Big Baby Bullshit
I don’t use that phrase lightly. Because most of what the medical profession will tell you about birthing a big baby is just that – bullshit. Our bodies are designed to grow and birth babies. Yes, some are bigger than others. But unless there are extenuating circumstances, your body is capable of bringing your baby into this world without too much intervention.
What is a Big Baby
When we talk about big babies, we are not just referring to babies who look or weigh a bit more than average. The medical term for a big baby is Macrosomic, which just means big body. Let’s have a look at some of the statistics:
- The average weight of a baby in Australia is around 3.4kg
- Macrosomic babies are those weighing 4.5kg or more at birth based on WHO figures, although some medical professionals in Australia use 4.0kg as the benchmark
- Around 1.8% of babies are considered macrosomic at birth in Australia
How do you Know if You’re Having a Big Baby
The short answer is you don’t really. There are flaws in all the common ways we use to determine the size of a baby:
- Ultrasound can be 10-15% off in estimating the size of your baby
- Weight gain is not always a predictor of a large baby. It may be a factor if there are conditions like gestational diabetes, but it is not a given
- Fundal height measurement can be distorted by the amount of amniotic fluid you have, the position of the placenta and the position of the baby
It is not until baby enters the world and you can pop them on a scale that you have an accurate idea of whether or not your baby is big.
What Makes you think Your Baby will be Big?
There are a few factors that could indicate you are potentially having a big baby – but again I stress, these are just indicators and are in no way a guarantee your baby will be macrosomic.
- If you have gestational diabetes there is a chance your baby will be a big one
- If you and/or the father of the baby are big people – and by that I mean tall, large framed or overweight
- History of large babies. If this is not your first baby, and your previous bubs have been big, the likelihood is this one will be too. The good news here is that you are probably well prepared!
- If you are overdue. Babies tend to put on weight in the last few weeks of pregnancy, so if you are overdue bub will have had more time to bulk up
- If you have gained an excessive amount of weight during pregnancy
- Boys are statistically larger than girls
Can I Have a Natural Birth with a Big Baby?
Again, the short answer is yes. Assuming there are no high-risk factors present, there is no reason why you can’t have your baby naturally.
You may come up against some opposition in attempting a natural birth if it is suspected your baby is macrosomic. Many health care professionals will recommend you consider an induction or even a c-section.
Recent studies suggest, in fact, that the expectation of a big baby increases unnecessary interventions like episiotomies and forceps delivery. Statistically:
Induction 42% for expected big babies; 14% for unexpected big babies
C-Section 52% for expected big babies; 17% for unexpected big babies
Complications 17% for expected big babies; 4% for unexpected big babies
Risk factors may include gestational diabetes, pre-eclampsia and pelvic abnormalities. If any of these are present they don’t necessarily preclude a natural birth, but you may need to have a frank discussion with your health care provider.
Preparing to Birth a Big Baby
If you suspect you are carrying a big baby, and want a natural birth there are a few things you can do to help make that a reality.
- Talk to your care team about your wishes. Doctors often jump straight to the need for induction or c-sections, but there is actually no evidence to support an improvement in maternal or baby health outcomes in going this route. Let your team know your preference for a natural birth and stick to your guns.
- Try to maintain a healthy weight during your pregnancy and maintain a gentle exercise routine.
- Prepare your body before you go into labour. Perineal massage is one way to begin softening and stretching the part of your body that will be under the most pressure during delivery. A good midwife or doula can give you instructions on how and when to start perineal massage.
- Optimal Maternal Positioning. OMP incorporates exercises, stretches, labour and birthing positions and massage to facilitate pelvic mobility and ensure the correct foetal positioning to help smooth progress through labour. Look for a Doula with qualifications in OMP to help you during late pregnancy and birth. These techniques can help whether or not your baby is macrosomic.
- Practice squatting. In a squatting position your pelvis can open up by nearly 30%, which makes all the difference when birthing a big baby. In fact, whether you are having a big baby or not, squatting is a great way to deliver. So get practicing.
- Stay upright during labour and delivery. The weight of your baby will help dilate your cervix, and guide your baby through the birth canal into the world.
- Remember, this is what your body is designed for. You’ve got this!
If you would like to chat about the likelihood of having a big baby and how you can manage a natural birth, or any other pregnancy, birth or postpartum concerns, please give me a call on 0422 258 771 or contact me: