's Mom but...

Gator I was wondering if you could expound on your thoughts about ERCS at 42 weeks vs. induction natural or otherwise.

I went to 41 weeks 5 days and caved to prostin and ended up with a section. My OB will not induce but has told me that if I go to 42 weeks this baby is coming out somehow

I don't want an RCS but how did you come to terms with it? Is it just the risk of rupture? (that's enough for me btw)

I will speak with my OB about natural methods in a few months
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#18 of 29 Old 01-15-2008, 05:47 PM
 
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Sorry to hijack the thread Ivan's Mom but...

Gator I was wondering if you could expound on your thoughts about ERCS at 42 weeks vs. induction natural or otherwise.

I went to 41 weeks 5 days and caved to prostin and ended up with a section. My OB will not induce but has told me that if I go to 42 weeks this baby is coming out somehow

I don't want an RCS but how did you come to terms with it? Is it just the risk of rupture? (that's enough for me btw)

I will speak with my OB about natural methods in a few months
I'm not Gator, but my DD was born in a similar manner to yours -- and I agree with Gator's thoughts.

I went to 42 weeks with no contractions, effacement, dilation, nothing. I was pressured to be induced but due to scares about shoulder dystocia, my OB thought it best to just do a C-section. So that's what I did.

This time around, I've been doing a lot of thinking about what I would do should the same thing happen. I do not feel comfortable at all with a pitocin induction. The risk of rupture is higher than natural labor and I do not feel comfortable with that. . so I would just opt for another C-section.

However, I am totally comfortable with natural methods of ripening and induction (evening primrose oil, accupuncture/accupressure, RRL tea, membrane stripping, and castor oil as a last resort, etc). I plan to really start all this around 40-41 weeks to hopefully get labor going.

If, however, I again made it to 42 weeks without any progress at all, my MW legally must transfer me to an OB. At which point, a c-section would be pretty much inevitable.

I've reconciled it in my mind simply by remembering that I'll be doing everything in my power to get labor going in a manner I feel comfortable with. I would start off now by doing research on all sorts of different induction methods and making a list of those you feel comfortable with and those you don't. Then when the time comes, you can make sure you try all the ones you feel comfortable with. If nothing happens, then you know you've given it your best shot.

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#19 of 29 Old 01-16-2008, 02:54 PM - Thread Starter
 
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Thanks for all the replies. I am so confused on so many issues about this birth.

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#20 of 29 Old 01-16-2008, 04:10 PM
 
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IvansMom--you're around 39 weeks now, right? What's going on? Remember to have patience with your body and don't let any midwife coerce you into a chemical induction or repeat cesarean that you don't want. Good labor/birth prayers going your way! Have an awesome birth!

Proud wife to my handsome husband partners.gif Malachi David (2010) and Jeremiah Daniel (2012) joined our family via two lovely homebirths. Rainbow.gif Doula for 7 years and now finally an apprentice midwife! bellycast.gif 

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#21 of 29 Old 01-16-2008, 05:36 PM
 
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There is such thing as natural induction........its called SEX!!!! Nipple stimulation is good too! These and a few other safe things will only work if your body is ready. BELEIVE ME i tried it all at 40 weeks, 41 weeks, 42 weeks!! Didnt work till i was ready. I had my singleton babies all over 42 weeks and they were 8 lbs, no complications. some womans bodies just cook them longer then others. There is no reason to have a c-section or be induced at the hospital unless there are pregnancy or baby complications happening. And even if they can tell you will some accuracy that you are having a big baby that doesnt mean it cant come out vaginally. its more to do with bone structure, all the other poundage is squishy. I just think of cave hunters or spalunkers who some how squeeze their adult bodies threw 1 foot long holes in the sides of mountains.

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#22 of 29 Old 01-17-2008, 01:26 AM
 
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Sorry to take so long to respond.

As far as the repeat, If my OB was pressuring to either induce or do ERCS then I would opt for the repeat. Mainly because I would not want a pitocin induced labor, for one thing the risk of rupture is increased and I think it is safer to have a repeat over being induced. If I wasn't comfortable with either, then I may try negotiating for daily NST monitoring or something instead of rushing to the OR at 42 weeks on the dot, especially if I or people in my family are prone to going "overdue".

I agreed to scheduling a 42 weeks repeat, partly because I had to go to a new practice at 41 weeks and the old provider kept mentioning pitocin and stressing me out. I actually relaxed a lot after "knowing" what would happen if I did not go into labor. But, I had gone past 42 weeks (for sure) with my first but he was breech and sometimes breeches will go late (from not being in a good birth position? I don't know, but he was double footling and that isn't a great position). The night of my appointment and scheduling the repeat to get the doctor to chill out, I went into labor. I think it was partly a mental thing for me. The doctor was very cool about discussing her schedule that week and was fine with me going several days over 42 so my "surgery" would be on the evening she was on call which happened to be a Friday and that was the best possible timing for my family etc.

At the time, I also was not sure if something was up with my pelvis that had caused my first to be breech in the first place. And at 41 weeks, I had experienced no impending symptoms of labor, and being a previous l/d nurse, I know the laundry list.

So, essentially, I think if I was pushed one way or another, or had a medical indication to deliver early, I would not agree to misoprostil, cervidil or pitocin induction. Maybe some nipple stim, since at least that is a hormone from your own body.
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#23 of 29 Old 01-21-2008, 12:59 AM
 
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With my first they told me he was measuring big, and they expected him to be over 9 pounds! He weighed only 7 pounds when he was born.

Again with my last pregnancy they told me I was measuring big from the beggining, but again my baby was a normal size.

Than this pregnancy, guess what? I'm measuring big again already. My midwife says it is because I have a shallow pelvis and short torso, so it sticks up more. It's normal for me...
Tara

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#24 of 29 Old 01-21-2008, 05:44 AM
 
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sorry but no one should "decide" to induce you! first of all that is your decision. second of all "big baby" is not a medical reason to induce!!

you say they aren't doing unnecessary interventions, but inducing at 38 weeks would certainly be one, and a big one at that.
: OP you contradict yourself by saying the practice is gentle and kind, and then saying they want to induce or are considering it! : Also, a PP mentioned sex and nipple stimm as "natural induction" methods. While they're not unnatural, I think doing them with the hope they'll start labor would be a bad idea. B/c if labor doesn't start (which it won't unless you and babe are truly ready), you'll be discouraged/frustrated/etc and that in itself could put off your labor as well. Your expectations and mental/emotional state have as much to do with when you go into labor as your physical condition. Just think about this and try to be as peaceful and stress-free as you can. Tell your MWs that YOU will make the decisions, and leave it at that. ! ! !
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#25 of 29 Old 01-21-2008, 10:26 AM
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Regarding measuring big, would you trust, to some degree, an ultrasound done from a perinatologist at 38+ weeks to get an idea of size or head circumference? How would this influence your decision?

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#26 of 29 Old 01-21-2008, 03:40 PM
 
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Regarding measuring big, would you trust, to some degree, an ultrasound done from a perinatologist at 38+ weeks to get an idea of size or head circumference? How would this influence your decision?
No, I wouldn't. Ultrasound that late in the game is notoriously inaccurate. . can be off up to 2 lbs either way. I was told my babe at 41 weeks was probably 7.5 lbs, turns out she was a whole pound lighter. Either way, I wouldn't let that influence my decision to induce.

But an ultrasound that late might help determine if there's another problem at play, like too much fluid or an improperly functioning placenta.

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#27 of 29 Old 01-25-2008, 06:26 PM
 
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I had a late U/S that said I was low on fluid (the day before birth) and I was induced for this reason (and a couple others....all 'discovered' by ultrasound and I was not low on fluid as evidenced during the birth.

Because of all the stresses I encountered due to u/s "diagnoses" I will never have another u/s. They just aren't accurate. It's like guessing how much gas is in your car by weighing the car...hello? Is there anyone in the car? Are there bricks in the trunk?

Kate: fumbling through the best years with W, L, F & V...newest arrival coming Jan '11
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#28 of 29 Old 01-25-2008, 06:50 PM
 
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#29 of 29 Old 01-26-2008, 09:39 PM
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they cant really tell how large the babies are. and what is "too large". a good MW knows how to deal w/ shoulder issues, etc.etc.
E was my smallest at 8.4. i just wonder what that MW considers 'large'.
i know that if i had been induced and my labor had been any more painful, i would have ended up getting a 3d c/s.

good luck!
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