Is there such a thing as 'Too Big'?

Ez - posted on 09/17/2010 ( 43 moms have responded )

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"Is my baby too big?"
I frequently hear gasps of fear from pregnant women when they hear of someone birthing a baby of 4kg/8lb 12oz (and automatic leg crossing!). It seems women are naturally fearful of birthing large babies. But is this fear really a natural fear? Where does this fear come from? If women are designed to grow and birth babies (which I believe they are) – why would they grow a baby that is “too big” for them to get out? Why would their body mechanics and rhythm be so far out of balance? In my experience this fear is not “natural” but imposed upon women from continual negative portrayal of birth in the media, in society and from care providers who often scare a woman with references of her baby being “too big” to birth vaginally. Up to 10% of babies that are born are given the label “macrosomic” or “large for gestational age”, though less than 2% are over 4.5kg/9lb 15oz(1) It has been recently been reported widely in the media that researchers have noted that larger babies are becoming more common with the latest figure being 12.1%.(3) It seems there are no shortage of women to tell the story of how a routine pregnancy check propelled them into a world of anxiety, tests and screenings because their baby was “too big”. This is further imprinted when the doctor starts talking (usually at 36 weeks just when a woman is settling down into the right ‘head space’ for birth) about the baby being “too big to be born vaginally” and getting “stuck” in the pelvis. Sometimes mothers are scared with graphic stories of breaking the baby’s collar bone to “get it out” or even the death of the baby. While there is indeed risk associated with larger than average babies, does it warrant the level of fear associated with it, and does it justify automatic caesarean section or early induction?

http://charisbirthsupport.com.au/main/pa...

As the mother of a big baby myself, this article rang true for me in so many ways. I was at a genetic predisposition to having a macrosomic baby (I was 10lb 4oz, brother 9lb 10oz - slew of cousins ranging from 9-11+lbs) and my measurements were off the chart, making it obvious to anyone with eyes that I was having a large baby. I was automatically upgraded from my 'low risk' category at the hospital (thus denying me the chance to deliver in the birth centre) and had a growth scan at 28 weeks when I was measuring 36.

My whole pregnancy was flooded with comments from friends and strangers. 'I hope they're going to take that baby early'... 'So you're going to have a c-section then?'.... 'You'll never manage to deliver that baby without an epidural'.... blah blah blah. There was talk of inducing me at 37 weeks, but then the baby's growth slowed down so my doctor then said he would be happy for me to go to 40 weeks. At 37 weeks I measured 49, then baby dropped and I was at 45. I started being checked every 2-3 days for favourability for induction at 39.5 weeks. I was extremely lucky that my doctor was reluctant to induce on an unfavourable cervix, so my induction wasn't actually booked until 41+5wks. I went into spontaneous labour the day before.

This article focuses on the notorious inaccuracy in determining foetal size, thus reducing the significance of LGA/macrosomia as indication to induce or do a c-section. I had a scan done just after my due date, which showed my daughter to be 10lb 7oz at that time. I went another 8 days and she was actually 9lb 6oz... still technically macrosomic but by no means too big for me to birth.

I know we have lots of other Mummas of big babies here on DM, so I'm interested to know what your experiences were like during pregnancy and birth. Did you feel any anxiety based on other people's comments? Did your care providers focus on the baby's size as a potential problem? Did you feel pressured to have an induction/c-section? How accurate were the size predictions?

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Ez - posted on 09/17/2010

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Ultrasounds have an inaccuracy of 15-20% in predicting foetal weight at birth, and the later into the pregnancy, the more chance they are wrong (baby is too squashed up to get correct measurements). As for basing an estimation on fundal height, that can be affected by several things other than baby's size (position, level of amniotic fluid, size of mother etc). I think most experienced maternal caregivers can get a good estimate based on abdominal palpation, but it is always going to be just a guess.

Kate CP - posted on 09/17/2010

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Sharon: I think they got lucky. It's never an exact science in predicting a baby's weight.

Ez - posted on 09/17/2010

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See I wasn't scared of birthing a big baby either. Many people do say that they *can* be easier to deliver (assuming the mother is in a gravity-friendly position), and dilating contractions hurt the same regardless of size. The thing that was worrying me was this pervasive idea that I wouldn't be able to do it myself, that I would need 'help' simply because of her size. As I said, my OB was excellent in supporting my desire for a natural birth, and has no interest in scheduling a c-section, but he was not on duty the night I went in. The doctor I got put me on the clock from the start, questioned my ability to push out such a big baby (since it was my first) and after a 2.5hr second stage pressured me into consenting to an instrumental delivery (forceps with spinal block). I can't help but think I would have been treated differently by that doctor if I hadn't had 'Clinical Suspicion - Macrosomia' scrawled all over my notes.

Nikki - posted on 09/17/2010

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Sarah my midwife told me that a good sized baby is often easier to birth, because small babies can get themselves into strange positions in the birth canal, where as a bigger baby doesn't have room, plus the gravity of their weight helps to move them through easier. I don't know if she made this up to make me feel better or not!

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Jane - posted on 09/19/2010

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Hmmm...interesting. It is not something I ever experienced with friends or family where a woman was anxious because she might have a big baby. My first, my daughter was 9lbs 5 oz. I knew I would have a big baby because I was 9lbs 14 oz and babies TEND to be somewhere in the same range as their mother. My doctor never said my baby was going to be too big. I knew she WAS big when they checked on things late in the pregancy but again, never told it was going to be an issue because it wasn't.

My son was 7lbs 10 oz which is unusual for the second to be smaller than the first, however, he was born at a high altitude and he had a knot in the cord which caused some weight gaining issues. But honestly? He hurt WAY more coming out then my daughter...go figure!! :)

Jenny - posted on 09/19/2010

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WTH? I thought this was going to be a discussion about penis size. I'm outta here.

Ez - posted on 09/19/2010

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Lucy, my mother's experience was the same. The only added intervention was an ultrasound to check for twins while pregnant with me (they were not routine 30 years ago as they are now). Otherwise there were no added pressures or worries, and she had very straightforward natural births - 5hr labours, 15-20mins pushing, no episiotomies, tears or stitches, and certainly no stuck babies!

Lucy - posted on 09/19/2010

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The size of both my babies was over estimated by the midwife. With my first, I was told to expect a 10 pounder which terrified me, especially as I am only 5ft and was told I may have to have a c-section, but she was a perfectly average 7lb 6oz- It turned out to be all amniotic fluid, which was mortifying when my waters broke, it was like a biblical flood! So with my second, when I was told the same thing, I didn't worry (except for the waters breaking bit!) and he was 7lb 11oz.

My Mum, on the other hand, had 3 big babies. I was 9lb 10oz, and I wasn't the biggest, and at 5ft you would think she may have had a problem giving birth, but she didn't. We were all natural births and quite short labours, no babies getting "stuck" anywhere! This does make me think it is a sign of the times, and the way we have made birth a "problem" to be overcome. 34 years ago, when my mum was having her first, nobody batted an eyelid about the possibility of big babies. Certainly nobody suggested she would have more trouble then a woman having little babies, and she didn't.

Ez - posted on 09/19/2010

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Tracie you make a good point. I often wonder how differently my pregnancy would have been managed if I didn't have the growth scan. I knew there was only one baby, so the only other option was that it was a big one!

Tracie - posted on 09/19/2010

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luckily for me I had no idea I was about to deliver a 5kg (5000gms or 11 pound) baby, as I chose not to have the other later scans- I think c-sections are done WAY too often, I had a nice (wouldn't say the easiest) quick birth, but I think it was due to the position the midwife told me to try which was on the floor knealing on the end of the bed with one leg turned out- I must say it was like giving birth to a six month old baby!! he's still a big boy- but not fat :-)

[deleted account]

Tbh IMO a baby which weighs 8lb 12oz isn't "big". Here in the UK the average birth weight is 7lb 8oz so big in my mind would be like 9lb+. I weighed 8lb 10oz and that was 20 years ago so yeah that was probably considered big then but most babies I know were around that weight and everyone of them was born via vaginal birth. My son Logan was predicted to be small and he was 6lb12oz lol!

Joanna - posted on 09/18/2010

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I've had 2 big babies (8 lbs 11 1/2 oz, 8 lbs 15 oz) and they were both very fast and easy labors/deliveries. I think the extra weight helped, with gravity and all :P

I was never worried, and I'm not worried this time either. When people hear about the size of my previous babies they make comments on how I'm going to have a 9 pounder. Yeah, I might... so? And I never listen to the doctors when they mention the possible size of the baby. I've never heard anyone get an accurate possible size, they're usually a pound or two off.

[deleted account]

My first daughters weight was predicted by the midwife spot on at 7lbs 70z from my starting weight to ending weight at 38weeks.Still the felt that was to big for my pelvis.Second baby was spot on but one doctor wasnt convinced by feeling her in my tummy..she felt bigger..lol.

Jodi - posted on 09/17/2010

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"when i told anyone else i could hear the sound of every female in the rooms vagina's snapping shut !"

Mine did.....after having a 7.5lb and a 5lb 2oz, believe me, 10 or 11lb would absolutely freak me out!!!

Charlie - posted on 09/17/2010

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The only people not surprised by my babies were Tongan side of the family where 10 pounds is the average baby weight when i told anyone else i could hear the sound of every female in the rooms vagina snapping shut !

Kate CP - posted on 09/17/2010

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I was waiting for you to chime in, Loureen. You had HUGE babies (to me, any way). ;)

Charlie - posted on 09/17/2010

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I had an 11 pounder and a 10 pounder and both a lot longer than average in height the labours were hard but the actual birth was easy both only took 2 or 3 pushes and came out with not one tear or stitch i was induced with both being overdue and due to the size of my babies , i didnt feel pressured to be induced , being overdue with large babies i wanted to be induced .
My ultrasound predictions were fairly accurate as was my doctors prediction by feeling my stomach , i wasn't worried about the size i went through the 11 pounder birth with only gas i had an epidural being put in but he was born before it was placed properly and honestly it wasnt that bad .


Oh did i mention my bigger baby also had a big head too ? all of the midwives commented on pushing that out LOL.

Amongst my friends the worst birthing stories i have heard have been from the smaller babies with tearing , stitches , pain UGH .

Jessica - posted on 09/17/2010

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Yeah if they're predicting it by ultrasound its the machine making the estimate, not the doctor. They just aren't that accurate at weight estimates. If its your doctor looking at your belly and guessing the size, then yeah that's dumb!

Like I said though, I respected my doctor in that he didn't even bother with getting weight estimates because he knew it didn't matter!

Sharon - posted on 09/17/2010

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Sometimes I wonder what kind of morons you guys were seeing for doctors.

My doctors were dead on in predicting my babies weights.

Tah - posted on 09/17/2010

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not even gonna tell you what i thought this thread was about when i read the title....and i was gonna say never...smh..sorry...i'll move on..

Rosie - posted on 09/17/2010

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much like you erin i had large children. my first two were slightly bigger than average at 8 lb 5 oz, and 8 lb 7 oz. each time my uterus measured larger than what it was supposed to. i was nervous that having big babies would be a problem, i WAS (not anymore, sigh) 105 lbs, and 5' 2" tall. tiny. nobody in my family has ever had a baby larger than 6 lbs, in fact i was the biggest at 6 lbs 10 oz. so everybody in my family was freaking out- you are just too little, this baby is huge, blah blah blah!! so yeah i was a little scared, but i don't know if it was because of my size, or because of the babys size.
with my last one, i was HORRIFIED of ripping to shreds. i wasn't scared of a csection, just the ripping. my first 2 i ripped very badly,making sex painful for almost a year. with my third i measured 48 cm. at 39 weeks when i was induced. i was induced because i was miserable, i was in constant pain, and they felt the baby was obviously big enough, and old enough (39 weeks). my doctors diidn't freak me out, it was the constant "are you having triplets?" or "holy, moly you're huge!!" comments from complete strangers on a daily basis. it gets to you after a while. my third birth was my easiest, even though he was 9lbs 5 oz, but i think thats because it gets easier everytime, stuffs already stretched.

[deleted account]

Also the first tore me ..i refused a episiotomy.I have to say i recovered fast from the baby cutting me than if i would of let them cut me.

Amie - posted on 09/17/2010

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Only one of mine (3rd) would have been considered larger than average. The other three were 6-7 lbs babies. My third came in at 8 lbs. 9 oz. Big enough.

My first was 6 lbs. 12 oz., second was 7 lbs. 8 oz. and the fourth was 7 lbs. 13 oz. All average size babies, from what I was told.

There was some speculation that my fourth would be even larger, as that seemed to be the pattern the kids were following. Not once did my doctor ever bring up her getting stuck, a C-sec or complications of any kind. I also have (as my grandmother so kindly told me when I was 16. ugh) good child birthing hips. They are wide and separated easily each time.

The size predictions were always about a pound off, except with the last and it being 2 lbs off. All predicting larger then they were.

I didn't feel all that anxious though, except with my last. I am not sure why it was then but all of my birthing memories came back with her. The pain and how long each labour lasted. Once labour had started though, I was fine. The weeks leading up to it all I had running through my head was "WTH were you thinking? Why are you doing this to yourself again?" LOL

[deleted account]

My second child was born in a different hospital.The had no record of her birth, the first child's birth.I told them my whole birthing story and the said the fear she wont birth well.At 7lbs 70z my first child, her head was the problem and it was the only part of her that delivered easy..even once her shoulders popped out after taking a nurse to stand up on the side of the bed and push down on the top of my bump, while the doctor twisted her out i still couldn't get her body out..the had to help from her shoulders down out as well.So with that said, the second hospital feared this child was over that size and most likely wont fit if the first had problems.She wasnt that size and i would of been able to birth her..but i do think myself if she was over 7lbs would i be able to do it? I dont know.The shape of my pelvis was normal.On the first they were very supried how big it actually was during the birth before her head came.I saw the look on there faces i knew something was wrong..i watch videos when the shoulders are out the baby comes flying out after that..that didnt happen.They said she was in a good position ,i remember them saying that so i dont know it seemed like a very tight fit.They didnt say my pelvis was small just that if the last didnt fit anything bigger most likely wont.I didnt give in..but as i said my daughter had complication which made her be c-sectioned..i would of been very pissed if the sectioned her over size.A Mother knows her body and i felt i could most differently birth her.

[deleted account]

I was told Roxanne would be a 9lb baby and she came pretty damn close weighing in at 8lbs 13oz. I absolutely was scared to death and I agree, Erin....it's a result of our society implying we won't be able to handle it. While our doctor was concerned that her size would be an issue she supported and encouraged me to give birth naturally. Unfortunately that wasn't possible, as there were other complications and a specialist insisted they do an emergency c-section.

Did I feel pressured to have an induction or a c-section? Nope, I was completely on board with their assessment. I won't go into the details but I will say that I felt that they had mine and my baby's best interest at heart. I welcomed their advice and expertise at that point.

Obviously the accuracy of the size prediction was almost bang on.

[deleted account]

I know a woman that is the sameish size as me (4'11" and thin) and she birthed a 9pounder w/ no problem and I believe no drugs. My friend is several inches taller than me and if her 5 pound 15 ounce son had been any bigger... she would've needed a c-section cuz he wouldn't have come out. Size of the woman does not necessarily corelate w/ the size of the opening in the pelvis.



For me personally.... size of baby was never an issue. Since there were 2 in there w/ one being breech... c-section was always a possibility even though they were small. When baby B was in distress... that's what happened. VBAC's aren't available where I live, so size was never an issue w/ my son either.

ME - posted on 09/17/2010

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My children were 8lbs 4 oz and 8lbs 6 oz...I weighed 8.4 at birth and so did my husband...I would say that our children were exactly the size they should have been. I'm sorry that I didn't get to give birth naturally...but I don't think babies over 8lbs are "bigger than they should be"...all of my 4 siblings were bigger than I was at birth; two of them approaching 10 lbs...my mother gave birth naturally 4 times and had an epidural with the last baby...women can make their own choices, certainly, but I think we are capable of more than we give ourselves credit for...

Caitlin - posted on 09/17/2010

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My first was 8 lbs 8 oz 8 days late (induced) but everyone marveled at the size of her head. She got stuck sadly at the last minute, and they had to forceps her out, 3rd degree tear in a very bad place (like a V shaped tear and and around the urethra) and it was incredibly painful, took almost 6 weeks to heal properly. My second child the Gestational age was a guess the whole time since I didn't have a period, so according to the ultrasound she was born exactly 1 week early - 8lbs, they gave me an episiostomy to prevent me from tearing the same way as my first and I had to problems with the delivery (except that my epidural wore off 45 minutes before I started pushing and they wouldn't give me a boost because I was too close to delivering - and I was on induction meds to help my contractions that "weren't strong enough"- worst idea ever, i'm never letting them do that again). They said she looked full term, she had a tiny bit of the languo(sp?) left on her in her armpits and stuff, but her head was even bigger than my first!

I think they make a big deal about it, and they shouldn't because unless you've had any sort of medical issue like a broken pelvis or anything, i'm sure in most cases the baby can be delivered naturally.

Tara - posted on 09/17/2010

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All my babies were average size or smaller than average size. (I'm teeny tiny). But, my third baby was delivered by a boneheaded doctor who told me she was too big and needed to induce me at 40 weeks 4 days gestational age. Although I told him over and over that they had my dates wrong and I was fine staying pregnant until the muffin was ready.
He told me that the baby was going to be too big to fit through my tiny pelvis, I told him my son was 8 lbs and had a head the size of a melon. He laughed and said "well this one is bigger than that and if we don't induce now you'll be coming in for a section!" so... I relented... and she was 6 lbs. 6 ounces. I was PISSED. Doctor was surprised. Nurses didn't even think she was full term let alone late.
After that, I had a midwife for the next 3 babies. :)
1 was late, 1 a day early, and the last 3 weeks early. All normal size for me.
Tara

Jessica - posted on 09/17/2010

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My son was on the larger side, though I'm not sure he'd be considered VERY large- 8 lbs 3 oz. Though, he was 8 days past his due date! I guess I didn't think he'd be that big because I myself am small. I'm 5'3" and before I had him was about 105 lbs. But I didn't have any problems birthing him, really. Once active labor kicked in it went quickly- I got to the hospital at 5 cm and had him 2.5 hours later. The doctor there (not one I'd seen before!) did give me an episiotomy so I tore pretty badly- but I think that was due to other factors. They made me stay on my back since I'd had an epidural, which is a bad position to push in; also he came out posterior. My doctor, a different one who I saw for most of the pregnancy, was willing to let me go as long as he was "allowed" past my due date and did not want to induce me- which I was all in favor of! He also would NOT take weight estimates when I had an u/s for postdates because he knew it wouldn't matter- they can be wrong, and we wouldn't know if I could give birth until I tried. I wish he'd been there the night I delivered, but he wasn't.

Its too bad we get hung up on size so much. I can see in some cases, such as if mom has GD, a baby may be too large for her. But you don't know that until you try! You can't say your pelvis is too small because your body is actually pretty handy, because the pelvic opening widens in labor and different positions can increase this and help get the baby through. I do think we get stuck in the trap too, like I was, of getting the epidural and then being stuck in one position. Not allowing your body to do what it needs to to get the baby out.

BTW that is interesting- I've never heard that bigger babies are easier to birth! Kinda makes sense though!

Sara - posted on 09/17/2010

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Great article.



I had a "big baby". She was 8lbs 15 ounces and my douchebag of an OB told me that she had shoulder dystocia, but amazingly I only pushed for 45 minutes and had a second degree tear. A-hole.



I wasn't pressured to have a C-section, but I was induced for medical reasons due to having GD. I think there is a stigma to having large babies and the medical community thinks that is somehow unnatural. But, I was a 9 pounder, my husband was a 9 pounder, I am 5'11" tall, too. It would be ludicrous to assume that i would have a small baby. It just concerns me, because it seems like judging people by their size starts even at birth. I know I was judged through my entire pregnancy because of my size.

Ez - posted on 09/17/2010

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Ashie, I would certainly question why your doctors have told you your pelvis is too small. If it's purely based on a difficult pushing stage with your first baby, there may have been other factors at play there (malpresentation etc). I genuinely believe that it is rare for a healthy woman (ie, no Gestational Diabetes) to grow a baby that is 'too big' for her to birth. My mother is only 5ft 4 (and very slim at the time lol), and delivered two macromic babies with no problems - not even a tear!

LaCi - posted on 09/17/2010

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Nico was 8lbs 13 oz. I had a c section though. Doctor did tell me (before planning a c section for other reasons) tall chicks have easier times with big babies, not sure how true that is lol. It did make me feel better though.

[deleted account]

I have to say yes there is such a thing medical as a big baby..your pelvis for many will only birth a certain size baby.As i said i barely did it with my first, the say any bigger for me there's possible no way i can give birth to a bigger baby with a pelvis that just wont fit it.As the doctors say.I am 4ft 11.A friend the same had no problem giving birth to her last child 9lbs 5 but she did say it took some time to recover from it, compared to her last 2 births.So obviously she had a good size pelvis to fit him through.

[deleted account]

To much is put on the weight or size of a baby.More times than not doctors have been wrong.In the case of my second baby at 37weeks the scan ended up being completely right.She was 4weeks under and between 5&half to 6lbs.They still told me no shes above 7lbs which was my first, she got stuck but i did birth her in the end.I was told we dont want that to happen..thinking a c-section will be required.I said i know my body i can birth this child.Anyway i had to be emergency c-sectioned.Her placenta came away a bit.She had to be taken but only this was found in the section.The thought the heavy bleeding and clots were a big show.She was 6lbs 50z and short.I was still told by many friends and strangers she was big.

Louise - posted on 09/17/2010

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I have had three large babies first son was 9lb 12oz and second son was 9lb 14.5oz and my daughter was estimated to be 11lbs full term but was born three weeks early at 9lb30z. My midwife always told me that big babies were easier to deliver and it never phased me at all. My third pregnancy was in a different district and I had to under go all sorts of invasive tests because she was a whopper. Some times these medical tests get in the way of enjoying your pregnancy because they just make you worry. Mother nature does respond to a good diet and better living conditions thus making the babies far healthier and bigger than they were before.

Sarah - posted on 09/17/2010

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I think that judging the size of a baby isn't entirely accurate at all, and it's unfair to make women worry when their predications aren't always true.

My friend had the opposite problem, they kept saying her baby was going to be teeny. Then one midwife said that it just looked that way because my friend had a really long abdomen. Her baby was a perfectly good weight of 8lbs 3oz.

Also, they didn't even realise that my youngest was in a breech position! So obviously palpitating the stomach doesn't always give accurate results.

I don't think that scaring women about a big or small baby is the right thing to do. Offering some advice, and saying it MIGHT be big would be more helpful.
Also, most of women I know who had big babies, actually said it was easier! :)

Nikki - posted on 09/17/2010

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My Doctor's freaked me out, I went for my ob appointment at 34 weeks, my bub was head down so he was having a feel, his comment was "wow, I have never felt a head that big before" the Dr was about 50 with a long career birthing babies, so I was beginning to shit myself at this stage. After that he proceeded to get another doctor and two midwives to come and have a feel of this huge head! They sent me for a scan, which said that she was about 8 pounds, therefore they expected her to be around 10 pounds when she was born. I wouldn't have had any problem with this except that they made me paranoid, they kept doing weight checks, discussed my c section options and kept joking about how big her head was. One midwife was obsessed on teaching me how to do peri...whatever it's called massage in preparation for this big head! My biggest fear all along was tearing, therefore my anxiety increase drastically in the last few weeks.

I felt like it was a problem, not knowing what to expect and all the negativity surrounding her size, I felt as if there was something wrong with me and my baby, it was really stressful. I just had to keep telling myself that it would be ok in the end, she would arrive safely even if it was by c section.

Then the week before I gave birth I met a wonderful midwife, I was in tears and terrified, she comforted me and told me not to listen to any of them, she helped me so much; I have never been more grateful to anyone in my life. She ended up birthing my daughter, no doctors and my daughter was a tiny 6.8 pounds. 4.5 hour labour, NO TEARING! I don't believe in God but somebody heard my prayers!

I should have trusted my instincts, all of the women in my family and my husband's have had tiny babies usually 4-6 pounds.

Next time I have a baby I am not going to listen to their predictions, to me it is obvious they have a chance in hell predicting the exact size, our bodies are made to deliver our babies, it's just a matter of trusting that you can do it.

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