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Too Big for Vaginal Birth
Should Women Having Large Babies Expect to Deliver by Cesarean?
By Jenn Director Knudsen
Should large babies automatically be delivered by Cesarean section? The answer to that question is no, but it is not a black-and-white issue.
Jill Pelton's labor seemed so smooth and easy that she couldn't believe it when, fully dilated and pushing, the doctor told her she'd need a Cesarean section. "You can push all day, but your baby's never coming out because it's head is too big," she recalls the doctor saying. "I was just dumbfounded because there had never been any indication I would need a Cesarean."
Pelton's attending nurse encouraged her to try delivering vaginally by hunching down on her hands and knees. But, says Pelton of Portland, Ore., she only got 10 minutes to try in that position before being prepared for surgery, without further discussion.
Pelton, 28, had her first baby two years ago. "The surgery was a terrible experience," she says, "I was cold and shaking the entire time." When it was all over, the doctor handed Pelton her healthy baby boy, Connor, who weighed in at 8 pounds, 10 ounces.
It is impossible to know if Pelton could have eventually pushed her baby out. But studies show that babies who weigh more than 8 pounds at birth are often considered too large to pass under the mother's pelvic bone without injury. Experiences like Pelton's raise the question: Should large babies automatically be delivered by Cesarean section?
The answer to that question is no, but it is not a black-and-white issue. Most physicians advocate for a trial of labor -- an attempt at vaginal birth -- first. Surgery can be riskier than a vaginal birth; if a woman has a Cesarean section, she is more prone to infection; and it takes longer to heal from the procedure than from a vaginal delivery. Additionally, Cesareans can cost up to $4,000 more.
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My Baby Was Too Big for Vaginal Birth by anonymous on 11/18/2008 02:38PM
I'm am currently 34.5 weeks pregnant with my second boy. During my first pregnancy the doctors told me that I wasn't going to have a big baby at all. That's with them only doing one ultrasound when I was 4 months. Mind you at the time I delivered I was 18, only weighed 113 pounds and was only 5'0". I'm very petite and was all baby. I knew that my baby was not going to be little because of course I'm the one who could feel him inside me, but the doctors are the professionals and they are the ones who know best, right? When I delivered my son two days late and having to be induced, the doctor about crapped herself when he started coming out. His head was 13.5 centimeters and was stuck for 55 minutes. The doctor panicked and cut me from vagina to anus, she was trying to mold her hand in just to get his head out. When he was finally out he weighed 7 pounds, 11.5 ounces and his head was very swollen and bruised. He was very healthy and still is today but I strongly believe that if the doctors would have relied on technology instead of their own thoughts they would have know that that vaginal delivery should have been done by c-section. So with this one they are monitoring very carefully. When my doctor was doing an ultrasound for fun she discovered how big he was already and now I go back this Friday to get another ultrasound to see how big he is and whether this will be done by c-section or vaginal. I told her I'm all for c-section after what I've already experienced during my first delivery. She advised me that this baby will be bigger then my last and c-section may be just what I need. I think for all women who become pregnant, they need to really discuss their thoughts on delivery with their doctor as they see fit for themselves. Doctors know best in most cases but only a women knows her body better then anyone else. If I was more educated and not so young I guess, I would have been more prone and open to my doctor my first pregnancy, so now that I know what to expect I'm going to make sure the decision that is decided upon is on that's best for me and my baby. I guess its just a case of "wish I knew then, what I know now."
Re: Too Big for Vaginal Birth by Kimberly on 09/29/2008 06:10PM
I have had two large babies. The first they had no idea he was the size he was. My labor progressed pretty fast and in nine hours I was ready to start pushing. It took over two hours to deliver my son who weighed in at 10 pounds, 7 ounces. I also have a daughter that was born over five years later. The doctors were watching closely over my pregnancy. She weighed in at a healthy 9 pounds, 12 ounces. In neither pregnancy did the doctors find any cause for my large babies. No gestational diabetes was found. They are blaming it on my genes. They are now both normal size children. I wouldn't have it any other way.
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Re: Too Big for Vaginal Birth by anonymous on 11/20/2008 11:17AM
I am 29 weeks pregnant with my fourth child. All of my previous children were large at birth, ranging from 8 lbs, 14 oz to 11 pounds. I delivered all naturally, but I was cut from front to back in order for my 11 pounder to be delivered. My second ripped my ligaments from my pelvis, which rendered me incapable of walking for almost 2 weeks after labor, and my third baby suffered a broken collar bone during birth. I do not want a c-section, because I know I can deliver the baby, but I do not want to go through all of that again. My labor was induced for every child. Two of the inductions were done at 39 weeks. I do not have gestational diabetes, nor am I a large woman by any means. It's hard to say what anyone should do. You just never know how things are going to happen, and you pick a doctor that you trust and you know will handle the situation to the best of their ability, especially in a crisis. I think that an induction at 38 weeks might be the small difference I need, but it's hard to convince a doctor to do that, and I am sure they have valid reasons. It just seems better than injuring myself or my child or having surgery.