Over time, to my surprise, I’ve begun to feel sorry for many natural childbirth advocates.
Why?
Because they clearly suffer from a pathetic lack of self-esteem, so pathetic that they cling desperately to any opportunity to feel superior to other women, even if they had no control over the issue in question.
I would feel sorry for any woman who bragged that she was superior because her nose was larger than that of other women. I would feel sorry for any woman who set up a website boasting about the size of her feet. And I do feel sorry for women who feel that their greatest “achievement” is their large breasts.
Therefore, I feel very sorry indeed for the women of the Big Baby Project. Apparently they are so desperate for some sense of self worth that they have set up a website dedicated to their internal pelvic dimensions.
The purpose of the website, according to the woman who created it:
This is a collection of stories. The stories are about Mamas who vaginally birthed babies that some people may consider to be big. People need to hear and see these stories, I hope you share it far and wide, and participate if possible.
The real purpose of the website? To scavenge for praise for the “achievement” of having a pelvis large enough to accommodate an obese baby.
The technical term for a very large baby is macrosomia. Macrosomia is no more worthy of praise than a 45 pound 3 year old or a 10 year old who wears size 14 sneakers, but that doesn’t stop psychologically needy women from bragging about it.
Not all macrosomic babies are obese. Some families simply grow large babies and macrosomia is known to be more common among those of Hispanic descent. However, a substantial proportion of fetal macrosomia is due to untreated or poorly treated diabetes, excessive maternal weight gain, or maternal obesity, which can double or triple the risk of macrosomia. In other words, women have no control over the size of their babies beyond the ability to render them obese through poorly controlled diabetes of excessive maternal consumption.
You will notice that the website refuses to accept pictures of macrosomic babies who were born by C-section, only those born vaginally.
Why?
Because these pathetic women are anxious that you should admire them for their pelvic dimensions, yet another characteristic over which they have no control yet want to take credit.
Just like there is tremendous variation in maternal stature, there is tremendous variation in the dimensions of women’s pelves. As this illustration demonstrates, there are four main “shapes” of the female pelvis.
The most common female pelvic shape, and the one best suited to accommodate a baby, is the gynecoid pelvis. Size variations within a specific shape can make a significant difference in the size of the baby that can pass through.
So the women who post on the site are bragging about the size of their baby and the shape and size of their pelvis, as they have control over either one, and as if you should be impressed with either one. In that sense, it is no different than boasting that you have a bigger nose than other women, or bigger breasts. It is the same old tiresome effort of women to judge each other by physical characteristics, with one important exception.
Macrosomia is a risk factor for various childbirth complications, including neonatal injury, neonatal death and maternal injury. The most dreaded complication is shoulder dystocia. That’s what happens when the baby head fits through the pelvis, but the shoulder become stuck. This is a life threatening emergency because the umbilical cord is compressed by being trapped between the baby’s body and the walls of the pelvis, thereby cutting off oxygen to the baby. The baby will die if not delivered in a timely fashion. Death is the worst possible outcome, but babies who survive are also at risk for serious injury to the nerves of the arm, which can be stretched as they pass through the neck. If the nerves are injured during birth, the baby may suffer permanent paralysis of the arm.
This can cause lifelong difficulties for the child as illustrated in a charming series of books produced by the Erbs’s Palsy Group:
As far as I can determine, The Big Baby Project makes no mention of whether any of the featured babies suffers from Erb’s palsy or whether any of the mothers had long term problems (tears, incontinence) from delivering a big baby. And of course, there are no dead babies on the site, because, apparently, women aren’t entitled to “hear and see” those stories.
It’s really rather pitiful when you think about. A group of women is so desperate for attention and validation that they post to a website bragging about the size of their baby and the size of their pelvis, as if they had anything to do with either. You really have to be pathetically needy to boast about that.
I’m 5’10”, so I’m by no means small myself. I also have a family history of large babies (there hasn’t been one under 9lb in as many generations as we know about – I myself was just over 10lb at 41+3). A plethora of women, both locally and on the internet (many of them natural childbirth advocates, many of them considerably smaller in stature than I am) told me that of course I would be fine giving birth to a large baby – they’d done it, and they’re smaller than I am!
My OB, however, realized before I was even showing that there was a very real possibility that I could not. I have an abnormally narrow pubic arch (which, go figure, has nothing at all to do with my height). An average sized baby would likely have posed no problem, but my family does not produce average sized babies – shoulder dystoccia and cephalopelvic disproportion were both very real risks. We induced at 40+0, hoping to get him out of there before he became too large (and also because I had severe SPD), and she had the entire delivery team on standby for a shoulder dystoccia emergency. It never came to pass… because what we had was cephalopelvic disproportion, and hours of pushing couldn’t budge him. He’s now a happy, healthy 5 year old – but if c section hadn’t been an option, he and I would both have died.
I think you are missing the point. The website is there to reassure women like me that we can birth babies. I am thankful for the pep talk.
I think it is you that misses the point. Just because some women can give birth to to 10 pound babies doesn’t mean that all women can or that it is safe to do so. A wide variety of factors, most beyond a woman’s control, play a role in whether or not a woman can vaginally birth a large baby. If you have an android or platypelloid shaped pelvis the chances of giving bith to a 10 pound baby is slim and no amount of pep talks can change that.
I am due next week. I am a small person. So if I am the one missing the point, does that mean I should just give up, because I am fooling myself? I am scouring the internet for pages that provide real life stories and numbers. I am naturally nervous. I came across this site in a search for encouragement, and this is what I get, a negative story about macrosomia, which is mostly for unhealthy diabetics, and the narrow-minded idea that “big baby” is 10 lbs. For me ANY baby is big. It’s all relative. All I wanted was some support. That’s enough discouragement for one pregnancy.
Actually I think that the official cut off for macrosomia is 8.5 pounds.
You think that OBs picked this number out of thin air?
Rather than scouring the internet for “stories” how about a PubMed search for scientific literature? What good is “support” if it induces you to make decisions that risk the life of your precious baby?
This page makes no mention that the “big babies” page is only for macrosomia. I was just doing a search for real women’s experiences with narrow pelvises, particularly the small android type. So to reiterate, a big baby to many women is a baby, like 7 lbs. I’m an advanced practice nurse and have visited pubmed many a time. I am aware that CPD cannot be diagnosed until a woman has a trial of labor. That is evidenced-based. I just want to see a woman of my pelvic size have a baby vaginally. That you can’t find on pubmed. I am shocked that you think labor is bad for baby! It is well documented that labor helps the baby transition into the world, squeezing out it’s wet lungs for example. If a C/S becomes necessary, at least labor would have helped to prep baby.
” I am shocked that you think labor is bad for baby!”
Where on earth did you get that from?
(Though, yes, vaginal birth is slightly more dangerous for baby – ANY baby, regardless of size – than planned pre-labor C-section.)
Besides, your argument for labor doesn’t make any sense. “Squeezing out it’s wet lungs” happens as the baby exits the birth canal well into stage 2…not during labor or stage 1. Labor doesn’t “prep” baby for extra-uterine life at all.
What difference does it make if you find a birth story for a woman with your exact measurements? Her experience is not transferable.
While I don’t know my specific pelvic size, I understand your concern – prepregnancy I weigh 108#. My first was 7 pounds 10 ounces. I was THRILLED his sister was a pound smaller. I really dread the idea of a baby 8 pounds or bigger. For his/her clavicle/neuro function/life and my perineum and to not wear depends for the next 40-60 years of my life.
Also:
” It is well documented that labor helps the baby transition into the world”
PubMed link?
My experience with an android-type pelvis is that I had skull moulding (a halo just above my eyebrows) that lasted for ~3 months after being born by caesarean due to a concerned Ob/Gyn begging my parents to skip induction/augmentation. I weighed 9lb,15oz and was lucky enough to not be damaged by the placental abruption that the doc found during the caesarean. (Quote: “I have never seen a live baby come out of so much blood.”)
My point? Vaginal birth is not as important as a healthy baby.
About the only problem with planned c-section at term is that lungs that haven’t fully dried out are a bit more common. This problem (TTN) requires treatment for a few days, then resolves, and doesn’t lead to long-term lung disease.
The consequences of labor gone wrong can be far worse and last a lifetime. And of course, planned c-section is far easier on the mother than many hours of exhausting fruitless labor followed by emergency c-section.
So. Small women can have big babies. Big and small are relative terms. Whether or not you have GD matters.
As other commenters said, when you reach your third trimester, sit down and have a talk with your obstetrician about YOUR chances of delivering YOUR baby vaginally, and what might happen if you attempt it. The doctor may think your chances are good. Or, he may think your risk of CPD is high, but favor trial of labor with the understanding that you’ll move to c-section if labor doesn’t progress. But if your baby is truly unusually large, or has a big abdominal circumference, meaning increased risk of shoulder dystocia, he may offer or encourage prelabor c-section.
I don’t have any of the relevant information. Only the doctor who’s examined you knows that.
Doesn’t it depend on the labor? I don’t think that laboring a large baby through a narrow pelvis is going to be a good thing, do you?
Good and bad, who knows. But there are degrees of risk. A small baby with a large pelvis? Probably a pretty good situation, and low risk (assuming nothing else). A big baby and a small pelvis? Labor is probably a lot riskier.
So sure, sometimes, labor is bad for a baby.
You should to two things. First you should have an honest conversation with you doctor about your concerns and listen to his/her advice. Second, you should stop looking at a c-section as “giving up” or failing. I understand surgery is a scary prospect but c-sections are one of the safer kinds of surgeries. Remember that the “goal” is not a vaginal birth but a healthy baby and mommy.
I never insinuated that only 10 pounders are big babies. In fact my point was that due to many factors beyond mother control vaginal birth might not be in the cards for some women. You might be one of them but again that is something you have to talk over with your doctor. The reason I use 10 pounds as my example is because multiples of 5 make my brain happy and it is obvious to anyone reading that 10 pounds is huge.
The only people you should really listen too about these issues are your doctor and his/her medical team. They know your medical history and have the medical knowledge to guide you to make the best decisions. It could be that you are a great candidate for a vaginal birth and even though you are small you still have a favorable pelvis. No one here has that information nor should we.
What’s discouragement? That if your baby is too big, you would be better off having a c-section? How is that discouraging? It sounds encouraging to me, because it means that you don’t have put up with a situation where the baby is too big to be delivered vaginally.
Support for what? Give up what?
Big babies happen for all sorts of reasons. Both my aunt on my mom’s side and my nephews wife on my husbands side had BIG babies (no they were not overweight or diabetic). The reason: my nephew is almost 6’5″ and his wife is about 5’4″.
My aunt is 5 foot 2 and her husband was 6′ 3″
Large babies make deliveries into more serious situations. one of my aunts babies had both his collar bones broken during delivery.
It has nothing to do with negativity, it has to do with geometry and physics, how big is the baby’s head, in what direction is the babies head pointing, what is the formation, shape and size of the woman’s pelvis?
If the baby’s head (or shoulders) won’t fit through then they won’t. Math doesn’t care about positivity or negativity. If a person has the shape pelvis that will only fit a baby’s head of a certain size, it doesn’t matter if the baby is a 6 pounder.
I know the original post is 5 year old, but the question is so dumb…it’s like asking if a child should give up on their dream of being six feet tall. Dream if you want, but you can’t will your body to be able to do something it just isn’t built for. If a kid’s parents are 5’3″and 5’6″, it would be destructive to be telling them that a future as a professional basketball player is theirs for the taking if they work hard enough.
Maybe you can, maybe you can’t. That remains to be seen.
Most babies do make it out…just a larger proportion of the larger babies get stuck and suffer serious effects…including death. I mean, they still get out…they’re just dead.
Cows, horses, dogs and cats ALL grow babies too big to birth. What makes you think you’re any different?
I hope things go well for you…but growing a baby “too big to birth” absolutely is possible and a website that seeks to sweep that under the rug is foolishly ignoring the risk of death that faces macrosomic babies.
Not to mention your long term pelvic floor integrity.
How bizzarre! My last kid was 9lbs 11 oz. I had GD (despite having a bmi of 17 when got pregrent, yes that’s right, you can get diabetes even if youre not at risk) which I THOUGHT was well controlled, but obviously not. Her blood sugar, incidentally, was 18!! She also had a true knot, which I guess is more common in big babies. Anyway, it was a very easy delivery, but regardless, this pregnancy I’m taking metformin and if the babe seems bigger than my last one, I’m having a section. I’m not risking shoulder dystocia!
I am definitely bookmarking this page and sharing it with my
friends.
“Your body won’t produce a baby that is too big for you to deliver”
From Evidence based Birth…
” If diabetic women were offered an elective C-section for every baby that is suspected of weighing more than 8 pounds 13 ounces, it would take 489 unnecessary surgeries to prevent one case of permanent nerve damage. This would cost $930,000 per injury avoided. If diabetic women had an elective C-section when their babies were suspected of being 9 pounds 15 ounces or greater, it would take 443 unnecessary surgeries to prevent one case of permanent nerve injury, at a cost of $880,000 per injury avoided.”
But as you can see, it only takes one lawsuit to justify the cost of all those preventative cesareans. $33,351,934 reasons why a doctor might consider offering an elective cesarean. These are only one year’s OBG Management Medical Verdict worthy cases. There are more that are just not published, this is not just a rare event parents and babies have do worry about.
1) WHEN SHOULDER DYSTOCIA WAS ENCOUNTERED
VERDICT A $5.5 million Iowa verdict was returned.
2) ERB’S PALSY AFTER SHOULDER DYSTOCIA
VERDICT A $1.34 million New Jersey verdict was returned.
3) FORCEPS DELIVERY INJURES MOTHER’S PELVIC FLOOR
VERDICT A $1,716,469 Illinois verdict was returned, which included $484,000 to the patient’s husband for loss of consortium.
4) LARGE BABY WITH CERVICAL SPINE INJURY
VERDICT A confidential Texas settlement was reached.
5) DID OB’S ERRORS CAUSE THIS CHILD’S INJURIES?
VERDICT A $1,314,600 Iowa verdict was returned.
6) 12 LB, 7 OZ BABY, BRACHIAL PLEXUS INJURY
VERDICT A $1,174,365 Ohio verdict was returned.
7) EXCESSIVE TRACTION BLAMED FOR NERVE INJURY
VERDICT An Illinois defense verdict was returned.
8) BRACHIAL PLEXUS INJURY AFTER SHOULDER DYSTOCIA
VERDICT A $72,500 Texas settlement was reached.
9) ZAVANELLI MANEUVER; BRACHIAL PLEXUS INJURY
VERDICT A Georgia defense verdict was returned.
10) Pelvic injury from the McRoberts maneuver?
VERDICT A $5.5 million New York verdict was returned.
11) 1. Severe birth asphyxia: cerebral palsy and seizures
Verdict: The insurance company ultimately paid $10.15 million.
12) 4. Shoulder dystocia, uterine tachysystole complicate vaginal delivery
VERDICT A $3.55 million Idaho verdict was returned.
13) CHILD’S ARM PARALYZED DESPITE MOTHER’S EXPRESSED CONCERN
VERDICT A $1.6 million Ohio verdict was returned against the ObGyn group.
14) MIDWIFE “PULLED TOO HARD”; CHILD INJURED
VERDICT A $950,000 North Carolina verdict was returned.
And those costs don’t include the cost of the legal defence, which makes it even higher.
expat
June 9, 2013
Your comment is awaiting moderation.
I really take issue with several claims in this article
-episiotomies are one of the main causes of 4th degree tears.. really? they cut diagonally. and isn’t there usually something else going on which would cause a tear into the rectum?
-one needs 450 unnecessary cesarians to prevent one case of permanent nerve damage for the baby (brain damage and death not included) at a cost of 880,000 usd per injury avoided.. really? what about the million dollar settlements for those injuries and the hundreds of thousands that go to the attorney?
– for every 3 cases of permanent nerve injury prevented in a non gd mom, one mom will die of cesarian complications if every mom with a suspected big baby gets a cesarian.. really? how did you calculate this? In a real paper, you have to show how you come to these sorts of conclusions. My guess is that you took the 3695 cesarians used to prevent 1 permanent nerve injury in a non gd mom and combined it with the 20/million risk of death from cesarian to get 0.07 maternal deaths per 1 nerve injury prevented.. oh wait, that isnt a ratio of 1:3, it is a ratio of 1:14, so heh? your numbers? and that isn’t even a fair comparison because the cesarian death rate is 3 times the vaginal birth death rate and the calculation above assumes no deaths ever. So, in the interest of accuracy, I’ll add 33% to get a ratio of 1:19 injuries prevented (brain damage and death not included, and only non gd moms, of course).. but we still aren’t close to the truth, because the standard of care for moms with suspected big babies and no other causes of concern is not cesarian, but early induction, which you mentioned tended to doube the 8% primary cesarian rate of the low risk, often first-time moms. So the reality is very different from the scaremongering 1:3 ratio you describe. If a mom with a suspected big baby chooses induction, she takes on a risk of death of 7/million instead of 8/million if she refuses. She also protects her baby from a host of real and serious complications which you spent thousands of words dismissing.
If your goal is to convince women to ignore their doctors’ advice and go post term with a suspected big baby, good job. I’m sure most won’t be able to get pet the bibliography salad to see the ideology underneath.
p.s. error bars, plus minus 1 sigma, would clarify all of the cobwebs you were painting around ultrasound and other topics.
reply
she replied at length and with a warning, so this is what I came back with:
expat
June 10, 2013
Your comment is awaiting moderation.
So *that* is where the discrepancy comes in. Rouse estimated a risk of death from cesarean of 13.5/100000 above that of vaginal delivery, you say. This is significantly different than what you find in other literature:
here they find no statistical difference in the death rates of planned cesarean and vaginal birth: http://www.cmaj.ca/content/176/4/455.full
this description of a study by the birth trauma association which used over 2 million women to find that the risk of death for the cesareans was 8/million worse than planned vaginal delivery – so, not statistically significant
http://www.telegraph.co.uk/news/uknews/1584671/Women-choosing-caesarean-have-low-death-rate.html
madhukar pai (2000) settled on a death rate of 20/million for cesarian under ideal circumstances with a healthy mom.
notice that I didn’t include any studies which counted emergency cesarians for pre eclampsia or whatever. That makes a very big difference.
Your numbers differ from mine by a factor of ten. That isn’t so easy to explain away.
reply
I doubt she will let either through moderation
ExpatJune 10, 2013Your comment is awaiting moderation.
I think it is important to point out another problem with using that 1997 study to draw conclusions about maternity care, aside from the error pointed out in the 1:3 ratio with respect to maternal death rates.
The 1997 study must’ve used some estimate of ultrasound error in order to estimate the number of cesareans which would be required to prevent the single case of permanent nerve damage for the baby.
But ultrasound has improved a lot in the last 15 years. The 2002 Chauhan paper that you cited provided some evidence of this with accuracy ranging from 15% to 75% over the decades preceding the review. Today, the measurement is a bit better.
Nahum GG. Estimation of Fetal Weight. Emedicine, updated April 2010
Using today’s ultrasound error rate of 10% (this means that 70% of measured babies will be accurate within 10%), if you measure 9 pounds, there is an equal probability that the baby weighs 1 pound less than this and that it weighs 1 pound more than this, but there is less than a 30% chance that it is more than a pound wrong in either direction. Indeed, 50% of the babies with this measurement will weigh less than 9 pounds, as you emphasized, but that isn’t the point.
If your doctor tells you that she has measured a 10 lb baby, you are most definitely carrying a big baby. If she measures 9 pounds at 36 weeks, you are going to have a big baby if you wait too long. They tend to gain a half of a pound per week. I don’t think this reality comes through in your writing.
And if the errors from ultrasound have been reduced from 50% down to 10% in the last 20 years, as suggested by the articles above, this would (in addition to the maternal death rate problem) have a dramatic impact on the 1997 1:3 ratio that you repeated several times in your article.
I really think that is wrong to spread about because it is easy to remember and could get repeated. And that would be a shame, because it is not accurate.reply
nope, not getting through moderation. And I thought I sounded pretty reasonable.
Despite the site name, the author appears to have some biases that she doesn’t like having challenged, which is disappointing. Someone who is truly scientific is able to question their facts and conclusions, and is open at least to polite challenges.
If I had put in more pleases and thank yous, do you think it would’ve passed moderation?
Your comment above (starting “I think it is important to point out another…”) seems perfectly polite to me. It makes no “sweeping statements” and is not disrespectful. I wonder if the site author would respond to an EMail with a polite inquiry?
Well, more than a day later, she did let the comments through, but gave me a special, go away message. Apparently, I was dominating the discussion, not that there was any discussion going on that I could identify. I’m fine with that.
I now see that Dr Amy has previously written about that site: http://www.skepticalob.com/2012/09/new-website-evidence-based-birth-suffers-from-a-shockingly-lack-of-evidence.html
I find it entertaining that Rebecca says that you have clearly made up your mind — so unlike her. To truly be evidence based, you have to use more than the studies that you like. You have to look at all of them, including the ones that don’t support you. She does not appear to do that.
She keeps her word. I wrote a nice note thanking her for letting my comments through, with a brief aside emphasizing the problem with using underpowered studies to draw conclusions, and it was deleted.
Both of mine would show up as elective – but neither of them were anywhere near the Too posh to push variety. The considerable risk of not having them was to me. Emergency CS is clearly different and more traumatic, but surely most of the time the risk is more imminent for the baby not the mother? My point being that conclusions about risk of mortality need a lot more detail than is available.
I posted the comment below to evidence based birth.. better than watching tv, at least.
There are just so many claims in that article, it is hard to no where to start. Is it really true that episiotomies are a main cause of 4th degree tears? Cause? Really? Don’t they cut diagonally to avoid the 4th degree tears? And in cases where they are required, you can’t place causal blame on the episiotomy because there was probably something else much bigger going on.
Exactly, why was the episiotomy being utilised in the first place? If it was needed to aide in the delivery of a macrosomic baby or forceps delivery then the relationship 4th degree tear:episiotomy is only correlational. This is high school stuff.
Compensation to the husband for *loss of consortium*? Can you imagine standing up in court and documenting your insufficient sexytimes? Oh my.
Is “loss of consortium” a legalistic term for “loss of sexual relations”? or is it more general for loss of the relationship, including sex but not limited to it?
More general.
I looked it up, because I didn’t even know there was such a thing. Apparently it varies by state whether it is more general or just sex.
she let your comment past moderation, but with a warning: lawsuits don’t count as evidence, if you try to use them as such, you will be blocked in the future.. this is your last warning. ooooo
I doubt mine will make it past moderation.
That’s hilarious. If lawsuits aren’t evidence of the cost of lawsuits then what is?
I wonder if her point was that a court of law uses a different standard of evidence — often a much looser one — than medical research does. For example, look at the lawsuits against Dow Corning (?) for breast implants years back, many of which were successful, before the scientific evidence came back saying that breast implants were not statistically associated with the host of complaints women were suing over.
If that is her point, then it’s a reasonable one in the context of what medical research says is the best care. But not in terms of the cost of that care or the cost of consequences, where she seemed to be ignoring it.
I can agree with lawsuits not being equivalent to evidence, BUT these
lawsuits represent real costs of extra medical care, surgeries, hospital
stays of these injured babies. If there was a way to add up the care
required, I’m sure it would greatly exceed the $880k.
Exactly. One can argue where the line gets drawn, but when you’re making a big point about how much money you spend per harm averted, it clearly makes sense to figure out the cost of that harm. If you spend $1mil per harm averted, but the harm on average costs $10mil, then it’s clearly the right money to spend. On the other hand, if that averted harm cost $100,000, then the $1mil spent to avoid it isn’t such a bargain.
You can argue about where to draw that line. If it’s 1 to 1, is it worth while? And so on. But to totally ignore that factor … I wouldn’t say it necessarily shows a bias because I haven’t read enough of her writings to know. But it’s either a bias or a significant oversight. If one is big into focussing only on the “medical research” side of things, I can imagine wanting to ignore the societal factors such as cost. Which is fine in that context if you then actually ignore it consistently. She doesn’t.
She’s throwing around these big costs without putting them into any context.
She makes me laugh. She comments how we all need to follow proper decorum as if in her classroom. That we all need to follow her comment policy protocol too. She states that although the legal aspect of practicing medicine is one way of looking at things it is not for this forum because it is not evidence based.
This reminds me of the movie Back to School with Todney Dangerfield when he is in economic class discussing the widget. One needs to discuss the personal emotional aspect of medicine in that every doctor tries to avoid every complication and is not just going to accept a brachial plexus injury for 450 shoulder dystocias. If Informed consent and elective cesareans can prevent injury and deaths and lawsuits then that is reality medicine. Doctors know that one legal case can cost more than 1000 preventative (unnecessary) cesareans. Rebecca needs to factor in all that otherwise she is teaching her class on Fantasy Island.
http://youtu.be/YlVDGmjz7eM
But, Dr. Amy, if you take away my three vaginal births of 7 pound babies then I”ll be forced to rely on my Magna Cum laude BA and AA and my great job and owning my own business….Oh and breasfeeding all my kids….WTF?!
http://evidencebasedbirth.com/ This site addresses the same topic, but with a – measuring the size of a baby causes more problems than it solves – attitude. Their claim that – to prevent 1 very rare baby nerve injury by performing a c section for a suspected big baby, 3 moms would die from c section complications – is quite a shocker were it true. Where are they fudging the data? They also poo poo the shoulder distocia risk while simultaneously writing that it is a physician’s biggest fear. That doesn’t compute. this article bothers me because they come across as so reasonable and I might believe them if I didn’t know better.
sorry, I got it backwards: for every 3 cases of permanent nerve injury prevented, there would be one maternal death
This is probably just dangerous when taken out of context: no GD, elective c section for suspected big baby. Plus, c section isn’t the standard of care for a suspected big baby, they try induction which should reduce the c section rate for that population dramatically. Say, 20% get c sections for a suspected big baby (no gd), then for one maternal death, you would prevent 15 cases of permanent nerve injury (not including brain injury?). This still doesn’t sound great, but I bet they fudged the data in some way. It was a 1996 study that she was using. If it was so great, then it would’ve influenced the standard of care by now.
I just thought of another reason why this comparison isn’t okay. You have to compare the aggressively managed big baby population to the conservatively managed big baby population, not to a mythical perfect birth population, which is what the 1:3 ratio does. The non- misleading, analogous statement would be that for a non-gd pregnancy, for every 30 permanent nerve injuries (not counting death or brain damage) that are prevented by early induction, 1 mother would die compared to doing nothing at all and for a gd pregnancy, the ratio would be 4430:1. That 1:3 ratio has really got to go; it is really misleading.
if I could write one thing to the author, it would be: error bars for every statistic quoted!!!
just a simple plus minus the standard deviation would do
it would go a long ways towards understanding the inaccuracies in ultrasounds.
My parents were in the NICU for 4 months after my twin and I were born early and tiny. We shared the NICU with a baby girl from the nearest reservation where medical care was non-existent and poverty was endemic. This little girl weighed over 14lbs since her mom had untreated gestational diabetes. She was delivered vaginally, got shoulder dystocia,and was delivered with two broken shoulders. Her parents weren’t proud; they were heart-broken. They hated that their little girl had to suffer like that.
On a positive note, the number of macrosomic births on that reservation has plummeted since the tribe opened a successful casino and tribal members have access to free, excellent health care.
My first child was 9 lb 14 oz. I was induced at 8 days past my due date, because my OB was getting concerned about my blood pressure, and the ultrasound I had the day before estimated his weight at 8 – 8 1/2 pounds. I felt a bit horrified that he was that much bigger than the ultrasound had predicted.
With my second, we’d moved states, and I was seeing a different OB. When we went over my history with my first pregnancy, she gently suggested that I might not want to go so far past my due date this time. We decided to induce the day before my due date (date that worked best with my work schedule and with grandma’s availability to watch kid #1). He was 9 lb 5 oz.
With my third, we’d moved again, and again had a different OB. She said that as I clearly had a roomy enough pelvis, she was comfortable going to 41 weeks, so long as baby appeared to be doing well, and no other complications arose. We induced right at 41 weeks, and my daughter was 8 lb 9 oz. And she had sticky shoulders. My OB was able to resolve the issue quickly, thank goodness.
I grow big babies, even though I passed the GD test with flying colors all three pregnancies. I apparently have a favorably shaped pelvis. It has never occurred to me to feel proud of either of these things, as they just are. I have the good fortune of having genes that are favorable for pushing big babies out, but unfortunately appear to lack the genes that tell my body when to get the show on the road and go into labor already. I’m still sort of pissed at my body for the latter.
Dr Amy, I really must say ‘thank you’ for these topics where you add in a bit of extra information to explain the ‘why’. The pictures of the different pelvis shapes I’d never seen before and it’s really helped me understand.
My mum bemoaned her ‘unnecessary c-section’ as she was judged too small to deliver vaginally by her obgyn at the time. She looked at other mothers that were smaller then she and felt gutted that she’d ‘failed’ (and focussed heavily on this when she had PND). I was motivated to try very hard to give birth vaginally (did hypnobirthing class and prenatal yoga and sat on a fitball a lot for that last trimester). I even considered a homebirth, although my husband told me he was very uncomfortable with that idea and so we decided against it.
My obgyn was happy for me to keep going with all this, even though he rolled his eyes at it. I can have pretty thick skin when I need to and ignored the sarcasm. I had friends who were tiny (I have quite a few chinese friends I studied with) who have big strapping Aussie husbands and who gave birth vaginally. I’ve never fully understood why my baby never made it into the pelvis even though I’d done everything ‘right’. Seeing these pictures makes a lot of sense to me why it doesn’t always work, even for average sized babies and average sized women.
For those who read the Big Baby Project website and may be thinking how they ‘failed’ and worry whether they had an ‘unnecessarean’ or can’t understand why their baby suffered a shoulder dystocia, I hope this information also helps them to come to peace with the idea that there are things that you just can’t change about your body. And that’s fine. There’s lovely doctors (or even rude sarcastic ones) that can help get your baby out safely for you.
Websites like the Big Baby Project, are really unhelpful for anyone trying to ‘research’ and second guess what their doctors are saying. They don’t go into any of these sorts of underlying issues that doctors know about. The big baby project people are cherry picking the positive stories and setting the bar far too high for someone that might have underlying issues.
I had a big baby (9lb 12oz). I am 5’1″ with no family history of babies over 8 pounds (on my side OR hubby’s side). I had a c-section after 24 hours of pitocin-augmented labor (due to an early rupture of membranes), and the realization that my OP baby was not going to flip over or move.
Upon hearing this, so many NCB proponents will say “your body won’t make a baby bigger than you can handle…unless there’s something else going on…”
Guess what? When I got pregnant, I was running daily and at a healthy weight. I had hyperemesis, and lost 10% of my body weight, and did not gain weight until well into the 2nd trimester. I passed my GD test with flying colors (even made the OB go back and check after baby was born). I walked 2 miles several times a week. I did yoga, spinning babies exercises, sat on the exercise ball for hours a night. A 3rd trimester ultrasound showed a normal sized baby. I only gained 25 pounds, well within the healthy guidelines. In fact, I left the hospital only 7 pounds heavier than I started pregnancy. There was nothing else going on.
“But if you hadn’t had an epidural, you would have made it work.” <–This was said by the midwife at my OB's office (which I luckily have risked out of seeing during my 2nd pregnancy…yay hyperemesis!) and even several NCB loving friends.
Read about obstetric fistulas in 3rd world countries…read about the fact that the risk of dystocia increases significantly with baby weight…
I considered a VBAC for my upcoming birth in December. Seriously debated…talked to women who had RCS, successful VBACs, and unsuccessful VBACs. Then, my brother's MIL took me aside. Her first child (brother's wife) was a large baby, born by c-section. It was the early 90s, and VBACs were all the rage, so she attempted for her second baby. That baby, now 21 years old, had shoulder dystocia, erbs palsy, cerebral palsy, and has struggled her entire life with a litany of physical and intellectual difficulties due to that decision. With tears in her eyes, the mom told me, "it's not worth it…no sense of accomplishment, no high, no bragging rights, not even the marginal increase in maternal safety…not worth the health of your child." She went on to have a 3rd, healthy child by c-section, which she describes as a healing experience.
I thanked her profusely. THOSE are the stories that need to be told. Yes, some people are built to birth big babies (a close friend is one of them!)…some are not. Her words convinced me to do the c-section. No idea why or how I made a big baby, but I'm not risking the health of my second child based on bragging rights or the unfounded belief that my body (which, incidentally has failed me at nearly every moment in the reproductive process) is built for this. Maybe it just isn't. Maybe I have a "lemon"!
I love the woman’s description of her “healing” c-section. And good luck with your second!
I, too, had a “sunny side up” baby with my older daughter, who was only 7 pounds & change…. she was postdates (40w6d) and we tried pitocin & cervidil at the hospital. When I’d had as much pitocin as I was comfortable with having, I was only 3 cm dilated. My OB asked me if I wanted a c-section and I said, “Please.”
Could I have pushed through (pun intended) and tried harder for a vaginal delivery? Probably, but at that point I was already tired and a little bit frightened. I’ve never seen my C/S (and my RCS) as a failure in any way. I have two happy, healthy daughters (now 6 and 8) and that’s what’s important – not the birth story.
I’ve always wondered what NCB folks have to say about obstetric fistulas. All these NCB women who brag about their labor lasting days and days, when that’s always the way the fistula patients tragic stories start out.
Umm… ” My first born was 9lb 11oz spontaneous drug free vaginal at 42 weeks. I went in to have an 8lb 11oz home birth, and then a drugfree, hands
off, spontaneous vaginal twin birth with both twins BREECH. Time for
people to stop telling us what we can’t do.”
*claps slowly* Congratulations on endangering the lives of your twins and having a big enough pelvis to birth your other children. Here is your cookie. That is what I want to say to that woman but I don’t think my tone would play well over there.
Well isn’t that just ducky for you. You must be such an amazing mother! Much better than me, clearly, what with my total failure to have a perfect pelvis and my vagina must be worthless since its clearly only good for half its job. Of course, even if my body had been inclined to not-fail, that damned epidural that I was weak and wanted. And I should be ashamed of my c/s, the lifelong badge of failure permanent on my skin. Woe is me (and my poor, unloved son) that I am not a REAL woman like you!
(the above is sarcastic, in case you missed that)
Stop telling US what you think we HAVE to do. My son is worth more than the single event of his birth (which was great because he’s alive and healthy)
Dear Ducky,
Since you put quotation marks around this statement, it was not your birth story, right? You even started your comment with the word “Umm…”. Which says to me that your comment was meant as a criticism of the mother of twins who took this risk.
Hope everyone gets that! (The second answer-comment seems to take that into account. But the first one, I’m not so sure of, because of the opening sentence.)
😉
I agree, I thought Ducky was quoting one of the scarier stories from the website, not one from her own experience.
If that’s the case, pardon the reaction…the feelings are pretty strong at this point @_@ sorry ducky?
I don’t know if anyone else caught this, but on the “participate” page there is this entreaty: “Be sure sure sure to tell us if it was a VBAC!!” Because extra kudos if you were able to VBAC a macrosomic baby!
So I sent in my son’s picture with a nice view of his “waiter’s tip” from his injury. Attached are the following words, “This is my son. 9lbs. 8oz. of him. Homebirth, severe shoulder dystocia, and birth injury (brachial plexus/erb’s palsy), sensory issues due to birth trauma, and suspected torticollis due to the pulling . I did it… never mind the broken tailbone and tears to my rectum.
Women should also know the risks of a big baby. I never thought I’d have a problem as I did everything “right” (homebirth, all natural, not even tylenol when pregnant). I wish I would have been informed of the risks and then I at least could have understood there was a risk and what they were.”
Think they’ll put it on their website???? eyeroll
I am so sorry for your son’s birth injury. According to the NCB books, hospitals kill women and babies, so you thought you were saving your son’s life.
Let us know if they do! (something tells me we’ll be waiting a while…)
One of the women is bragging about her 9 pound baby that gave her a third degree tear and had “moderate” shoulder dystocia?? Um, what about that story is going to change anyone’s mind about what babies are too big to birth vaginally?
Also, this story sounds like a joke. This has to be someone joking, right? Let’s celebrate risky, stupid behavior! Yayyyyyy momma rulez.
““February 5th, 2010 (also my son’s birthday he was 8 that day) – My mother gave birth to a 10 lbs 2 oz baby boy, (her due date for him was January 7th!) at home in her bathtub, with just her and her husband. The doctors tried to convince her to do a c-section for many reasons… her weight (40+ lbs overweight), her age 45 at the time, they said she had gestational diabetes, and this was her 6th live birth. She said she had never had a c-section and she wasn’t about to start. She also said it was by far her easiest labor. The rest of us were between 8-9 lbs at birth!”
Six live births? Just how many stillbirths has this overweight, older, GD mom had?
Also Gotta love “they SAID she had gestational diabetes”…. as though, its just something people SAY. Not something that can, like, be verified by testing or can cause you/baby actual harm or anything.
agh… will anyone she knows be brave enough to tell her that her risks of another s/d increased around 7x because of her previous one and that her babies might get bigger? Will it take her next child suffering from an OBPI or worse to stop her bragging?
And even having a gynecoid pelvis doesn’t guarantee anything. I do, but I just don’t seem to go into labor. 1st baby was 2 weeks overdue (induction, c-section for fetal distress), and 2nd was a week overdue with polyhydramnios when my OB called it. I never had any contractions that I could feel with either pregnancy, never effaced or dilated, and none of my NSTs ever picked up contractions. If we have a 3rd, I plan to just schedule a c-section, not keep waiting around.
I never had any kind of contraction or dilating or anything with my first two until I was induced. My first was very late and my second I started leaking fluid so was induced around 35weeks 4/5 days. Then with my third I became effaced really early and ended up having some contractions that sent me to the hospital where they promptly ended, but I was 100% effaced and dilating so they kept me and I ended up having on and off contractions and continued to dilate so they broke my water and gave me some pitocin which finished things very quickly. The labor itself was so ridiculously easy, but I am not positive it was worth the 3 months of pain and leg numbness that came before it.
My mother-in-law was the same way. She went at least 2 weeks post-date with all of her pregnancies and never was able to begin labor.
Are these people a distinct group from NCB/paleo? Because I just cannot imagine that 10,000 years ago the average child weighed anything close to 8 pounds / 4 kg.
We have those books because we have a Brachial Plexus/Erb’s Palsy son. THe midwife pulled so hard on his neck that she severed nerves from his spinal column. The nerves can be stretched, torn in the middle of the nerve, or severed from the spinal column. My son has a combo of all 3. And even in stretched nerves can have scar tissue (neuromas) on them that need dealt with. Our son had nerve surgery at 3 months old and has scars on his legs and neck, and had muscle transfer/tendon releases at 19 months old with scars on his arm and arm pit. He will never have full range of motion and he lacks being able to move his arm certain ways. He is in OT, Aquatic Therapy, pediatric chiro care, gymnastics for strengthening, and sees his specialist (he has graduated from PT).
This is a risk of a big baby that no one talks about. Thank you, Dr. Amy for helping make it known. Our son was 9lbs.8oz. Too big for me and I wish I would have known then what I know now. Our whole lives were changed the day he was born. It was almost the day of his death… we are blessed and we know it. Thankful God intervened and blessed us even though I stupidly chose a homebirth.
OBPI Mama, every time I read one of your posts it brings tears to my eyes and I want to send you a big hug.
I appreciate your kindness.
You just wrote the perfect reply to”
“They can treat that, right?”.
Yeah, you would be impressed at how much time and money all that treatment takes. Makes a c-section and extended stay look like a bargain in comparison.
Oh my goodness, yes. My babies, after my first son, were c-sections… the cost of all 3 of those c-sections put together don’t even come close to the cost of my first son’s injury and care. Though he will never be “normal” and his shoulder deformities (due to his muscle imbalances and lack of range creating a domino effect) may cause pain as he grows, life long care will help (constant strengthening, stretching, chiro care, possibly more surgeries, etc). And it costs time and money and most of all…hard work from our children.
Whenever I get nerve twinges on my scar, post-c/sections, or pain when I’m doing abdominal workouts, I think “SO WORTH IT!”. Not to mention, those births have been the most peaceful, beautiful, and healthy. 🙂
Thank you for sharing your son’s story with us. This is why I will continue to fight against the lies of the NCB movement. I am sure that you thought that you were doing the safest thing for your child, and it pains me to see the grief and guilt that parents experience in the aftermath of bad outcomes.
I’m really sorry, OBPI Mama.
I am so sorry. 🙁
I am so sorry to hear of your experience. Hugs to you.
By the way, a nurse told me that her employer/OB always induces every patient at 39 weeks and the woman always ends up with a C. So I can see why this blog exists.
This is in California, but the nurse would not give me the name of the OB.
I have a hard time believing that. She won’t cough up the name because you could easily check the OB’s stats and likely note that he/she does not, actually, have a 100% Cesarean rate.
How can one check the stats of an OB? I would like to do that …
Is it true that 20% of women have android pelvises?
Probably has a strong correlation with ethnic group.
I’ve mentioned before that a friend of mine went nine days past her due date and then had a two hour labor, delivering a 10lb 4oz baby (her first daughter was just 7.5lbs). Baby had some mild respiratory problems and low blood sugar following birth, which I understand is more common with GD. My friend said she passed her GD screening at 28ish weeks. I wondered about late onset GD but kept my mouth shut.
BTW, afterward her husband said this labor was so easy they should do the next one at home.
Please tell me your friend told her husband to pound sand.
She did say that despite being pro-natural birth she did not feel comfortable giving birth outside of a hospital. Thank God. I try to ignore the anti-formula stuff she posts on Facebook almost every day; my head would explode if she started posting pro-homebirth crap.
Does pelvic shape have anything to do with baby’s presentation? I only ask because all of my babies have been breech. So I’m pretty sure it is me that does not “know how to give birth”.
Uterine anomalies can cause higher incidence of breech presentation.
Unsure if skeletal structure can influence it.
Both of my babies were face-up (not sure of the official medical term for it) and I was wondering if my pelvic shape had anything to do with their inability to turn.
Having a baby who weighed slightly over 4 kilograms made me an object of curiosity and sensation-seeking from some people, who assumed that if the newborn weighed the magic number of 4 kilos or more, then the birth must have been really bad. Hey, don’t they know there are other factors involved as well?? I am tall, and I was found to have an ideal pelvis (measured because our son was in the breech position for a while, and this was back in the early nineties, when they were more restrictive C-sections even for breech.)
Anyway, I did have some problems with the birth, and one of the reasons was a (somewhat) big baby, even in relation to my height/pelvis size.The birth could have been much better, but could also have been much worse. When I think of people’s curiosity and intrusiveness about how much the baby weighed and the presumed terrible birth, I sometimes cry. I also thought about how, if I had SMOKED, maybe he would have weighed 3950 grams instead of 4150, and people wouldn’t have gasped about the presumed difficult birth. Don’t get me wrong — I’m glad I don’t smoke. But I have thought about that now and then.
Another strange thing, though: Some of the same people who think that a birth weight over 4 kilos = terrible birth, they are the same ones who think that C-sections should be avoided at all costs. I don’t get it!
Say, is it still customary to give the baby’s weight on baby announcements? If they have stopped doing that nowadays, that’s a step in the right direction. I don’t think the baby’s weight is anybody else’s business!
My family used to joke with me that I should take up smoking while pregnant so I would be less likely to have the 10+ pound babies that I ended up with. I had all csections though so I figured they could get as big as they wanted since they would not be coming out the traditional way.
Do they have an honorable mention section? My 8 lb. 10 oz. baby didn’t fit, but I want credit for the two hours I pushed.
Me too! Except 4 hours of pushing.
Me too. Spot on 8 pounds, good presentation, water broke at home after some not very painful contractions. No dilation, no engagement in the pelvis. I didn’t even get to pushing she was that determined to come out via the sunroof.
Maybe I should send my story in as the ‘average sized one that doesn’t fit’.
Pushing for 5 hours was really one of the more ridiculous decisions I ever made. (I won’t call it stupid, because we had constant fetal monitoring showing that the kiddo was doing fine – the only person suffering for that foolishness was yours truly). Should have called it much earlier and just gone with the c section I wound up needing anyway. (Kiddo was large and posterior)
I am reminded to the Chinese women of old, whose worth depended on the size of their feet. Am I the only one?
Nope, I thought of that and of women who would pride themselves on how white their skin was. I read that women used to take a mixture of arsenic and other things to whiten their skin.
Or the women who’d corset themselves and deform their spines in order to have the tiniest waist.
I’m curious – I know that big babies are associated with a large weight gain. Do we know the cause and effect or the mechanism there? I had a macrosomic baby (by c-section, we tried an induction and she just wasn’t going to fit), and I gained an insane amount of weight – more than 60lbs. I had no diabetes (GP and OB both said chances are slim it was a missed diagnosis), I exercised a lot and ate relatively well, I just was hungry all the time from the beginning to the end, in a way I haven’t been before. I’ve lost almost all the weight with minimal effort after six months (I suspect the last five or so pounds are primarily breastfeeding related). It’s early days, but my daughter is still big for her age, but she’s average in her height/weight ratio, following the 50th percentile curve.
I vaguely wonder if preventing her huge size and hypoglycemia would have been as simple as eating less, or if the insane hunger was related to some underlying cause.
I am curious about this too. My first was like this. I gained #57, and could not stop eating, my hunger was insatiable. I did eat pretty well, without a lot of junk food and no sodas or caffeine, so the sheer amount of food was ridiculous. I wasn’t slim pre pregnancy, but I wasn’t obese either, just a little chubby.
My son was only #9.2, but his head was huge. I pushed for 4 hours, with a 2 hour break, and he never even descended. I had originally requested an MCRS and was told no, that a VB would be easier… I was happy to end up with the CS when I saw his head. He was so stuck it was tough to get him out even via CS. There was no way he was gonna fit.
stacey—I am trying to reach you by every electronic method available! Pls get in touch!!
I don’t know. I actually lost weight with my last one because even though I was not diagnosed as having GD and my sugars were fine I was eating like I was. She still ended up being 10 pounds.
My friend lost something like 20+ pounds in her last pregnancy (she was obese to begin with) and had the 10lb4oz baby and no diagnosist of GD. I too was obese pre-pregnancy, and only gained 12 pounds. I did not have GD and I didn’t try to control carbohydrate intake. Baby was less than 8lbs, and by the time of my six week postpartum check I was 24 pounds below my pre-pregnancy weight. My metabolism was just whacky during pregnancy and early lactation – the one time in my life I could not gain weight!
In my prenatal class, there was one NCB pregnant woman who complained constantly that her insurance wouldn’t cover the homebirth that she wanted. She bragged that her mother homebirthed all of her kids, including her younger brother who was THIRTEEN pounds. I think she took my shocked/horrified face for admiration and awe.
My cousin just happened to post on FB about ten minutes ago that she is due today, but that the dr refuses to induce, citing ACOG guidelines, even though the baby is estimated at ten pounds. This is her sixth baby and she has never gone into labor on her own. Wouldn’t it be better in this case to induce? What’s the research on this?
Someone in this group got to her due date and when the OB declined to schedule an induction, she called and said “I’m not comfortable with the risks of going past the due date.” She reported that her induction was scheduled right away after that.
That’s sick. That is just sick that (probably one of these moms) authored a book series on a disability that the kid wouldn’t have had if the mom hadn’t been so selfish.
I don’t think those books are related to these moms! It was just an example of how common Erbs palsey is, and how it is a well known risk.
It could have been a mother that wanted a c-section or to be induced earlier and was refused. You can’t know which way the wind blew…
I seriously doubt that the Erb’s Palsy Group (website: http://www.erbspalsygroup.co.uk/aboutus.php ) has any connection to the bragging festival which leads off the post above.
With the existence of crap like “Melanie’s Marvelous Measles” (http://www.amazon.com/books/dp/1466938897), I can see how you got that impression. However, as others have pointed out, these series of books do not appear to have been created from that viewpoint.
Wow, it’s appalling that someone would even think to publish a book like that. Why am I still capable of being surprised at how crazy some people are?
Appallingly still is that Melanie’s Marvelous Measles is a spin-off of Roald Dahl’s book George’s Marvelous Medicine.
Roald Dahl’s own daughter died aged 7 of measles and Dahl himself was a strong advocate for immunisation. How disrespectful to write a pro-measles/anti-immunisation book based on a book written by a man who lost his daughter to the illness.
My twin and I were born prematurely. We were very lucky in that the only disabilities we have is very mild hypertonic cerebral palsy for me and profound deafness and very mild hypotonic cerebral palsy for her. We’d of both liked more books with characters who had disabilities and discussed activities that were normal for us – physical therapy, occupational therapy, speech therapy – but that our friends didn’t understand.
I’m glad they have those books. The books will help kids with Erb’s Palsy.
I think books featuring heroines and heroes with disabilities are long overdue. I do think/see how these could be especially helpful for children.
My point was this: isn’t it just a little self-serving to write books on the disabilty that you casued your child to have through your own careless choices? Without doing any further research, I assumed that was the case with the books in the post. From what I read on Erb’s palsy, it is almost always entirely preventable- and a homebirth with a macrosomic baby sure seems like the simplest and easiest recipe to Erb’s palsy.
I think the website is about more than bragging rights. It’s proving that those dumb doctors are WRONG for telling women that they need c-sections for big babies. 9lbs+ is just a variation of normal. If they can birth them vaginally, anyone can!
antigone23, I read their About section, and I think you are spot on: “This is a collection of stories. The stories are about Mamas who
vaginally birthed babies that some people may consider to be big.
People need to hear and see these stories, I hope you share it far and
wide”
Creepy. I do not want to know what other women can push out of their vagina.
That is just…
Really it is no different than being proud you managed to pass a kidney stone.
Or that you didn’t need braces for your teeth.
Or me boasting that I have such small feet I can buy shoes in the kids’ department .
Ladies, you have pelvises that your over large babies were able to squeeze through.
Well done you.
Move on, lean in, and find an accomplishment you actually worked for and didn’t luck into that you can be proud of.
If not for you, do it for your daughters, because they need to know that their worth depends on the content of their character and not what goes into or comes out of their vaginas.
“I crap bigger than you” – Curly, City Slickers
Being proud that you managed to pass a kidney stone without using ultrasound or anything else to break it up, and without pain relief. And that when the kidney stone came out, it was huge. (Let’s ignore the damage done to your urethra by the stone as it came out. That’s not important. Move along now.)
Maybe someone should start a spin-off of this website in which mothers compare 4th-degree tears.
I only had a 3b tear so still not mom enough I guess
I saw some interesting research a few years ago about high maternal estrogen leading to higher birth weights. I also found things showing an elevated risk of breast cancer for moms who give birth to larger babies. I’ve had some really large babies and I wish I had smaller ones. Went through some significant work ups last pregnancy to make sure there was no diabetes and passed everything. Still a 10 1/2 lb baby.
Women’s bodies were designed to have vaginal births. The Creator would not have made a flawed design in women’s bodies. But women can generally have four different shapes of pelvises, some of which can hinder successful vaginal birth.
Captain – didn’t you post a series of links about court cases and the 4 P’s? Is that somewhere else? I wanted to look them all up when I had more time.
It’s really more like my 5’10” friend talking about how she doesn’t need a stepstool to get things from the highest shelf of her closet. She doesn’t control the size of the closet or her height. Neither of those things make you a better person. And reading stories about how other people don’t need stepstools doesn’t make it possible for me to reach without one.
Of course, as a guy I am used to seeing such type of boasting. I don’t think I need to say more.
OTOH, it does bring up something that I see as a common feature of the NCB types: they tend to be very “manly” in this respect. If not in terms of boasting on their physical features (esp size of, as the case may be), but also in the “toughness” stuff. For example, those who insist on a non-medicated birth because it shows how strong and tough they are.
It took me a while, pretty much toward the end of college, when I finally got over the whole “tough guy” thing (not me, I was never one, but even with respect to others; oooo, you are going to kick my ass because I called you an asshole? OK, but I’m not quite sure how that is going to change my opinion that you are an asshole, tough guy), but the whole machismo crap is still pretty prevalent. It’s sad to see women taking it up, too.
At our home, in honor of bombardier beetles and their unique defensive mechanism…we call this farting fire. I often observe farting fire at the car repair store, sporting events, and now also on competitive mothering sites.
I find it irritating that the Alpha Male type boasting gets crossed with the Prized Cow version of women – that their purpose is to have children and a woman who has them easily is more “womanly”. Yuck.
Oh dear. I was looking at the website and noticed: VBA4C of a 10.1# baby. Scary!
I was a big baby. I weighed 11# 3oz and 23 inches long. Pictures of me in the hospital bassinet are funny. I am only 5′ 11″ and 190# now. My older brother and sister were only in the 7# range. I always thought that was curious. I have always known my mom to be diabetic. She had diabetic candy that I used to steal from the cabinet and she used saccharin in her coffee. When I was in medical school, a retrospective realization occurred to me. I asked my mom when she was diagnosed with diabetes and she recalled about one year after I was born. That was the 1960’s. I speculate that my mom was diabetic during the pregnancy with me and the doctor did not detect it and I was lucky, I said lucky not proud or impressed, that I didn’t die or have a permanent brachial plexus injury during that vaginal birth. I consider it malpractice that my mother wasn’t diagnosed or treated for her diabetes. I am glad to be alive. And I screen and monitor my patients well because of this personal issue I survived. I have never delivered a baby bigger than my own birth weight and I am proud of that. I have not had a child permanently injured or die because of macrosomia or shoulder dystocia.
I was 5 lb 0 oz at birth (born a month early). In the well-baby nursery, the nurses always put me next to the 11# baby. The contrast always got a lot of attention, my parents tell me.
My 9lb4oz baby wound up in the nursery for some high-intensity bilirubin lights – he and I have incompatible blood types. We were leaving the nursery after I’d fed him, when they brought in a tiny baby girl, born only a couple hours earlier. He was easily twice her size.
Today, we were at our local elementary school, registering him for Kindergarten. Another incoming kindergartener came in while we were there. He’s always been tall for his age, and she was quite small for her age. There was easily 6 or 7 inches difference between them. The more things change, the more they stay the same…
My nephew’s wife gave birth to a 10lb11oz baby a few years ago. She’s not very big and the birth turned into an emergency due to shoulder dystocia. They were able to deliver him but he was in the NICU for almost a week. He looked like baby Godzilla next to the 2 lb preemies.
No permanent issues so far for the baby, but that was luck and a OB team that was able to resolve it… No idea if his mom has permanent damage though.
I still wonder why they didn’t schedule a C-section when they realized the baby was measuring big and decided to induce instead…that worked out well…not
I’d be interested to hear a post or comment on the pelvic types. My OB told me I have an android pelvis and that this was a contributing factor in my c-sections despite having 7lb (give or take) babies both times. She seemed to know this based on a pelvic exam, which was sort of fascinating to me. I’ve been on websites where NCB folks think these sorts of labels are totally bogus so I’d love to hear a response to that.
Yes, my mom swears she was told by two different OBs (one for me, one for my sister) that her pelvis was too small for her to give birth to a baby larger than 7lbs. Neither my sister nor I were anywhere near 7lb so this was not an issue, but our mother was told this back in the late 70s and early 80s. This was before ultrasound, so this had to have been based on physical examination.
I mentioned this to my OB when I was pregnant…when she did an internal exam, she said everything seemed normal and did not expect I should have difficulty assuming any baby of mine wasn’t insanely enormous. Totally moot, as one was 4.5lb and the other a bit over 5lb (36wk twins). My sister was not told anything of the sort, but her 9.5lber (no GD, only 4 days overdue) couldn’t fit, so she had a Csection. I know she would not be at all upset to learn she could not participate in that ridiculous Big Baby Project, what with the Csec and all.
Son born in 1979 and daughter in 1982. I declined an sono when OB felt the baby was small for dates. cringe. I tried to decline the Doppler with the second but the CNM said no homebirth without it. First was 9#8 second 7#9. Second was the one I refused the sono. Point being they did exist then. Technology is much better now and still a pelvis is judged mostly by exam and history. There is such a thing as Cray pelvimetry but I don’t know when that was used or if it was ever common.
OH I know they existed, but they weren’t in widespread use like today. My mom was never offered a sono for any reason. She didn’t have access to an epidural either, for my birth, and my sister’s birth was precipitous, so she didn’t make it to the hospital in time to get one, though she might have been able to then (1980).
I think they use pelvimetry here for breech VB TOLs. One hospital specializes in breech VB (one reason) because breech babies were dying at HB, or were near miss transfers in the NICU.
I was sent for a third trimester ultrasound. I thought it was routine. I left with an estimated baby weight of ten pounds and a diagnosis or macrosomic. I had a nursing textbook that my sister had lent me so I looked up the definition. It must have been a basic book since all I learned was probable cause: maternal overnutrition. (my sister told me I ate too much LOL) I was obese and gained about 40 pounds.
In retrospect, my son was probably checked for head circumference and chest circumference. He was 8 lb 15 oz, large head, I pushed for 1.5 hrs. All was well. I am definitely apple shaped with no hips.
Did we get lucky? If so, I’m happy we did!
I did have a GD test that was negative. Second baby only gained ten pounds and he shot right out at 7 lb 12.
You like that picture a lot, don’t you? 😉
I’m proud of my 6lb 6 oz boy who everyone said would be at least 8 or 9 pounds because my husband in 6’3. My stupid mother in law would not shut up about how tiny he was and how big her children were and how I should have eaten more.
Well, I’m just impressed to know that there is a type of pelvis called android. Does that make you a FemBot if you have one?
I hope I have an android pelvis (I’ve no idea, but my average sized first baby didn’t fit, or even engage after many hours of labour). I’m also a mutant, due to a genetic defect that has caused a rare disease. If I could be a mutant android, well that would just really make my day!
I want to know if there’s an app for that.
Maybe a Cylon?
Macrosomic babies are at risk of more than just Erb’s Palsy, or brain damage due to the hypoxia occasioned by cord compression. They also can have sudden, severe attacks of hypoglycemia which lead to convulsions, and then brain damage.
Of course, one suspects that women who like to brag about their huge babies are likely to be the ones who reject testing for GD. Erin Long can comment about that. Her first child, stillborn, was over 10 lbs. Her second, when she did have intensive antenatal care, was 7+ lbs and survived [in her case, it seemed to relate to thyroid problems]
Diabetes does increase the stillborn risk. And hypoglycemic encephalopathy can be just as bad as hypoxic ischemic encephalopathy.
For my second, my OB and I were very open to a VBAC if the conditions were right. I tested positive for GD and managed that extremely well with just diet and exercise and I consider it an achievement that my baby was 7lbs 7 oz – which is a very healthy just right size! I gave up a lot of chocolate cake for him to be that small. Which is a cruel thing to do to a pregnant lady! lol But to some extent, I had *some* control over the size of my baby.
What I couldn’t control was how I am shaped. The OB determined my pelvis was flattened oval shaped like exhibit D and I’m a pretty small person, so we went with the scheduled csection to be on the safe side. I am so glad we did and I can’t imagine preferring high risk of death over a csection. Please. It was fine.
Again I find myself thinking, it must be uncomfortable to have so few real accomplishments in your life that you spend so much time fixating on your macrosomic unmedicated HBAC river birth. If you’re looking for something to do with all this time and energy, I bet your local service club could point you in the right direction.
What a great blog. How did you discover it?
You would not believe how much time I have to read everything under the sun when I am supposed to be doing bar prep.
Reminds me of working on my dissertation, when just about ANYthing else was clearly more interesting. The Internet was quite a bit smaller then, fortunately.
I have this program called “SelfControl” that blocks your problem websites for the time period of your choosing. The funny thing is, my blocked site list in that app is severalfold longer than the list of sites I check daily, because I have to keep adding new distractions I just found.