Do You Have To Have A C-Section If You Have A Big Baby? It's All About Options

"Whoa, that’s gonna be a big baby." I mean, what mother doesn’t love to hear that from well-meaning family members, friends, and complete strangers? (Who should really just keep their mouths shut if they know what’s best for them, am I right?) But even though you shrug it off, it’s tough to ignore the questions that begin swirling in your head as your feet disappear from view and your due date approaches, including, do you have to have a C-section if you have a big baby?

It’s all about knowing your options, says California OB-GYN Dr. G. Thomas Ruiz to Romper in a telephone interview. "The answer is no — you don’t have to have a C-section if a large baby is suspected," he says. In fact, Ruiz notes, an automatic C-section is never his first choice. Instead, there are several factors he considers before suggesting a C-section, including whether or not a mother has diabetes or gestational diabetes.

Dr. Michael Foley, Department Chair of Obstetrics and Gynecology at Banner University Medical Center in Phoenix, Arizona, tells Romper that means the conversation begins when a baby is predicted to be 5,000 grams (or more than 11 pounds). This is in order to reduce the risk of shoulder dystocia — when a baby’s shoulders get "stuck" behind a mother’s pelvic bone as she enters the birth canal — and other complications that come with that during a vaginal delivery.

"It’s important to understand that when a baby’s weight is predicted, I am always working with a plus or minus 10 percent," says Ruiz. "That means the baby could be 10 percent larger or 10 percent smaller. So, we have to account for that and provide a mother with options."

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As for mothers with diabetes or gestational diabetes, Foley says there are a different set of rules. He recommends a C-section if the baby is predicted to be about 4,500 grams (or more than 9 pounds). "This is because diabetic babies tend to put on weight around their shoulder girdle and have an even higher risk of shoulder dystocia, among other complications," he says.

Ruiz also points out that if a mother is 39 weeks pregnant and he predicts a larger baby, then "it is perfectly acceptable to offer an induction so that we can try and get that vaginal delivery."

Most of all, he says, "stay informed," noting that in the case of a normal pregnancy, there is not a one-size-fits-all approach to delivering larger babies.

Turns out that, like women, the pelvis comes in different shapes and sizes, too. So, before you go all-in on the C-section, be sure to discuss your options with your healthcare provider.