What do you consider a "big" newborn?

[pcha72]

I'm 4'11" and was 107lbs pre-pregnancy. This is my 3rd DC and I'm currently 30 weeks pregnant. My first DC was 6lbs 5oz at birth, and my second was 8lbs 2oz. I had them both au naturel, although I can tell you that the DC #2 was a heck of a lot harder and more painful!!

For me, 8lbs 2oz was really big, although my dr said that was a pretty avg birth weight. DC #3 seems like its going to be REALLY big - I've already gained 37lbs and still have 10 more weeks to go. I don't think I can have him naturally if he's more than 9 lbs...but then again, I won't know until the time comes. My goal is to have a natural birth. I've discussed with my dr the risks of having a big baby and what options I have, but I'm still kinda "hmmmmm" about all of it. So I guess my questions are: What do you consider a "big" baby? Would you opt for an elective c-section or early induction if the baby was big?

I just don't really know what to do...you'd think that by the third DC I would know how to handle this, but I don't!! :D

Thanks for your responses.

~P

[lizajane]

my mother is 5'2" and weighed 99lbs pre-pregnancy. at the time of my birth, she weighed about 120lbs.

i was 10lbs. i was born in 2 1/2 hours. and i was an au naturel baby.

it really just depends on YOUR body.

i had no trouble delivering my 9.5lbs boys. but my tiny friend just had to have a c-section for her 9.5lbs boy. she is the same size as my mom, but mom could do it and my friend couldn't.

after 2 kids and several horror stories, i think i would go with your dr's recomendation, UNLESS you don't trust your dr. and in that case, i would go find one that you did trust!!!

[justlearning]

Are your ultrasounds showing your DC#3 to be big? I don't think there's a strong correlation between mother's weight gain and baby's birth size, but I may be wrong.

With both of my pregnancies, I gained close to 40 lbs. My 1st son was 3 days late and weighed 10lbs, 13oz. I wasn't medicated when I pushed him out, and I didn't have any complications (other than the doctor having to use a vaccuum at the end). My second son was 9lbs, 7oz. but was taken out a couple of weeks early via c-section due to him being breech.

I would definitely get your doctor's input, especially considerng your small size. I'm not small at all--I'm 5'9" and weighed around 200 at the time of my first son's birth (after the 40-lb weight gain).

[Alice523]

I was 10 lbs at birth, three weeks late, and my mom handled it just fine. (Well, she claims she was certifiable by the 43rd week but that's another story!) My sister was 9 lbs. She didn't push more than 3 times with either of us.

I was induced on my due date and delivered a healthy 10.5 pounder. I can remember feeling elated when I realized I had pushed him far enough that they wouldn't do a c-section. ;) The way they talk, you'd think every baby over 8 lbs has to be delivered by c-section!

To me, 9 or 10 lbs is a big newborn. I wouldn't consent to a c-section except in the case of emergency. I also wouldn't consent to an early induction because I'd rather let my baby fully develop. Good luck!

[brittone2]

I couldn't agree more. It depends on your body. Larger boned women can have small pelvises that make it a tighter fit. Some women have more give to their ligaments, enabling their pelvis to stretch and deform more effectively for the baby to make its exit.

DS wasn't that big, but I'm not either, and I had a super easy birth with him. I was about 115 pre-pregnancy (and about 5'2"). I gained 38 lbs and had one of the largest bellies you'll ever see in your life. I had a midwife, and I never asked for a guesstimate on his size because even w/ US it can be off by quite a bit (a pound or more in either direction). My theory was he had to come out one way or another, and stressing over a "big" baby wasn't going to help my confidence, kwim? Right as I was in labor my midwife said she thought he might be a 9 pounder (I had avoided any discussion of it until she decided to blurt that out LOL).

I had DS 6 days before my EDD (and my EDD was exact due to an IUI with ovulation on CD 14) and he was 8lbs 4 oz. Not huge, but not tiny. I had a 6 hour 20 minute labor start to finish, and pushed for less than 15 mins total. He was *right* there by the time I was complete. Only a small little tear that took 3 stitches or so...no biggie. I feel reasonably confident I could have pushed out a baby weighing quite a bit more but who knows?

I actually think a lot of doctors scare patients by telling them their baby is going to be big. What that means is anyone's guess though. Try not to stress over it if you can. I think a lot of it depends on positioning of baby prior to birth ("sunny side up" babies for example that are trying to turn as they make their exit), finding alternative positions in which to labor, how stretchy your ligaments are, how the baby is shaped...there are sooo many factors. I know people who had two kids with very different birth weights and some of them have said the smaller one was harder for them. There are just so many factors.

[jenjenfirenjen]

I would consider anything over 9 lbs to be "big" but I don't think that is any indication of whether or not you can deliver vaginally or not. And in my limited experience (of talking to other mamas who have had big babies) the mother's overall size and/or weight gain really has little to do with it.

Personally I never pay attention to my midwives guesstimates at my baby's size. And I wouldn't trust an ultrasound either. I think when it's getting late in the game, that baby is so crushed up in there it's just hard to tell how big they will be. My mother had a C-section with my brother because they told her he was probably 13 lbs (based on an X-ray.) Well, turns out he was 9 lbs 15 oz. She had already delivered me vaginally at 9 lbs 7 oz so she most likely could have delivered my bro as well but didn't even try because of a faulty guess of his size.

Ultimately, I don't think you'll know if you can deliver this particular baby vaginally until you try. BUT, if you are worried about it, it may make it harder for you to relax and open up the way you need to so it's definitley something to think about and talk with your doc.

[brittone2]

Just wanted to add ITA with not inducing for size in the absence of a medical indication for induction.

I know this topic gets people upset sometimes, but I had a friend who was induced early (37 weeks) because her doctor swore based on US she was going to have a "big baby." The mom was very uncomfortable but there was no medical reason for the induction. The baby ended up quite small (under 6 lbs I believe), ended up in the NICU w/ respiratory issues, and had a very unhealthy first year of life (multiple bouts of RSV, and quite a few other "preemie" type problems). I've also known several people since then that were told they were going to have huge babies and ended up with 6-7 pounders. I'm not suggesting there aren't reasons to do an induction sometimes, or that all inductions go badly. I just think OBs should fully inform patients of the risks that *can* be associated w/ elective induction and that should be weighed carefully against just letting mom and baby progress on their own.

I believe Tarahsolazy has mentioned that she's seen heartbreaking complications w/ elective inductions done particularly before the mom is term (she's a neonatologist). Hopefully she'll respond.

[o_mom]

I think 9 lbs isn't that big - DS2 was 8 lb 12 oz - all natural in less than 2 hrs. DS1 was 7lb 15 oz and I had over 24hrs of labor. 8 lbs is 50% birth weight for boys. BTW.

The weight of the baby has little to do with "fitting" - it is head size that matters most. Fat will squish while bones can only mold so much. Since you have already had two vaginal births, there is no reason to think you would not be able to birth a 9+ lb baby. Also, there is not a reliable way to know weight until they come out. Late term ultrasounds can be off by as much as 1-2 lbs. (Just watch "A Birth Story" for a while. If I had a nickel for every time they said "Mom is having a c-section because the baby is so big... Happy Birthday to 7 lb baby boy...")

I guess I wouldn't be in any great hurry to have major abdominal surgery with a much longer recovery. I would at least give it a try - I don't think there are any big risks just because the baby might be a little bigger given that you are not a first time mom.

[buddyleebaby]

My great grandma was a little over 5 feet and about 100 pounds. She had eight children, the smallest of which was over 9 pounds, the largest of which was almost 13. They were all "natural" non-medicated births, and she said there was no difference in delivering a "small" 9 pound baby and a "large" 12 pound baby.
So I think it is really a case of mind over matter.
Hope all goes well, whatever you decide!

ETA: By the way, they were estimating my dd's weight to be around 10 pounds when I was induced three weeks early. She was in actuality 7 lbs, 9 oz. at birth and 7 lbs, 2 oz, by the next morning.

[JBaxter]

My grandmother was just over 5 ft and weighed a whopping 98lbs when she got married. My dad weighed 9lb8oz born at home ( weighed on the meat scale).
Nathan weighed the same amount and I agreed to an induction on my due date because they "thought" he was over 10lbs. Think if there is a next time I'll let nature do her thing

[ykc]

Babies over 8 1/2 lbs or so are considered big, but that doesn't mean that mom can't deliver vaginally perfectly well. Like PPs have mentioned, it's the fit that counts. If you have a "good" pelvis, you can probably deliver just about anything that your body will grow (barring factors like gestational diabetes). But you/the doctor can't always tell whether the baby will fit till pretty late in the game. There definitely are risks associated with delivering big babies vaginally, but most come out just fine.

I'm not a big fan of early (before 38-39wks) inductions for size because I have seen problems with babies who really weren't ready to come out. And as others have pointed out, u/s estimates of size can be quite inaccurate. I also wouldn't opt for an elective c/s personally, because I'd rather avoid abdominal surgery if possible. I'd probably choose to try a vaginal birth first (maybe with induction closer to 39-40wks), knowing that a c/s could be possible. But if you trust your OB (which I really hope you do--or get a new one!), then seriously consider his/her recommendations because your doctor is the one who has experienced the good, bad and ugly of all the scenarios and knows how your pregnancy is going. In the end, no one can make you be induced or have a c/s, and everything will probably be fine. You just need to keep in mind that complications from big babies can happen occasionally. On the other hand, if your doctor's not that worried, I wouldn't be either.

[Momof3Labs]

My two boys were almost exactly the same size, and DS2 was a breeze to deliver compared to DS1. The difference? Their positioning. Well, that and my body knew what to do the second time around. And I had an amazing birth team (who was on top of DS2's positioning, compared to my OB for DS1 who didn't care one bit that he was posterior). Was your second baby's position an issue?

If I were you, I'd ignore all the "big baby" stuff (weight gain alone is NOT a predictor of baby size). Go forward as you plan with a natural birth (c-sections and inductions carry their own risks, no matter the baby size). As long as his positioning is good and his head isn't a basketball, I bet that he'll come out just fine!

For lots of info on positioning, check out the Spinning Babies website.

[jenjenfirenjen]

I'm just wondering what complications from vaginally delivering a big baby you are referring to?

[maestramommy]

I'm 5'2" and weighed 125 pre-preg. At my 7th (or 8th?) month check I asked my OB if he had an idea of size, and he said maybe 7 lbs. or 7.5. I was a little freaked because out of my siblings the biggest was 7 lbs even. I went into labor a week early. Don't know if I could've done it naturally but I had an epidural and and episiotomy (The OB suddenly said,"I'm going to need a little more room here, and then DH said he snipped me), but DD turned out to be 5 lbs. 13 oz! Talk about a peanut, I was stunned. And I gained 37 lbs even though I hardly ate differently at all.

These days I think you can get an epidural very late in the game if you need it. I guess if I were you I'd try to do it naturally first, but probably end up getting some drugs :-). I would NOT go for early induction unless I was having problems of my own (preclampsia or something). I haven't heard any positive outcomes with early induction.

Tough decision! Talk it over with your OB and think about it, but try not to stress!

[Wife_and_mommy]

I would *never* even consider a c-section unless it was a life/death emergency situation.

If you've had two babies unmedicated and did fine, I think you'll be fine. Yes, this baby might be a little bigger but that doesn't mean your body can't handle it. You can do it!! :)

FWIW, I had an easier delivery with DS(8.75#) than DD(6.5#) because of who my attendants were. I had less tearing(w/ no stitches!) with my *bigger* baby. They were both posterior; DS was directly face up. I ended up pushing him out flat on my back which if you've done Bradley is almost unthinkable. ;) He had bruising on his head but no ill effects from the birth.

Oh, and I'm not as small as you(5'3") but it is all about positioning like Beth and Lori talked about. I highly recommend the spinning babies web site.

Best of luck and please post an announcement when your baby is born. We'd love to hear the happy news. :)


Elizabeth
mommy to DD(April '04) and DS(January '06)

http://www.gynosaur.com/assets/ribbons/ribbon_gold_12m.gif[/img][/url]

[tarahsolazy]

I don't think the ultrasound size estimates in late pregnancy are anywhere near accurate enough to predict "large". So its tough.

I think in your case, since you have had two normal vaginal deliveries, that that's the way to start. Each babe is different, so you could have a smaller baby this time, too.

I would not advise induction before 39 weeks unless very medically necessary. Elective CS babies as a group have a much higher risk of neonatal complications resulting in NICU admission. Not the worst thing in world, but if avoidable, best avoided.

[lizajane]

for the mom- you can have a third degree tear that could cause you trouble with bowel movements, etc. for the baby, s/he could break a collar bone.

[jenjenfirenjen]

But aren't those just risks of delivering a baby vaginally? I mean you could have a bad tear with a small baby if it is too big or positioned poorly for your body.

[jennabear]

I'm about 5'3 135 before preg and I delivered 8lbs 5 oz and 9 lbs 3 oz babies. Ouch! My larger baby was much easier to deliver.

[LucyG]

ITA. And sometimes, those things just happen anyway. I delivered a 6 lb. 14 oz. baby and had a 4th degree tear. I pushed two times and she went from a tiny bit of hair showing to fully delivered. My midwife said she honestly did not think anything could have prevented the tear. No one knew how fast I was progressing, and I did not have an epidural. When the urge to push hit, I pushed! There was no time for perineal massage, etc. I am fully recovered now, but it was extremely painful for the first couple of weeks. If we decide to have a third child, though, I will absolutely have another vaginal delivery. DD#2 was a VBAC.


DD #1 (2/03)
DD #2 (3/06)

[amp]

Well, I'll be the first to admit that I had a CS with both of my children, but they were both big and even if I didn't push them out vaginally, I still had to carry them, both in my belly and out, and they had to cut a gargatuan hole to remove them!

DS was 10 lbs 9 oz
DD was 9 lbs

[mamato1]

I can testify to the fact that weight gain does not correlate to baby size. I am 5'4" and about 125 lbs. I gained a whopping 41 lbs and my water broke at exactly 37 weeks. I had to be induced because I did not go into labor on my own and pushed 2 VERY LONG hours to get my 6lbs 1.6 oz baby out. Now, admittedly I did not do this au naturel, and my incredible respect and admiration go out to those of you that do, but I think you are going to be fine!
Chris

Mama to Brendan (aka Boomer) 01/04


http://b3.lilypie.com/FnI6m5/.png

[megs4413]

as the pps said, early induction without medical indication is probably not the best idea. They were estimating my daughter at 8 and a half pounds at 36 weeks and she was only 6'14" when she was born TWO WEEKS LATER! They just used the bones sizes and estimate. DD was very tall and had a big head and that made their estimates go too high.

Also, I saw on House of Babies (Discovery Health channel show about midwives) that the midwives have a theory that shoe size is the best indicator of how large a baby a woman is capable of having. A woman had a size 7 shoe on the show and wondered how big a baby she coudl have and the midwife told her she coudl easily deliver a baby that was 8-9 lbs.....I don't know if it's true for everyone but that woman did deliver an 8 1/2 pounder naturally without tearing....

Good luck! You're brave to want to go au naturel....I love epidurrhals but have so much respect for those of you who can go without!

[brittone2]

I would have been screwed w/ that theory LOL. I wear a size 4, unless it laces like a sneaker or is something like a boot or clog which is a bit more flexible...then I can fit into a 5 :)

DS was 8lbs 4 oz and fit just fine.

I've heard that theory before...maybe it holds true for the normal population...I just am stuck with annoyingly small feet.

[bunnisa]

I'll add my 2 cents:

My good friend is 5'6", 120 lbs. With both of her pregnancies, she gained over 40 lbs (gained slightly less with the second one). The first baby was 8 lbs 3 oz and the second was 11 lbs 15 oz!!

She had them both vaginally, with episiotomies both times. She had a slightly larger episiotomy with the second (prob due to being unable to change positions -- she had an epidural both times as well).

She said pushing was "really difficult" with the larger baby. Okay, that's relative, because she only pushed for 45 minutes! By contrast, with my first baby (8 lbs 4 oz) I pushed for 4 HOURS!

And as an aside, I've read that the actual percentage of women whose pelvises cannot accomodate the baby is VERY small. (maybe someone else has the source of this data?)


Bethany
blessed wife and mama to two!

"And children are always a good thing, devoutly to be wished for and fiercely to be fought for."
-Justin Torres

[pcha72]

Thank you for all your responses.

I'm actually more worried than my Dr, since DC #2 was an 8.5 hr delivery, vs DC #1 at 9 hrs. Additionally, DC #2 was PAINFUL, partly because he was sunny side up. I did tear, but it only required 3 stitches. Dr thinks I should be fine, considering the two previous deliveries were ok. She’s also not pushing early induction or elective c-section, but did let me know that those were options.

My next u/s is in two weeks, but I feel and look HUGE! I feel like I’m ready to pop at any moment, but baby is not in position yet, although he’s really low. I’ve pretty much decided that natural is the way to go for me. If it ends up that I will need a c-section, then so be it, although I’m trying to avoid that as much as possible. I realized that my ultimate fear is the pain involved, but no pain no gain, right?! LOL! I’m hoping that since DC #2 and DC #3 will only be 19 mos apart, labor will go faster this time.

Again, thank you!

~P

[pcha72]

RE: "I'm just wondering what complications from vaginally delivering a big baby you are referring to?"

Pretty much what Liza said. My Dr did mention the worst case scenario, in which the baby's shoulders can be too big to fit through. Baby's head will already be out, but since the shoulder is stuck, baby has the risk of not getting oxygen. In that case, they would have to push baby back in and do an emergency c-section, and it's not always successful. She strongly emphasized that these cases are RARE, but I always get spooked out. Hope I didn't scare anyone either...

~P

[jenjenfirenjen]

Shoulder distortia (the condition you're referring to) was my #1 irrational fear when I was pregnant with DS1. But I have never heard of them pushing the baby back in and doing a C-section. That sounds absolutely ridiculous. I always heard if they simply could not get the baby's shoulder's out, then they would have to break the baby's clavicle (not an enticing idea either.) Either way, that is extremely rare and again, I would think had more to do with the mother's body vs. the shape and size of the baby and not just the fact that it is a "big" baby.

I guess I'm just a little wary of any claims that having a bigger baby has any inherent risk that is not just as present with any vaginal birth.

[o_mom]

OK, let me get this straight... you have delivered an 8+ lb, posterior baby vaginally in 8.5 hours an only reqired 3 stitches????

Girl, you have nothing to worry about, LOL! :-)

Check out the Spinning Babies site that was mentioned earlier and do the pelvic rocks, etc that are recommended. That will help prevent another posterior presentation which hopefully will speed things up and lessen the pain.

I laid in a recliner for 4 wks before DS1 was born and he had a transverse head and was a very long labor and very, very long pushing. With DS2 I did all kinds of pelvic rocks and such and labor was dramatically shorter - so much so that we almost didn't make it to the hospital.

[Wife_and_mommy]

lol. i needed to hear that too. i find myself worrying about having an even bigger dc3.



http://www.gynosaur.com/assets/ribbons/ribbon_gold_12m.gif[/img][/url]

[buddyleebaby]

Beth,

I am staring down at my post pregnancy size tens and hating you at this moment. ; )

[s_gosney]

Me too! Though I think any of us on the far ends of the spectrum are probably always stuck with fewer shoes to choose from, so we all lose out equally, I guess.

FWIW, while I might fit this theory (I'm tall but thin with big feet and had a quick delivery with an 8# babe), but I think like pps have said, it's all about internal bone structure, and I'm not sure any of that can be determined by external features. A lady I once worked with was a very large woman (very tall, very big all around, not just overweight) and she had to have a 3rd degree epi with a 6# baby. I had a small epi (that I still don't think needed to be done, but that's another post). Anyway, to the OP, best of luck! And though this is totally the pot calling the kettle black, try to not worry about it. Even if things don't go as you hope, just cross that bridge when you get to it. I wouldn't have an induction or c-section unless it was medically indicated though either. Good luck to you and keep us posted!

[brittone2]

Oh, if you saw my shoe wardrobe you wouldn't be LOL.

My choices are small old lady shoes, kids' shoes, special order (and still ugly!) shoes, or occasionally shell out huge money to some of the European designers that do small shoes (alas, $300 a pair Italian stilettos don't work well w/ my SAHM budget or lifestyle LOL). Payless is one of the only places (other than Nordstrom) where you can find in stock 5s, and now they seem to not be carrying many 5s at all anymore. Most dept stores carry nothing smaller than a 6. I can't fit in a pump in a 5 even, so a 6 is waaaay out.

You are right, it is tough at either extreme of the spectrum!

My mom has size 6.5s. Perfect IMO. Her feet are cute (she's petite in size and they look proprotional) but she can still find SHOES.

I was *hoping* my feet would grow when I was pg LOL. A size or two would have been a big help!! ;)

[ykc]

Having a bigger baby will increase the risk of complications, such as unplanned c/s, shoulder dystocia, clavicle fractures, brachial plexus injury, vaginal lacerations, etc. But it doesn't mean that these complications can't occur with vaginal delivery of average or even small sized babies. And definitely, it doesn't mean that having a big baby will result in any of these problems. Like I said in my earlier post, the fit between pelvis and baby is the main factor determining the likelikehood of complications. But the risks do go up with the size of the baby--most likely because the bigger the baby, the higher the chance that it won't fit well through the pelvis.

The most worrisome complication is probably shoulder dystocia, and you're right that you can't push the head back in once it's delivered. I'm not an OB, so I'm no expert on the different maneuvers you can use to help deliver a baby whose shoulders are stuck, but I do know that, usually, it can be done without trauma to baby or mother.

Again, I'm not claiming that having a big baby will result in complications or that these complications can't happen with smaller babies. But the probability of complications does go up with the size of the baby--even though most of the time, everything will go smoothly--and the difficulty is that you can't predict ahead of time which baby and which mom will have a problem. Which is why it's worth thinking about options like the OP is doing.

[ykc]

If your doctor thinks you'll be fine, you probably will be. Especially with your previous success with #1 and 2! And you know, with this one, you may just breeze through it and wonder why you ever worried!

FWIW, my mother tells me that my birth was the absolute most painful experience of her life, even though she supposedly had some sort of pain control and she has a very high pain threshold. I was very average sized (7-ish lbs) but sunny side up. So you already know that you've triumphed over one of the most painful experiences in life, and if you need to, you can probably can do it again. But here's hoping for a down-facing baby!!

[american_mama]

There are ways to resolve shoulder dystocia and apparently, the worst case scenario is indeed pushing the baby back in (Zavanelli maneuver). But the easiest and usually safest way to fix it is for mom to get on all fours (knees and hands. See http://www.inamay.com/gaskin_maneuver.php

WARNING: the article is not graphic, but you may not want to read it if you are pregnant and highly sensitive. She is describing some stuck babies and tough deliveries, and if that will prey on your mind, skip it.

Th link describes a study of 82 babies born using this technique: 60 percent of the mothers had NO tear and none had a third or fourth degree tear. Among the babies, thirty of the 1-minute Apgar scores were less than or equal to 6, and two were less than or equal to 3; only one of the 5-minute Apgar scores was less than or equal to 6.

The link is from the website of a famous American midwife, Ina May Gaskin, who originally had the technique named after her (although she actually leanred it from a Mayan midwife).

She does mention other techniques that can be used, such as rotating the baby, delivering the arm first while also doing some other maneuvers, applying external pressure to pelvis, and, worst case scenario, pushing the baby back inside and doing a C section. Apparently, some of these techniques resulted in impressive success stories, but also a few tragic outcomes. In contrast, the All Fours technique had none of the severest complications. She makes the point that the All Fours technique is non-invasive, quick, and does not preclude using any other technique if it doesn't work.

I hope this relieves the mind of anyone reading this who thinks a stuck baby automatically means a dire consequence like a huge tear, broken collarbone or worse.

[Melanie]

I think of anything near 9 lbs as big, but that doesn't mean that you can't do it. I would never opt for an elective C-section or an inducement due to guesstimated birth weight. I was told my first was going to be big and he was 7 1/2 lbs.

Try hypnobirthing...