Friday, March 13, 2009
The "Big" Baby
Contrary to everything you may have been told, a big baby is a good thing! Women have become afraid of giving birth to a big baby because their doctors, and even some midwives, have instilled fear into these mothers. When a woman hears the phrase "birth trauma," do you think she's excited to start labor and give birth? Of course not. A woman's body is less likely to start labor when she is fearful.
How does your doctor know the size of you baby? Ultrasound? While ultrasound can be a useful device in estimating a number of things, when it comes to the size of the baby, it can be off by more than 2 pounds, either way! So if you have a doctor telling you that you are carrying a 10-pound baby and a C-section is the way to go, you likely are NOT really having a baby that big. Do not allow a doctor to conveniently (for him/her) cut you open because he/she is afraid of your "big" baby. They do not trust your body to give birth if they are recommending a C-section. I have a lot of confidence in a woman's body being able to give to birth to the baby that her body allowed her to grow.
And what if you are carrying a 10-pound baby? Congratulations! My dad was 10 pounds, born at home. So was his brother. My grandma, who I lovingly call a "hillbilly," lived on the land. She ate the food she grew. She knew where her food came from. And she grew healthy, big babies.
Most women are afraid to birth a big baby because they are afraid they will tear at the time of birth. You are actually more likely to tear with a smaller baby than a bigger one. How can this be? A small baby tends to come through the birth canal faster and the skin, or perineum, doesn't have as much time to stretch. A bigger baby allows the skin more time to stretch over the baby's head. I've seen women be fearful of a bigger baby, because, surely if they tore with a 6-pound baby, an 8-pound baby would be dreadful. Just the opposite is true.
I have a lot more to say on the subject of tearing, episiotomies, etc., but I'll reserve that information for those lucky enough to take my class! Wink, wink.
I would also like to point out a very important statistic: The #3 reason for a C-section in America is for CPD, or cephalopelvic disproportion, but only 1/2500 women actually has this very rare condition. This is when a doctor says that your baby is too big to fit through your pelvis. The only way for a doctor to truly diagnose this condition is when a woman is in labor and has spent a considerable amount of time pushing or has had an X-ray. No one is going to do an X-ray on a pregnant woman, let alone in labor!
We all know the tiniest women who have birthed 9 and 10-pound babies. You cannot tell by looking at woman's hips whether or not her baby will fit through them. During labor, there are hormones released to help soften the cartilidge within the pelvis. It shifts with the baby, allowing more room for him or her to pass through. The baby's head will also mold to fit through. Understanding the process of birth instills confidence in this natural process of the baby passing through the pelvis.
True CPD was more common in the 19th century when a lot of women had suffered from rickets, causing the pelvis to be misshapen. Very rarely does a mismatch occur with the baby's size and the mother's pelvis, but there is no way for a doctor to prove it, so it is used as a diagnosis very often, even in pregnancy when a woman has never even experienced labor! Give me a break!
Let's talk about that "birth trauma" we hear so much about. Specifically, shoulder dystocia, is seen more often with bigger babies, but certainly not as common as the doctors make it sound. This is when the head is born, but the shoulders are "stuck." Honestly, the baby doesn't have to be huge for this to happen -- just to have really wide shoulders. A doctor will usually deal with this by giving the mom an episiotomy and then by breaking the baby's collarbone. Ina Mae Gaskin, who I consider to be the nation's leading midwife, has a different approach, called The Gaskin Manuever: have the mom get on all fours and lift a leg. This will release the baby's shoulders. I have done this with one of our births. It's amazing.
Briefly, let's contemplate what is believed to be a "big baby." What do you believe to be a big baby? If 7 1/2 pounds is average, does that mean anything over that is "big." I don't believe so. I do not consider a baby in the 8 pound range to be "big" -- just healthy. We want this! I, personally, think that once a baby is over 9 pounds, they are "bigger." I love asking moms that have "big" babies if they tore, and I am constantly amazed by the amount of moms that say no, or very little.
I had a mom in my class a few years ago that gave birth to a 12-pound baby with a 1st degree tear. She gave birth in a hospital with a midwife. Her family and friends couldn't believe that no one knew the baby was going to be so big. They insisted that if she'd had a doctor instead of a midwife, they would have known. I made the point that if she'd had a doctor who was expecting a 12-pound baby, she would have had a scheduled C-section and not the wonderful birth experience that she did.