“Big Baby” Inductions

big baby inductions

Today I posted this picture on Instagram and it went crazy with comments. I wanted to make sure I took the time to dive deeper into this because miscommunication happens and as a birth doula informed consent means the world to me.

Are there cases when a baby is indeed too big to fit through the pelvic outlet? Absolutely. Mother’s who have diabetes or Gestational Diabetes tend to grow bigger babies and are often induced between 38 and 39 weeks gestation. Outside of that, I believe that women’s bodies will not grow a baby bigger than they can birth.

Then why is there a rise in women who have big babies needing cesarean or inductions? I firmly believe there are several factors that play into this.

  • The typical position of a mother laying supine (on her back) while birthing. Research has shown that for delivery the best positions are those where women are upright is the best. For big babies, the best position for delivery is hands and knees or squatting.
  • Babies position, specifically their head, plays a key role in how they enter the birth canal. No matter what size a baby is, if they enter the birth canal with their head tilted to the side (asynclitic) the birthing process will take longer and pushing will need more effort. Big babies especially need to enter the birth canal in good alignment so they can tuck their chins properly and descend.
  • Shoulder Dystocia is a real fear for OBs and while the evidence shows that if a patient is presenting with shoulder dystocia they should be flipped to hands and knees and that should be sufficient enough to dislodge the shoulder doctors do not handle it that way. In a hospital I’ve seen nurses get up on a step stool and press down as hard as they can down on the women’s pubic symphysis in effort to physically push the babies shoulder down under the bone. Big baby or not, shoulder dystocia can happen. However, if more doctors practiced the act of getting a woman up onto her hands and knees (as we would in a home birth setting) the fear could be lessened.
  • Are there situations when babies truly just aren’t going to come through the birth canal? Absolutely! I have been in situations where nothing we do works. There are times when a cesarean is our only option! What I do want to be clear is that I believe every woman should be given the opportunity to have a trial of labor, no matter what size baby the ultrasound says she’ll be delivering.

    The women from my post were clear:
    Big baby does NOT mean you need to induce in order to have a successful vaginal delivery.
    Bib baby does NOT mean you need a cesarean.
    Big baby does NOT mean you cannot have a vaginal birth.
    Big baby does NOT mean you will need an epidural.
    This DOES mean that providers need to stop telling women they are and aren’t capable of in giving birth.

    Trust in the process. Trust in your body and it’s ability. You trusted it to carry this baby, trust it to know how it wants to get the baby out.

    Want more information on Big Babies & the Evidence on Inductions & Cesareans? Click here! For more information on Jenn click here.