For a woman with a small build, I birth pretty big offspring. After delivering a baby I thought was large at over 8.5 pounds, I was surprised when the second was nearly a pound bigger. As I'm nearing the finish line of my third pregnancy, I can't help but wonder if the trend will continue. Surely this won't be a 10-pounder? It's very possible, my midwife says. So how do you know if your baby is too big for a vaginal delivery? I'm determined not to live in fear of childbirth, but I'd be lying if I said the size of this baby isn't on my mind. I always want to go "natural," but is there a point where I'm simply asking too much of my body? I turned to a leading voice in women's health to find out.
Dr. Nita Landry is a board-certified OB-GYN who has served as a medical expert for the United Nations Foundation and now co-hosts the Emmy Award-winning talk show The Doctors. Landry says one part of her job that she most enjoys is dispelling myths and misinformation surrounding women's health and pregnancy. One such myth, Landry explains, is that the estimated weight of a baby alone is enough to order up a C-section.
According to Landry, ultrasounds are not totally reliable in determining the weight of babies, so having one as the sole basis for a planned C-section is controversial. Nevertheless, she says, "Many doctors will discuss a planned Cesarean if an ultrasound determines that a baby weighs at least 11 pounds in a woman without diabetes and 9.9 pounds in a woman with diabetes."
But there are other reasons a vaginal delivery may not be planned that are not controversial, but rather agreed upon in the medical community as necessary for a safe delivery. Landry says that Cephalopelvic Disproportion (CPD) is a diagnosis that means a baby’s head or body is too large to fit through the mother’s pelvis. However, she tells Romper, "It is believed that true CPD is rare. According to the American College of Nurse Midwives, CPD only occurs in one out of 250 pregnancies."
Landry says when an accurate diagnosis of CPD has been made, the safest type of delivery for both mother and baby is a Cesarean. Possible causes of CPD could include hereditary factors, diabetes, post maturity (substantially past one's due date), abnormal fetal position, or a woman's small or abnormally shaped pelvis. But again, the fear of CPD is more prevalent than the actual condition.
Many women with abnormally shaped pelvises are still able to birth vaginally, Landry explains, and having a certain shape does not guarantee you a successful vaginal delivery. If you're not sure whether yours is considered normal or not, ask your healthcare provider. Landry says there should be an exam performed at the beginning of your pregnancy to determine the shape of your pelvis, so if you haven't been alerted to a potential problem then no news is most likely good news.
As sometimes happens, you might not know that your baby is too big for you to birth vaginally until you start trying to push. In that case, remain calm and keep in mind that your medical team is already prepared for such events, even if you aren't necessarily. Sometimes a tough call must be made in the heat of the moment, which is all the more reason to carefully choose a midwife or doctor that has your unwavering trust.
At my last checkup, my midwife reminded me that there was no reason to fear the size of this baby I will deliver in eight weeks. "You were made to give birth," she said. And, one way or another, I believe that's true for all of us.
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