13lbs baby delivered vaginally in Iowa

Ania - posted on 01/31/2012 ( 28 moms have responded )

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http://www.facebook.com/l.php?u=http%3A%... eo-02921%3Ftrk%3Dfbfp&h=pAQGk640ZAQFr4UbMHVcTeWU1HB0PZq7RificVVhtf3YCZQ



Did anyone see this post and a video?

Wow!!!I had a natural birth, but my baby was 8lbs. Maybe this is not possible for every woman, but obvioulsy is and judging from the comments under the story there were many instances of women having bigger babies vaginally.

Do you think that women in many cases are denided and scared into c-sections for no reason (it is a serious abdominal surgery) because of the claim that there baby will be too big (often it is mych smaller than ultrasound predicted) or you think it is good that doctors are cautious and cutting women open to get babies out just in case...

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Mary - posted on 02/05/2012

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I think it all comes down to how much risk one is willing to take. If a baby is thought to be exceptionally big, both the parents and the care provider need to make a joint decision about just how much risk they are willing to take. At best, it's an educated guess. There is no way to know, without question, whether or not a baby will "fit" until you try. It should also be noted that some babies who "fit" do so with varying degrees of damage to mother, baby, or both.



I'm not saying that everyone who is suspected of having a big baby should automatically be sectioned. I'm not even saying that some sections for either LGA or macrosomia aren't unwarranted. I am, however, responding to some of the comments that have popped up in this thread that seem to suggest that this birth is somehow proof that everyone is capable of delivering vaginally without (severe) consequences, or that a woman will not produce a child that isn't too big for her body. There are a multitude of deliveries that prove this thought process to be mistaken.



It's not just the size of the head that matters, either. Shoulder dystocias are a truly terrifying thing. The head comes out, and the shoulders get stuck. Often, there are maneuvers and position changes that can help this, up to, and including intentionally breaking the baby's collar bone to help it "fit" out. Some of them, despite all of that, still won't fit - in which case, that baby dies.



Some of these kids do okay, and others suffer irreparable brain damage as a result of that compressed cord not supplying adequate oxygenation while they are stuck. Some will experience brachial plexus nerve damage of varying degrees of severity. These injuries can range from a transient immobility of the affected arm for a few days after birth, to a paralyzed arm that requires extensive surgery to repair.



Why do doctors recommend sections on big babies? Some of it really is because they, like the rest of humanity, truly do not want to see a mother or baby permanently harmed. If you knew you had the ability to prevent a catastrophe, wouldn't you be more likely to chose that route? Some of it is also fear of being "punished" for "allowing" a woman to attempt a vaginal delivery of a baby expected to be big.



Google brachial plexus palsy or shoulder dystocia. I guarantee you that something like this will pop up at the very top of the list:



http://birth-injury-malpractice-law.com/...



This quote is taken directly from this site:



" Below are some examples of negligent care on the part of doctors, nurses, and other health care providers that can result in Brachial Plexus injuries:



*failing to properly estimate the weight of the baby.

*failing to determine that the baby's shoulders are too large



to fit through the birth canal.

*Applying excessive lateral traction to the fetal neck during delivery."




Before you all jump to bash OB's or midwives for recommending elective sections for a "big" baby, please consider that.

Tanya - posted on 01/31/2012

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I think it's awesome, as long as she didn't have tremendous damage.



I had my 10 lb son without any pain meds. It was awesome! Pushing didn't actually hurt, it was just really intense pressure. I had a second degree tear, but probably only because I had to actively push him out at the end due to a low heart rate. If I'd continued to push WITH my body, I probably wouldn't have torn. He came out in 13 minutes, which was just a bit too fast.



If I have a third boy, I expect he'd be around 10.5 lbs. Doesn't scare me at all. I know I can work with my body to birth my babies.



C-sections for babies that are "too big" irk me. If you go into labour, try lots of different positions, and the baby doesn't move down, then you know it's too big! Things like shoulder dystocia CAN happen, but usually they are the result of a dysfunctional labour (ie. mom is lying in bed unable to move into different positions to allow the baby to descend).



Lying on your back to push is probably THE most dysfunctional way to push, because it makes the pelvis SMALLER. It's a wonder that women can get ANY baby out that way!

Janice - posted on 02/03/2012

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I live in upstate NY and how many ultra-sounds you have depends on the doctor but the average is 3 or 4. My OBGYN does do a US at 36 weeks to check weight and I just like getting an extra glimpse. But those weight checks can be really off. With my daughter they were right on but with my son his weight slowed at the very end - I could just tell, don't ask me how - and he was smaller than expected (still bigger than DD). My friend was high risk and had a US every 4 -6 weeks and they said her so would be 10+ lbs but he was only 8lbs 3oz at 39.5 weeks.

I do think women are scared into c-section unnecessarily sometimes. Typically, your body will not make a baby it cant deliver. My friend is average weight and height, bigger than me, yet her babies were both tiny, while mine were average weight. My hips are wide and then widened further during pregnancy. She has very narrow hips. Every woman is different and obviously some can birth a big baby no problem.



A women who had an 11lb baby recently said to me "Its not the weight, its the size of the head" I think that makes a lot of sense too!

[deleted account]

As a mom whose child was in fetal distress... I would say a c-section is better than takinhg the chance of going through labor then finding out the child can't come out and is in distress. Nothing is more scary than seeing your baby come out grey and blue and nonresponsive because they were under too much stress.



Sometimes the risks just aren't worth it.



However that decision shouldn't be made lightly. There are a lot of variables that go into a child getting stuck. All of them should be accounted for.

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Natasha - posted on 04/11/2012

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I have birth vaginally to a 10lb 15oz baby - and mind you she had a bowl movement as soon as she was born BEFORE she was weighed. It was not an easy delivery and we did experience some complications with her shoulders not moving under my pelvic bone as it should have, it felt like forever before she was actually birthed but in all reality it wasn't that long of a time. In NC we get 1 ultrasound unless there is a medical reason to later - so the doctors were unaware that she was so large. I had told them she felt different in her movements than my other 2 (she is my 3rd child) but I assume are used to women saying they think their babies are huge, so kinda ignored my concern. I am now pregnant with my 4th child and I know they will want to induce earlier in my pregnancy just so that we don't experience another large baby. I know in my hospital at the time Sarah was the largest baby delivered vaginally there for many many years. It is possible, but its def. something to discuss with the doctor before you make the decision to either deliver naturally or with a C-section. Much Love to you all!

Caitlin - posted on 02/07/2012

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If my doc had known the weight of my third, i'm sure he would have recommended a c-section. My first was 8 lbs 8 oz. and needed a forceps delivery (she had a huge head apparently and there's a dip in my pelvic bone that makes it hard to deliver bigger babies). She was also in distress at the end, her heartrate dropped in the 20-30 bpm range. I had horrible tearing from that one! She's fine and healthy now.



My second was 8 lbs and it was a fine delivery. My third the pregnancy was going fine like all the others, I was measuring on par with the other 2 babies and my ultrasound that was done at 18-20 weeks (the only one that they do here unless there are issues) said he was right on par with his 2 sisters. He was born 2 days early at 9lbs 14 oz. The birth was hell - I was not only epiduraled but he was preesing on a nerve in the birth canal that had me screaming in pain and they had to boost me with more pain meds.. Labour took FOREVER (it seemed - it was about 20 hours) and it seemed like longer because even the epidural and the pain meds didn't cut the pain completely. I was miserable. I was lucky to not have issues with the actual delivery part though. He was brifly caught on my pelvis, but i think things were more elastic on the third than they were on their first and he got through just fine, but BOY was everyone surprised at his size! (His head was the same size as my first too, I have big headed kids because I'm big headed)

Allison - posted on 02/06/2012

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I respect her and yet i am excessivly happy that i'm not her. i feel bad for her poor vagina. well i know that vaginal is the best way to go but i have never encountered a doctor that demanded c-section. they said vaginal is best unless there was precident to do c-section. like previous ones or health reasons or something. i dont know and never heard of a dr tell any patient to not give birth vaginally. so i cant really answer your question. but jeese how big was this lady? was she big? i just i guess i'm curious why was this kid so freakin large?

Mary - posted on 02/06/2012

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The problem, Kelina, is that those specific details are only relevant to that specific mom and that particular baby. Even the same mother can have two drastically different outcomes with each baby. I've seen a woman push for over 3 1/2 hours with a 7lb baby that never descended even a millimeter turn around two years later and blow out an 8.5lb baby with only a few pushes. The difference?...position of the baby's head. Child number one was direct OP (sunny side up), and baby number two wasn't.



The best that any practitioner can do is make an educated guess based on each individual woman in each individual pregnancy. They are not gods, nor is there any magic eight ball to tell them what to do. Even after the delivery, do they know, for certain, that they made the right or necessary call? No. There is no magic do-over to prove that that woman could or could not have delivered vaginally. There is no set weight that is "too" big. I've seen women put forth no more effort than a hard sneeze to push out a 10lb baby; I've seen others push for 4 hours and still be unable to push out a 6lb kid. Maternal size isn't a good indicator either. An otherwise petite woman may have a pelvis that a truck could fit through, and a 6ft woman might have an unusually small one, or one that is oddly shaped. (20 yrs of nursing has led me to believe the best indicator of pelvic adequacy is shoe size - I worry about anyone with a foot smaller than a US size 6 - but that is far from scientifically proven!).

Ania - posted on 02/06/2012

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Good points Mary. You are right, but I'm telling you what I've noticed here where I live and talk to other moms - we have weekly meetup groups, different women are coming to the mix I can state that In NY women are really pushed into c-sections or inductions that are not at full term, because they are sent to these ultrasounds at 37 weeks - everyone....and are told at least 50% of the time that their baby measuers big. meanwhile they are very average. On the night my son was born and he was 8 lbs he was the biigest out of 11 kids in nursery and half of them were c-sections, for different reasons of course....I'm just fed up with obgyns in NYC. Even now with midwife practice I've been already sent to 2 sonograms at 12 weeks and 20 weeks (this one is obvious) I'm definately refusing to go for 37 weeks unless medically necesarry

Kelina - posted on 02/06/2012

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sorry mary I was pretty tired when I read your post last night, i must have skipped a few parts. I guess I'd need to read into it a bit more. I see these birth stories of women having their babies c-sectioned because they were "big" and they turn out to have been 8 lbs, 7 lbs, sometimes smaller. What I'd like to see more clarification from doctors on when they choose to do a c-section is why baby was too big. Birth weight? womans birth canal? and what constitutes too big? 9 lbs? 10 lbs? The problem is that rarely are birth stories detailed enough for me to glean these details :) However I ahve a lot of issues with the whole health care system when it comes to pregnancy and birth. There's a lot of things that happen that are unnecessary on both sides, health care and parental, that drive me absolutely insane because they totally could have been prevented if mom had been more educated or doctor had been less pushy.

Mary - posted on 02/06/2012

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Kelina, I'm very aware that a baby's size (or weight) alone is not foolproof indicator of a successful, uncomplicated vaginal delivery. It's all about that baby's size and position in proportion to the shape in size of the mother's pelvis.



The point of my post was twofold: to remind everyone that one mother's uncomplicated vaginal delivery of a 13lb baby is not proof that every woman is capable of this, as well as the fact that vaginal deliveries can result in harm to the baby. (I didn't even go into the damage that can occur to the mother - I have seen more than a few demolished bottoms that required extensive repair).



I also said that there are most certainly times when sections are recommended that are, perhaps, unnecessary. The problem is - how exactly does one prove that claim? Even if a woman undergoes an elective section because the EFW was 9lbs, and the baby is only 8lbs at birth that doesn't automatically mean that the baby could have "fit" without complication. All that was conclusively proven was that the EFW wasn't accurate (which, given the use of the word estimated in that term, is already implied).



To clarify - I am not advocating that every woman who is suspected of having a "big" baby should automatically be sectioned. I am only pointing out that she should be made very aware of all potential consequences that could occur. Both the mother and the doctor need to jointly determine how much risk they are willing to accept. Yes, some docs are much more apt to err on the side of caution. Often, these are the ones who have had some really catastrophic outcomes with a baby who got "stuck". Fault them all you want for being quick to cut. However, remember that they are only human, and just like the rest of us, they are impacted by prior bad experiences.



It is really easy to sit at home behind your computer and say what someone else should do. It is entirely different when you see that baby get stuck, watch as it turns bluer and bluer, needs a full resuscitation at birth, spends weeks in the NICU, and is irreparably brain damaged. It is entirely different when you have to see that woman in the office 6 weeks later, and she is crying inconsolably because her beautiful precious baby is going to need a lifetime of special care. It is different when a few years later, you are sitting in court, listening to an attorney, and an army of paid "experts" say that you could have prevented all of this if only you had performed a c-section.

Kelina - posted on 02/05/2012

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I'm curious though Mary what the ratio of babies delivered with those complications who aren't big as opposed to babies delivered who are is. See, the size of the baby isn't always the determining factor. And it isn't always size of baby but like someone else pointed out, the size of the head and shoulders. My SIL's baby was 6 lbs ish. I think she was closer to seven but can't remember. But she could never have birthed baby. Her head was just waaaaaaay too big. My kids were both closer to 8 pounds and had smaller heads than hers. Not to mention some women just aren't made for birth. Their bone structure isn't right for it. When I have time and energy I will probably go looking for those stats but for now, i'm exhausted lol. I just don't think it's right to recommend a c-section based on guestimated birth size alone, expecially considering that that can be incredibly inaccurate. I was told my daughter would be more than a pound smaller than she was. And when they come out that small a pound can make a huge difference.

Ania - posted on 02/05/2012

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Good for you Emma!

Someone said about the size of the head, I agree with that too. head is the most important part, the rest somehow will go through, sometimes there are issues with shoulders, too though. Big baby Kayla :) congratulations :)

Stifler's - posted on 02/04/2012

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Usually it has to do with the heartbeat, the cord being wrapped.. those kind of things. Not always "the baby is too big... women can't give birth to a baby over 7 pounds!!!". I had a scan at 37 weeks in case the baby was big etc. and even though he thought she'd be big no one offered me an elective c-section just in case.

Kelina - posted on 02/04/2012

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Not necessarily. I'm not sure what the procedure was or what kind of medical care she recieved, but if she was with a midwife they may have only sent her for one ultrasound or none at all if she didn't feel she needed it. My midwife told my husband the biggest baby she's ever delivered vaginally was 12 lbs 13 oz which really isn't all that far off or 13 lbs. and if the baby is head down and dropped why not? Sure all of us will wince and cross our legs and eyes and moan with the thought of the pain at a child that big passing through the birth canal but until there's evidence that it can't happen why shouldn't it?

Jodi - posted on 02/04/2012

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It is only standard here to have one at 18-22 weeks too. BUT, they do measure you at appointments, and if they are concerned will send you for more ultrasounds. I only had the one with my son. But because with my daughter, my measurements were tiny, my OB was concerned about her size, so he sent me off for another ultrasound, then another, and another, and another, and I had a 5lb 2 oz baby, so I can understand their concerns and wanting to monitor the pregnancy more closely.



A woman having a 13lb baby would be been measured, and would have been obviously much bigger than average I would imagine. So she *should* have had more scans to check on the size and development. So while I understand that ultrasounds can be notoriously wrong, I am assuming the doctor WAS aware that this lady was having a bigger than average baby.

Mary - posted on 02/04/2012

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Sherri, it's similar here in the Baltimore area with regards to ultrasounds. Unless there are complications, you only have that one anatomy screening at around 20 weeks. That's all I had with my daughter (and I was considered a little bit of "risk" since I was 38 when she was born). The vast majority of women I've delivered only had one US as well - and most of them were pissed about it, since they expected and wanted to have more in-utero pic of the baby for their scrapbooks!

Kayla - posted on 02/03/2012

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I just had a 12 lb baby completely natural. Vaginal birth and no drugs whatsoever. My ultrasound at about 36 weeks stated that the baby was about 10lbs but I didn't believe it really cause when I had my first baby, the ultrasound 1 day before I had her stated she was measuring in around 9 lbs and she was born at 7lbs so that was wrong! I guess with my 2nd baby the ultrasound was more accurate but you never know exactly how big the baby will be until it is born

Ania - posted on 02/03/2012

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I guess every state has its rules. Here in NY and possibly in NJ it is crazy!!! I'm telling you ladies you get 3-4 ultrasounds during pregnancy. Brittany I didn't know that babies actually slow down at the end, good to know. I never believed in those ultrasound estimations either, I've never met a mom that had a huge baby. I mean 8-9 lbs is not small I'm not saying that, but for most women it is possible to deliver.

[deleted account]

Wow Ania that is horrible. My doctor was worried about weight gain with both of mine (I loose weight during my pregnancies). But that ultrasound was done at about 32 weeks, they didn't even give me an estimate for birth weight.



I would think that at 37 weeks that most babies would be at about their birth weights. I thought that by that point their weight gain was slowing down.

Sherri - posted on 02/03/2012

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In NH you get one ultrasound at 18wks and will never get another unless there is a medical reason too.



I only had one with my first 3. This one has just been a different pregnancy and I have had loads of complications so I unfortunately have had to have several but that is not the norm.

Ania - posted on 02/03/2012

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Oh I was just talking about the woman from the article. Had the dr known that baby will be this big , he would not let her have vaginal delivery. I don't know where you are from but in NYC women get 37week ultrasound - everyone and their baby's weight is estimated magically the weight is always 7, 8 lbs at 37 weeks and then drs scare all these women to c-sextions saying that their babies will be huge like 10lbs!!! and at this point plenty of women schedule c'sections. I know so many stories from the moms I know around me that it just makes me sick.

Sherri - posted on 02/02/2012

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Why Ania?? I get to deliver anyway I wanted even with my hospital births and no doctor would tell me I couldn't deliver the way I wanted or was most comfortable.

Ania - posted on 02/02/2012

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My first one was quick and I actually preffered to stay in bed in a sitting position with my husbands arm digging into my back, but for pushing I really wanted to be higher than flat on my back. I don't think the woman from the article was aware of the big baby, I don't think any dr would let her deliver it like that, I don't know if I mentioned it was a hospital birth :)

Sherri - posted on 02/02/2012

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If I was due to have a 13lb baby I am sorry but give me a c-section no way am I going to even attempt to try and deliver it vaginally. FYI I for one am not for c-sections unless necessary either. All my kids were born vaginally.



Oh and I refuse to deliver anyway but delivering on my back in bed. It is the ONLY way I can deliver, I can not and refuse to move once I go into hard labor. Not to mention if my babies came any quicker I would be in serious trouble, my labors are all pretty stinkin quick.

Katherine - posted on 02/01/2012

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Crazy- congrats to the woman for pulling that off. I wouldnt do it. Then again I wouldnt want to be cut open either.

Kelina - posted on 01/31/2012

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I don't think a woman should have a c-section for a baby that's "too big". You don't know until you try. And it's really difficult to tell how big baby is in there anyways. And Tanya I find it funny cause I know that that's true, but it's the only position I'm able to give birth in. My legs will move for me respond the way I want but the second I try to stand during a contraction they turn to putty. I can't even kneel or be on all fours. So on my back is the only way I can giv birth. Worked out great though, as soon as i stopped listening to my midwife, each of my kids was out in five minutes of pushing.

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