Is there REALLY Such a Thing as A Too-Big-To-Birth Baby? - Mothering Forums

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#1 of 51 Old 07-09-2005, 12:13 AM - Thread Starter
 
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I'm dying to know the answer to this.
I have heard too many "well she has to have a c-section because the baby is just TOO BIG"
:
I cant imagine this really ever being the case and certainly not as much as the excuse is used.....
Has anyone ever heard of/experienced a valid senario where this was a real issue?
Any midwifes have a *ooo this is gunna be a toughie* cut-off point?
Please Please tell me!
I want fodder for my next imprompto 2 cents.
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#2 of 51 Old 07-09-2005, 12:16 AM
 
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Hehehehe....I totally read a different question via your title (nothing wrong with title...eyes not reading well...) and I read Too Big to Birth *A* Baby...

hope you get the answer you're looking for...

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#3 of 51 Old 07-09-2005, 12:28 AM
 
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I know many homebirths have included big babies 12+ pounds easily and beautifully. I also konw that many 8 lb babies have been far too big to birth vaginally in hospitals.

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#4 of 51 Old 07-09-2005, 12:48 AM
 
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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.).

But, I really don't see it happening very often at all. Women are built to deliver babies, and I think our bodies would generally have some kind of built-in limits on how large a baby we'd make, paternal genetics notwithstanding. From what I've learned here and elsewhere, positioning is much more important. (I also think head size means waaaayy more than weight.)

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#5 of 51 Old 07-09-2005, 01:21 AM
 
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I guess it depends on how much damage the mom is willing to sustain - my friend has had 2 babies who were near 11 pounds vaginally. One had shoulder dystocia and my friend had very severe tears, she was still in pain nearly a year later. The other baby did OK, but again my friend had terrible tearing and will be having some kind of surgery on her urethra as a result. Does that count as too big? IMO it does!
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#6 of 51 Old 07-09-2005, 01:22 AM
 
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I wish I could remeber where I found this info. but it was that TRUE CPD (too small pelvis a very common "reason" for sections) is less than 1%
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#7 of 51 Old 07-09-2005, 01:28 AM
 
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I know of two personal accounts where the baby has been too big to birth...my personal birth and my friend's birthing experience with her first baby. My mother and my friend both ended up having emergency C-sections and both myself and my friend's baby had interesting skull features because our heads were stuck, couldn't get past the pelvic bones. Some women aren't built to birth...there used to be more women who died in childbirth. There is a time and a place for C-sections; it's the ones that are scheduled due to the convenience factor that frustrate me.

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#8 of 51 Old 07-09-2005, 01:31 AM
 
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The true answer is about one baby, one mother, on a particular day.

Sometimes, on a particular day, a particular mother is not able to give birth to an individual baby. Ya just gotta try.

I've heard the 1% rate of CPD in the developed world.

Prior to C-sections, there were babies that did not come out. The rate was much higher due to maternal malnutrition in childhood, especially rickets, which deforms the pelvis.

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#9 of 51 Old 07-09-2005, 02:33 AM
 
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My last baby was almost 10lbs with a 14 3/4 inch head. Honestly I know I could deliver a bigger one. My aunts was 11lbs. I think it depends on your pelvic size.

Jeana Christian momma to 4 sons Logan 18, Connor 15, Nathan 6, and bonus baby Jack 1
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#10 of 51 Old 07-09-2005, 02:36 AM
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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.
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#11 of 51 Old 07-09-2005, 03:31 AM
 
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I know a man who was 16 lbs at birth. His mother delivered him vaginally!! Seriously, he is about 60 now and a BIG man!! Like 6"10 and 300 lbs. And he looks smaller now cause he is older I've known him all my life (friend of the family) and he seemed biggger before. But I digress...

I can imagine it would have alot to do with the woman's pelvis, some women are not shaped properly to deliver...some women could deliver a 16lbs baby and not only be fine, but deliver 2 more afterwards...so I think my answer is yes and no. Depends on the woman.
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#12 of 51 Old 07-09-2005, 05:24 AM
 
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IMO, rarely. I birthed a 14lb-er, with an average sized head- only 14 1/2" with no difficulties. I had a 9lb baby with more problems. A lot of this, IME, is down to positioning. An unusually shaped pelvis is its own challenge, and isn't the same as the baby being too big.

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#13 of 51 Old 07-09-2005, 07:25 AM
 
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Oh! Helen you're soooo cool!!!

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#14 of 51 Old 07-09-2005, 07:32 AM
 
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As I understand it, true CPD is really rare, but things like childhood malnutrition can stunt the mother's bone growth and make childbirth difficult (that's used to be big factor in maternal mortality in this country, actually, and I'm sure still is in many many parts of the world.)

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#15 of 51 Old 07-09-2005, 08:04 AM
 
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My first was 8lb1oz delivered vaginally, my pubis (?) was separated delivering him, I don't think I would have liked him ti be any bigger
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#16 of 51 Old 07-09-2005, 10:05 AM
 
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Like others have said, its less like to happen in the developed world, where we dont see cases of rickets and other bone diseases due to malnutrition.

Optimal fetal positioning is a huge factor. There is an "ideal" way for the baby to fit through the pelvis, factors such as the direction the baby is facing, the angle of his/her head, whether the chin is tucked all come into play. Also, some women might have small maladjustments of their pelvis, due to poor posture, injury, etc which can cause the uterus to be constrained and lead to poor fetal position.

So an 8 lb baby that is asynclitic (angled wrong) may be much harder to deliver and require a Csection than an 11 lb baby who is lined up correctly - even for the same woman/same pelvis.

Searching on optimal fetal position will give you lots of info. Chiro care is also a key factor in baby positioning and aligning moms pelvis. (Not a chiro myself, just enjoying an almost pain free preganancy this time due to one! )

And the other big factor is pushing position. Laying supine in a hospital bed is not the best way to open the pelvis for delivery. I struggled to push out my 9,2 baby, but I was flat on my back with an epi, in the hospital. I am fully planning to birth a 10+ lb baby this November at my homebirth...pushing upright, in the water or on the birthing stool.

Jenn, perpetually tired mom to DS(9): DD(4.5): DD(2) :
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#17 of 51 Old 07-09-2005, 12:59 PM
 
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the only way to know is to labor - not induction and not just lying down- labor changes mom's tissues and baby's head shape.
I am not sure it has much to do with racial differences as it does with maternal environment
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#18 of 51 Old 07-09-2005, 01:47 PM
 
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My great grandmother was a big woman, over six feet tall. Her husband was just over 5 feet. Her babies were 12, 13 and 15 pounds. All vaginal, and I don't know anything about damage. But I'm glad subsequent generations got smaller, not larger.

By the way, none of those huge babies grew into particluarly large people. I've always wondered if she was an undiagnosed diabetic.
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#19 of 51 Old 07-09-2005, 02:08 PM
 
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Okay, odd story, but bear with me.
My grandfather was in World War 2 and a kamikaze pilot flew into the ship he was on. My grandmother saved the newspaper clippings. Years later, they gave all kinds of things to my dad, including the clippings. When my dad died, my mom and I went through his things and we read the newspapers.
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.
It got me thinking...how DID those conjoined twins come out? Not all of them could be joined in easier to birth positions [like, wouldn't head to head be easier to birth than side by side?] So how was it done way back when? I never hear of conjoined twins orphaned by their mother during childbirth.
So I have the same question!

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#20 of 51 Old 07-09-2005, 05:42 PM
 
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Quote:
Originally Posted by Storm Bride
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.).
[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.

: This is a serious matter and I would like to reflect more before I post, but my kid has a major diaper need now. Bad timing, Bleuet!
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#21 of 51 Old 07-10-2005, 12:08 AM
 
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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.
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#22 of 51 Old 07-10-2005, 12:33 AM
 
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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--
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#23 of 51 Old 07-10-2005, 03:11 AM
 
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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...
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#24 of 51 Old 07-10-2005, 03:13 AM
 
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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.)

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#25 of 51 Old 07-10-2005, 03:26 AM
 
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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.
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#26 of 51 Old 07-10-2005, 12:01 PM
 
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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.)
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#27 of 51 Old 07-10-2005, 12:19 PM
 
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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
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#28 of 51 Old 07-10-2005, 12:37 PM
 
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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.

Mom to 4! Welcomed Aila Wren on Friday, February 25th!
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#29 of 51 Old 07-10-2005, 01:25 PM
 
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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.
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#30 of 51 Old 07-10-2005, 03:13 PM
 
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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.

Lisa, lucky mama of Kelly (3/93) ribboncesarean.gif, Emma (5/03) ribboncesarean.gif, Evan (7/05) ribboncesarean.gif, & Jenna (6/09) ribboncesarean.gif
Loving my amazing dh, James & forever missing ribbonpb.gif Aaron Ambrose ribboncesarean.gif (11/07) ribbonpb.gif

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