If you’re reading this the likelihood is your midwife or consultant has diagnosed your baby to be larger than normal, you may have been referred for, or already been to a growth scan and you may have heard terms batted around such as Induction of Labour, Shoulder Dystocia, Caesarean Section!!
If you are feeling anxious and fearful please take a minute or two to reconnect with your baby before carrying on with your research. (You can instantly reduce all the harmful stress hormones whizzing around your body)
Try my simple introduction to breathing practice here
Now that you’re feeling calmer and more relaxed lets move on…
Is it possible to grow a baby too big to birth?
No - a healthy woman will grow the perfect sized baby to be born beautifully!
We have been evolving for millennia, and humans in our current phase of evolution have been around for 200,000 years without any significant change in genetics (actually our brains have shrunk slightly as they got more effective!) Now just think that we have only been using modern interventions for the last 50-100 years. Any babies / women that didn’t grown the right sized baby would not have passed on their genetic material – meaning that we are perfectly placed to birth our babies with ease – just like the rest of the animal kingdom!
So in the absence of pelvic injuries, malformations, Diabetes and other health complaints you can trust your body to grow the perfect sized baby for you.
Now I know what you are thinking – what about all those terrible stories and images of women dying during childbirth in history – I certainly had those imprinted on my mind as a child, but here is what I discovered.
- During the industrial revolution, many people moved into cities for the first time, there wasn’t enough food to go around and many were malnourished and/or didn’t get enough sunlight causing
malformation in the bones (and the pelvis to be exact).
When a woman is in labour she releases relaxin which allows the bones in the pelvis to open up really wide creating a big open space for baby to descend. In women who were malnourished, had rickets or pelvic injuries this wouldn’t happen in the same way. Successful caesarean sections would certainly have saved a lot of lives in those circumstances! We are fortunate that most of us don’t have those issues now.
- We started meddling! A new fashion began of getting women to lie on their backs to give birth, replacing the less ‘ladylike’ birthing
chairs, and stools that were previously used – this reduced the space in the pelvis by 33% and meant that gravity worked against the baby being born.
A new breed of male Doctors became involved in birth and saw women in a lot of pain and needing help to birth their babies – but they had forgotten that healthy women left to move around in their
own space could birth perfectly well!
(Plus they knew nothing of the hormones of birth – no wonder the women in that era of extreme modesty didn’t relax with a strange man in the room)
- Cleanliness – It is true that one of the biggest causes of maternal deaths was infection, and thinking back to the towns and cities pre second world war era with no running water or waste disposal systems and little knowledge of germs and how they impact health there is little wonder. We also now know that women who birth in their own environment are exposed to less unfamiliar germs and so suffer with less infections that those who birth in unfamiliar surrounding.
So you can the size of the baby was always perfect – but the health, comfort and position of the woman wasn't!
Have we removed all of these issues in modern times? Well almost – although there is a new issue on the horizon which can effect the size of the baby.
Gestational, and Pre Existing Diabetes
In these conditions, a woman’s body doesn’t make enough insulin to convert her blood sugars to fat stores, meaning that if the condition is not well managed either through diet or treatment then
additional glucose is transferred to baby through the placenta. In which case the baby begins to make extra insulin, and lay down additional fat
stores – often around the body and shoulders rather than equally throughout the head and body.
If you have one of these conditions and you’ve managed it well, either with diet, tablets or injections of insulin to control your blood sugars then you can rest assured that everything will be developing perfectly well.
If your blood sugars have been a little up and down, baby will have laid down additional fat stores making them potentially not a correct match to the size of your pelvis.
Why am I being offered / advised to have an Induction / Caesarean anyway?
The personalised growth charts were first trialled in the Midlands, and have been brought in nationwide as a measure to pick up Intra Uterine Growth Retardation – a condition where the placenta stops working as effectively and baby stops growing.
These charts are fantastic in picking up these babies and reducing the stillbirth weight – their effectiveness and impact should not be underestimated. However they are now being used outside of this criteria to look at babies on the opposite end of the spectrum – babies who are growing really well and
THERE IS NO EVIDENCE THAT PREDICTING BIG BABIES IMPROVES BIRTH OUTCOMES
THERE IS NO EVIDENCE THAT ABOVE AVERAGE BABIES CAN BE
(By scan or other means)
NICE guidelines state:
DO NOT OFFER INDUCTION BASED ON ESTIMATED ‘LARGE FOR DATES’ BABY
Also many midwives question the number of women with previously healthy babies, and straightforward births who are now categorised as high risk, forced to birth on labour ward, with interventions they do not want. What is the risk vs benefit ratio? And why are women being manipulated and scared into accepting interventions they do not want?
The interventions you are being offered such as caesarean, and induction of labour have some pretty severe risks associated with them both long and short term for mothers and babies. They are not the fix all safe option and not to be taken lightly. I’m sorry to say life is never 100% safe.
Having said that, it is possible to have an empowered experience of using medical interventions just as Clare & Ste did with their positive Caesarean Birth, and my friend Kate with her empowered Forceps birth after transferring in from a planned homebirth.
However, the key is these parents had done lots of research, were confident in their own decisions and knew how to jump off the birth conveyor belt, before getting lost in an impersonal system being processed and lied to (which I’m sorry to say I do hear very often). Sometimes you have to stamp your feet and make a fuss to get the right care. Getting the healthiest and most positive birth possible is not selfish IT IS BEST FOR YOUR BABY. You will not be rewarded for being a ‘good patient’ more likely the opposite.
If you do not feel respected by your caregivers, if you feel they are piling on pressure and scaremongering then you should change them, or sack them. You are entitled to change hospital, carer, get a second opinion, third opinion or purely to ignore all medical opinions and make your own informed decisions many women do, and have wonderful experiences.
Medical staff may be specialised in risk management, and figures, but they may also be very biased in favour of interventions which means they are not practicing shared decision making with you about how to proceed with your pregnancy or birth choices. They are coercing you into their way of thinking, and ultimately disempowering you.
They are NOT a specialist in YOUR BODY. Only you know how you feel, and what feels right to you. Be confident in your own choices, listen to your gut instinct whatever that may be.
NB - there are also many respectful and amazing maternity staff around so it is well worth getting a second opinion, and speaking / writing to your Head of Midwifery to form an individualised care plan, if you've been unhappy with any aspect of your care. Speaking to the right people means you can completely shift the trajectory of your experience.
NICE Guidelines -
1.2.10 Suspected fetal macrosomia
18.104.22.168 In the absence of any other indications, induction of labour should not be carried out simply because a healthcare professional suspects a baby is large for gestational age (macrosomic).
See full NICE Guidance on Induction of Labour
AIMS - Association for improvements in Midwifery - Can support you in exercising your right to make choices during pregnancy.
Emma is available for one to one support and teaches regular Antenatal & Hypno for Birth classes, alongside a weekly pregnancy yoga class. You can book a call with her below to see how she can support your family in making empowered decisions and having a calm and straightforward birth.