# Is a baby (really) ever too big?



## UrbanCrunchyMama (Aug 7, 2007)

Even before she was pregnant or thinking about getting pregnant, my friend said that she'd have to come to me (when it's her turn) for natural birth resources. Immediately after it was safe to share the good news, we had a nice afternoon together, and I sent resources to her (in the form of emails that contained local resources as well as a copy of _Ina May's Guide to Childbirth_ and _Birthing From Within_). Her first "to do" on her list was to find a doula.

The next time I met with her, her OB had talked her out of a doula, saying that hiring one would take away from her supportive husband's experience. In my head, I screamed,"OH, NO!" She didn't seem ready to be "pushed", so I left it alone.

The next time I saw her was at her shower. She and her hubby had just taken a childbirth weekend intensive class. Of course, it was recommended by her OB and pretty standard information.

At this point, I'm growing more and more worried, but she still didn't seem to be in the right place to be "pushed".

Fast forward to her birth...
She labored at home for 8 hours, and arrived at the hospital at 1 cm dilation. Instead of telling her to go home, they told her to walk around the hospital until she was further along. She was admitted at 2cm. Shortly after, she asked for an epidural. Right before pushing, she experienced extreme pain. She pushed for 2 hours, unable to get the baby passed 0 station. A c-section was performed. She was told that her baby was too big and that her anatomy did not allow for the passage of the baby. (To my knowledge and her knowledge, she does not have Rickets.)

Her son is only 8 weeks old, so it's still a wacky time for her, I know. I asked her about writing her birth story, but she told me that she wanted to forget the bad parts. Of course, I told her it would be a good thing for any mom.

So what am I to do? From what I know of chilbirth, it seems that the "big baby" theory and the "you're too small" song and dance are a load of crap. (Her son was 8lb. 14 oz.) But maybe that's just my limited perspective?

When she gets pregnant again, do I say anything?

Any and all thoughts and questions are welcome.
Thanks,
Lydia


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## Veritaserum (Apr 24, 2004)

It does happen, but it is extremely rare. More likely is that her baby wasn't in a great position (which is common with reclined, epidural moms) or the baby was largish for her body and she needed to squat to maximize the room in her pelvis and use the help of gravity.


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## mother4good (Mar 16, 2003)

Yeah, I hear this alot too. I think it has more to do with the drugs and the birthing supine, etc than anything. Some of the moms who tell me this tell me their OBGYN says they will always have to have a C-section. How depressing! (knwing that it is probably not true, that is.) If it were so common wouldn't the human race have just died out by now? Or at least we'd all have to be brother and sister. Just kidding!









I think it depends on your relationship with her. Some people are more comfortable "washing their hands" of it and say thing "there was nothing else to be done" Than to try to take charge of their own lives. I see that alot more where I am now (rural area) than I did where I was before (a suburb).


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## Belleweather (Nov 11, 2004)

I'm not one of those people who believes that your body will NEVER grow a baby that's too large for your pelvis, but unless that kid was somewhere between 12-15 pounds, she probably got hit with a combination of a lack of support and an impatient and ignorant doctor.

Unfortunately, there probably isn't much you can do unless she decides she wants to re-evaluate her birth choices before her next baby.


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## BetsyS (Nov 8, 2004)

My son was big (11lbs, 14 ounces), he was in a bad position (persistant OP, despite weeks of trying spinning babies optimal fetal positioning stuff), and so that combination DID add up to him being too big for me.

With the next baby, I'll still do the optimal fetal positioning, but I'm also going to try to have a smaller baby.


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## DoomaYula (Aug 22, 2006)

There's a story on the Birth Stories about a 12lb 4oz baby born vaginally at home. He did have dystocia, but he was fine...


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## SublimeBirthGirl (Sep 9, 2005)

It's too bad our friends and family don't use us as a resource. I'm more than happy to share free information but nobody ever seems to want it. Very strange.


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## UrbanCrunchyMama (Aug 7, 2007)

Veritaserum - Which makes me think, as eager as she seemed when I shared the resources, she didn't actually use them. Had she actually read either of the books (which I ear-marked for her because she was a busy, busy traveling corporate woman), she would have known to stay at home as long as possible, to explore positions, to refuse the epi for its likely domino effect, etc., etc., etc.

mother4good - Hilarious!







I've been thinking and saying the same thing. If childbirth was REALLY that bad, our species would have died out long ago. (I'm not trying to trivialize labor here. I'm just looking at the big picture.)

Belleweather - That was my sense of her son's weight too. He's definitely bigger but not to the point that it would greatly hinder birth. I'm hoping she'll at least entertain the thought of reading posts similiar to, if not, MCD, so she can begin to heal.

YumaDoula - Those are the stories we like to hear!







Where did you see this story? Do you mean MDC birth stories?

SublimeBirthGirl - It seems strange to me too, but from their perspective, I'm sure we're the ones that sound nutty. I've always been adamnant about telling the truth and seeking the truth. I just can't relate with living life any other way.


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## dlm194 (Mar 23, 2005)

I do believe it happens sometimes but I agree that it's very, very rare. Whenever I hear of a woman who had an epidural and couldn't push her baby out, I shake my head. That's drugs and usually directed purple pushing - not a baby that's too big to pass through the pelvic bones.

That's what I was told. My baby (8lbs 6oz) was too big. My midwife actually went through this big explanation about how my pelvis is more of an oval shape and I have a thick sacrum so my baby's head couldn't pass through. She went on to say that *maybe* I could vaginally birth a 6 lb or 6.5lb baby but not bigger than that. When a provider gives you a serious explanation like that, it sounds pretty legit. I remember thinking how strange it was that my anatomy was so "off" and thank heavens for the c-section. However, as time went on, I began hearing these stories over and over. I swear, obs must be learning this in school because sooooo many women are being told that their babies are too big now. Funny how in 2007, we can't birth out babies. All these years of evolution and we've evolved into women whose pelvises are too small to allow out babies to come out. My sister came over the other day and told me how her coworker had a c-s after many hours of labor. The doctor told her that he could tell after her c-s that "her pelvis really was too small." My good friend's doctor told her that she's a small person (5'1" maybe??) so she'll never birth vaginally. She did actually labor for a good 8 hours or so (induction, epidural, a week before her edd) before they determined that she wasn't going to dilate.

So I began researching several months after my dd's birth. I found stories of women who were diagnosed with CPD (cephalopelvic disproportion) go on to have much bigger babies. It no longer made sense. Then I researched more about modern obstetrics. I think obs want to shift blame away from the mothers and make it more nebulous. "It's not something you can help. You were just born with a pelvis that was too small." So women believe they are defective through no fault of their own and dutifully schedule repeat c-sections with their subsequent babies. That's a perfect situation for doctors! No worrying about when a mom is going to present in labor if we schedule her 1 hour birth. Staffing and resource issues are alleviated since we know when a mom is going to come in to have her baby. It's a vicious cycle.

I wouldn't push your friend. She needs time to come to terms with her birth. I think it's okay to ask how she's feeling and how she feels that recovery is going but I wouldn't try to get too far into her feelings unless she brings it up (let her do that - she may really want to talk but needs an environment where she won't feel judged or attacked for what happened). If she gets pg again, you can ask her about her delivery plans. If she plans on a repeat c-section you can mention vbac. Emphasize that she is not broken and every labor and delivery is different. ICAN would be a good resource for her (www.ican-online.org).


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## Ironica (Sep 11, 2005)

The Sears Birth Book puts *true* CPD at less than 1% incidence.

Uncontrolled gestational diabetes can grow babies that are VERY large, and they *may* be too big to be born vaginally, as well. (That's not the head, but the entire thing, I guess.)

So yeah, it can happen. But it's much, much rarer than the OR reports make it out to be.


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## MommaCrystal (May 25, 2006)

I was told this! After an ultrasound (that no one told me could be off by 2lbs or more) I was told my baby could be 8.5-9lbs. I was told that I should be induced before the baby got any bigger if I had any chance of deliverying vaginally.

No one told me you are more likely to have a c-section if you are induced. My induction was a NIGHTMARE! Posterior, NO ONE did one DARN THING to help me with that or to manage the pain. I laid in bed gripping the rail believing I was dieing and something must be HORRIBLY wrong because I wasn't have contractions I was having NEVER ENDING HORRIBLE PAIN. Yes I had an epidural, I knew no better.

Long story short... despite making it all the way to 10 cms we had fetal distress and I was rushed to the OR and delivered via c-section. I never had a chance to try to push. On the operating room table my OB declared my pelvis "incompetent" and declared that I'd always need c-sections.

My baby was 7lbs 3oz.

I feel like I was violated, lied to, and really assulted.

I've learned so much since then. I am DETERMINED to have a different experience this time.


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## glendora (Jan 24, 2005)

I do know one mama who had a c/s for a baby that was "too big" which I feel was perfectly justified. But, it was specifically the HEAD that was too big. Baby had a chromosomal disorder. He's 5 now, and his head is still proportionally larger than his body. So, YEAH there are "too bigs" that are actually too big. But, certainly not as many as doctors seem to find...


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## DoomaYula (Aug 22, 2006)

I found the story here on mdc. It was a 12lb 12oz baby (!) and they did have to break his arm







, but he is fine now







.


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## thebarkingbird (Dec 2, 2005)

the kind of pelvic formation that make for an unlikely successful vaginal delivery can't be seen from the outside. it's not the hips it's the pelvic opening. if a woman's pelvic opening is truly odly shaped and the baby is truly quite large the woman can have problems. the thing is, that kind of mild deformity is extreemly rare!

i would NEVER go back to a doc who discouraged a doula. the OB i saw actually asked us if we had one! sounds to me like someone feels that someone else might get in the way!


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## applejuice (Oct 8, 2002)

I have posted this a million times, but Frank Sinatra was 13-15 pounds and was born at home, 1915. One version of the story says the doctor used forceps and messed up his ear. The doctor thought he was stillborn so he set the baby aside and went to work on the hemorrhage his mother was experiencing. His grandmother, a midwife, worked on the very large but limp baby, putting Frances Albert under some cold water and got him going after a while. His mother did have diabetes and did not have any more children. Frank Sinatra was an only child of an Italian immigrant family in New Jersey, an unusual situation.

So a small Italian woman gave birth at home to a 13-15 pound baby and lived and so did the baby. No big deal. Happened every day.

There are also rumors, OT, that his mom and or grandmother performed illegal abortions in their community also. Just a rumor. Probably the only way a midwife could use her skills once women all went to the hospital to birth their babies and the state legislatures refused to license midwives.


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## WillowBrook (Nov 24, 2007)

CPD does indeed exist, I happen to be one of the rare cases of true CPD myself. I have had an Eating Disorder for a very long time (since childhood) and the resultant years of malnutrition during my developing years has resulted in my pelvis being somewhat malformed. I was having MRI's, X-rays etc for an unrelated condition when the Pelvic Disproportion was discovered. When the Doctor showed me the images and explained what it meant it was really one of those situations where in all honestly you didn't need a medical degree to see that something was really wrong with the structure of my pelvis. So if (and hopefully when) I do have a child(ren) I will be having a C-section because for me it's pretty much a choice of labour for days, risk the babies life and risk serious damage to myself (Obstetric Fistula for one) with absolutely no chance of actually giving birth vaginally and ending up being rushed in for an emergency C-section or have a pre-planned C-section that is as comfortable, pleasant and positive as I, and the Doctors, can possibly make it


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## Romana (Mar 3, 2006)

Of course! True CPD _does_ exist. It's just quite rare (1% or less) and usually is the result of malnutrition or prior pelvic injury. It's really not possible to diagnose CPD prior to labor since the ligaments loosen and the bones move during birth to make room for the baby. However, in extremely unusual cases, it can be diagnosed if the pelvis is clearly malformed OR major prior pelvic injury makes it obvious.

I wouldn't be convinced in your friend's case . . . I suppose it's possible, but lots of babies won't come out when you're pushing with an epidural while lying on your back. I would find a CPD diagnosis to be suspect after anything but an unmedicated, uninhibited labor with a pretty long pushing phase (i.e., mom given plenty of time to change positions, choose what feels best, etc.).

I like this article: http://www.bellybelly.com.au/article...s-big-baby-cpd


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## UrbanCrunchyMama (Aug 7, 2007)

Romana9+2 -- Great article! I've bookmarked it for future reference. Thanks!


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## flapjack (Mar 15, 2005)

My eldest was born at home and was 14lb 2. No SD, unlike his brother who weighed in at 8lb 13oz.

If I can offer you advice, the best way of helping her heal is to put her in an environment with new mothers, womens whose births are recent and who share her philosophies on parenting (you know, people like us...). Over time, they tell their stories again and again and you can see the healing happen. You can see the passage from numbness to questioning to anger and then to "what if ?" It's really hard- in fact, it's heartbreaking, when you see a friend suffering with the realisation that with different caregivers, her baby's birth could have been much different and you watched all along, but this is your role. To support, to nurture, and to pick her up again when she stumbles and falls. It isn't possible to show someone the light. Be aware, also, that the story she tells of the day her son was born might not be the story that her heart tells- she may already be on the journey, but not yet sharing it publicly.


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## Ahimsa (Apr 7, 2004)

I know a woman who is petite 5'2" or under, and on the trim side too, who birthed an 11lb+ baby in the hospital with no drugs. She said she got up and squatted on the delivery table. She said all the nurses were impressed and had to come and see. The boy must be at least 20 now.


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## Gilby (Nov 27, 2007)

There's that midwives tale about shoe size... Take the size of your shoe (mine would be size 9) and add 1, you can easily birth a baby of that weight (which would be 10lbs for me). I'm sure it's been defied though!


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## lyttlewon (Mar 7, 2006)

I am sure it probably happens. If you are in a bad labor position then a small baby will have trouble passing. That is what is so wrong with people dictating how a mother gives birth.


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## lyttlewon (Mar 7, 2006)

Quote:


Originally Posted by *Gilby* 
There's that midwives tale about shoe size... Take the size of your shoe (mine would be size 9) and add 1, you can easily birth a baby of that weight (which would be 10lbs for me). I'm sure it's been defied though!









Well I wear a 7 1/2 and DS was 11lbs 4oz.


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## turtlewomyn (Jun 5, 2005)

Quote:


Originally Posted by *Gilby* 
There's that midwives tale about shoe size... Take the size of your shoe (mine would be size 9) and add 1, you can easily birth a baby of that weight (which would be 10lbs for me). I'm sure it's been defied though!









What about your feet growing in pregnancy? I was a size seven prior to pregnancy, now I am an eight. I had a 9lb8.5oz baby that was a coerced scheduled c-section for fetal macrosomia, I was not "allowed" to go into labor. They tried to tell me that they had missed GD, and that is why I grew a baby "too big" for me (and hence why I wasn't going into labor by their due date, either). Never mind that I had aunts birthing nine and ten pounders vaginally.

I am sure that it is possible to grow a baby too big for you, but it is rare. Having a prior condition that affects your pelvic size would be one cause. Untreated GD would be another. I also think that fetal positioning has a lot to do with it too.

To the OP, I guess you can only do so much for your friend. I know there are a lot of women out there that buy right into the "Oh my baby was too big for me, I am so glad I had a c-section." and there are those of us who are traumatized and pissed off over the whole experience (and a whole range in between). Only time will tell how your friend feels about her birth. Remain open to her, whatever her experience is.
www.ican-online.org is also a great resource.


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## Climbing Rose (Dec 10, 2006)

I'm sure anything is possible... but not common or normal, yk?

I am pretty small. I weigh about 110 when not pregnant and have a small frame.

My third baby was ten pounds and one ounce. Before him, I'd had two little six pound babies.

I had the big guy at home, and it wasn't a long or hard labor-- although I did have to push harder and move around more than I did with the other births. It was all over in less than three hours, and I didn't tear or anything.


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## PoisonousBlonde (Apr 27, 2007)

Quote:


Originally Posted by *Gilby* 
There's that midwives tale about shoe size... Take the size of your shoe (mine would be size 9) and add 1, you can easily birth a baby of that weight (which would be 10lbs for me). I'm sure it's been defied though!









I wear a size 8 and add 1 then I would've had 9lb babies, all 3 of my were 6lbs. That midwife tale didn't hold true for me.

As for the OP, my cousin had a baby and her Dr. said her pelvis was way to small for her daughter to pass through and her baby started to go into distress, so she had to have a C section. Her baby was 7lbs 3oz.


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## heathenmom (Mar 9, 2005)

Quote:


Originally Posted by *PoisonousBlonde* 
I wear a size 8 and add 1 then I would've had 9lb babies, all 3 of my were 6lbs. That midwife tale didn't hold true for me.

The rule doesn't mean you'll HAVE 9 lb. babies, just that you could easily BIRTH 9 lb. babies.

FWIW, my shoe size is 9 and my kids were 10 lb. 9 oz. & 10 lbs. even.


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## Evergreen (Nov 6, 2002)

Quote:


Originally Posted by *Gilby* 
There's that midwives tale about shoe size... Take the size of your shoe (mine would be size 9) and add 1, you can easily birth a baby of that weight (which would be 10lbs for me). I'm sure it's been defied though!










I have a friend who is the same height and build as I am ( 5'1", 110 lbs) but she has bigger feet (size 9.5 vs size 5). She had a ten and a half pound baby, mine were not even seven pounds. We always joke about this little tale being true.

ALthough my feet did grow with the last pregnancy, so maybe now I can birth bigger babies.


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## milkmommie (Apr 19, 2005)

It's hard to say when or if your friend will be ready to revist the decisions made during her birth. You might consider bringing her to a birth circle if there's one in your area...or organize one yourself.







She may not even choose to share her story there but we always get just what we need and I'm sure listening to other women's stories could be healing for her also. We had one when I lived in NM and it was amazingly healing for many women who had births they needed to mourn or heal from. It's also a nice "unpushy" way to open people's eyes to the many different ways of birthing.

As for a baby being too big...
My first birth was extremely medicalized in an Army hospital, we had shoulder dystocia, forceps, episiotimy, I had a HUGE tear, ds had a pneumothorax. He weighed in at 9lbs 8oz and we were told he should have been a c-sec. My second child was 6lbs 10oz and a breeze. I was petrified during that entire pregnancy that I would end up with another big baby and a c-sec. My third child was born in a birthing center with a midwife and a doula, in a tub with NO medications. He weighed 9lbs 2oz and I had not so much as one fissure. Our fourth was a planned home birth with a wonderful midwife, a few friends, a doula, dh, and all our kids. DD was 11lbs even!! We had shoulder dystocia and her birth was a little scary but she is fine and the tear I had was less than with my first birth. I thank God that we were not at the hospital for her birth. I believe strongly that we would have ended up with a c-sec. And I am more thankful for my amazing midwife who knew just what to do.


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## DavinaT (Jun 28, 2005)

Am with WillowBrook on this one.


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## tbaldwin (Nov 8, 2007)

I agree what your friend needs most now is support... if/when she gets pregnant again, the other information can be offered... but here's my story. My husband & I hired a midwife, someone who was experienced, 30 years of experience with 3000 births. Fewer than 5% of her patients ever tranferred to the hospital & fewer than that ever had a c-section. I know at least 3 people who had babies with her years ago who had wonderful experiences. I am extrememly careful with my diet, avoid trans-fats, avoid high fructose corn syrup and take my cod liver oil every day.

We called her at about 1 am because I started labor, she was in no rush, which was fine since it was my first and labor wasn't intense yet. She arrived with her assistant around 4 am and labor was still about the same. A few hours later I was dialated to 6-7 and decided to labor for a while in the tub, which helped ease the discomfort between contractions, it really helped me relax. After a while, I got tired of that & decided to move back to the bedroom. She let me move around, snack & drink as needed, I basically had the freedom to do what nature was moving me to do.

I didn't progress pass 8 and labor was growing more & more intense, so after some discussion (it was around 10 pm now) we decided to break my water to intensify labor and move my body to dialate to 10. Wow, did labor intensify... well yes, and I did dialate to 10. However my daughter's head was ever so slightly tilted up and I failed to progress, I don't remember what "station" she was at, although the midwife & my husband could see her head. After a few hours of that, I was done.

We transfered to the hospital about 20-30 minutes away (there was one closer if baby was in distress, which she wasn't) and after examination, the doctor told me I could either have an epidural and try some more pushing (been there, done that for 26-28 hours by then - or at least the pushing part 4-6 hours by then) or have a c-section. After (ever so quickly) consulting alone with my midwife and husband, we unanimously (though it was my final decision) opted for the c-setion, which was performed at about 5 am.

My daughter's head was 14.5 centimeters, 9 lbs 7 oz (I'm 5'7 and thought I had "birthing hips"), and she was stuck in the birth canal, they had to pull her out with some force.

After some consideration and some research (especially Price-Pottenger Foundation research), I've come to the conculusion that I'm healthier than the previous generation and had a baby with a bigger head than I could birth. That didn't happen generations previously when everyone was eating native foods and there was no white flour, sugar in anyone's diet.

With that being said, I'm still going to labor at home with (hopefully there will be a) baby #2, before tranferring to hospital. We don't have the funds to hire a midwife and go to the hospital, though I will plan on hiring a doula. Personally although I want to vbac, I want to make sure I'm a little closer to help if needed, just because of my history.

Well, hope this helps support anyone else out there who may have experienced anything similar.


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## tbaldwin (Nov 8, 2007)

just saw the shoe size string... I was a 6 1/2 - 7 before I got pregnant... and a c-section witha 9 lb 7 oz baby... hmmm interesting...


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## mwherbs (Oct 24, 2004)

well some babies sometimes may not fit-- in this case we can sort of trace the probable causes -- this mom was not able to cope with pre-labor and the medical professionals she trusted did not support her in having a vaginal birth-nor did they even attempt to keep this normal . unless she had cervical strictures 1-2 cm in no way represents active labor. prodromal labor, braxton hicks contractions... but true active labor no way so how long was the labor and was pit added?
what may have been needed was some theraputic rest and reassurance she may have woke up in true labor.. or it may have went away...to re-start later--
so that she actually got to complete and pushing is fairly amazing to me- that this baby did not make the passage-- not a surprise given the beginnings of the story-- upright and moving would be my preference for trying to get a baby to dip into the pelvis and fit through - normal daily routine if it was her normal awake hours and if it is night time then sleeping is what should have been encouraged at 1-2 cm-- ignoring labor as much as possible - a hot bath or shower- belly banding-- possibly take some magnesium - it is a smooth muscle relaxant and can help to settle some irritable cramps as well as relieve constipation -- medically a sleeping pill- there are some with a very short half-life 4 hrs and it may have made a big difference on her state of mind and ability to cope-- did she have a knowledgeable, TRUSTED doula or other support?
ACTIVE labor for a first time mom- fully effaced and at 4 cm with regular contractions that are lasting 1 minute to a minute and a half long -- that is active labor that should last about 12 hrs-- ( this is an average -- more recent studies suggest an even longer active labor 14-16 hrs)
I could not even begin to think that there was something wrong with her in a physical- way like CPD until these other social and medical problems have been addressed---


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## ~threemoons~ (Dec 13, 2007)

My babe was 11lbs 4oz and and she fit after ALOT of pushing!!!! I was in second stage forever. I was shocked when they weighed her-we were all shocked. I am really glad I didn't have a late ultrasound because if I would have known she was that big I would have convinced myself that i could not birth her.


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## burke-a-bee (Jan 8, 2005)

I think position has a lot to do with it. My DS 1 was 9lbs 1oz born born in the hospital. In bed a lot and pushed on my back for 2 hours. Didn't really go with the urge to push. My DD (my 4th) was born at home standing in the bathroom at 10lbs 4oz with maybe 10 minutes of pushing. No shoulder problems. DDs birth was much easier and faster than DS1.


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## UrbanCrunchyMama (Aug 7, 2007)

flapjack -- I had never considered that my friend's internal dialogue may be different that what she shares publicly. Thank you for those words of insight and wisdom.

Ahimsa -- I love when birth professionals are amazed by the strength of mamas on a mission.

Lyttlewon -- I have a feeling that birth would have gone more smoothly if she was mobile, but with the epidural, it just wasn't possible. (sigh) My friend is a very religious person too. On some level (whether conscious or not) she's probably walking around thinking that God is a sloppy mechanic (to paraphrase from _Ina May's Guide to Childbirth_).

turtlewomyn -- Yes, ICAN would be a great resource for her. However, I think she's still at a point where she doesn't even acknowledge that she might benefit from such a thing. I suggested that she get on MDC and at least read what other c-section mamas are saying, but I don't know if she has or not.

milkmommie -- Holding a birth circle would be a wonderful event. Getting my friend in the door would be a whole 'nother effort. Anyway...how would you write an "advertisement" (for lack of a better word) to entice people to come? I ask because people who are aware of their traumas would be very open to it, but the ones who don't even know they are hurting would miss out, ya know?

mwherbs -- I had a conversation recently with my midwife, trying to glean wisdom about speaking to pregnant friends about their birth choices. We determined that as I talk to women, I need to focus more on support measures (finding a truly supportive HCP, doula, etc.). I knew to insert that in my information sharing before, but I really need to address support more fully.


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## mwherbs (Oct 24, 2004)

I wanted to pass along this journal abstract-- a bit to the point to some degree

J Midwifery Womens Health. 2007 May-Jun;52(3):216-28.

A review of factors associated with dystocia and cesarean section in nulliparous women.
Lowe NK.

Oregon Health & Science University, Portland, OR 97239-2941, USA. [email protected]

The primary indication for cesarean section in nulliparous women continues to be clinical diagnoses that fall under the rubric of dystocia. These diagnoses account for approximately two-thirds of all cesareans experienced by otherwise healthy nulliparous women. Contemporary research evidence suggests that this clinical phenomenon is complex and multifactorial. This review explores factors associated with the phenomenon of dystocia in the context of a conceptual model that considers women's physical and psychological characteristics, fetal factors, intrapartum care and interventions, assessments and clinical decision-making of health care providers, the sociopolitical environment, and the social and physical environment of childbirth. Clinical recommendations include emphasis on
the maintenance of normal weight and weight gain during pregnancy, delaying the admission of nulliparous women to the hospital until active labor is established, avoiding elective induction for nulliparous women, keeping women well-hydrated and well-fed during labor, providing high-quality supportive care during labor, staying the course with effective treatment when dystocia is encountered, and a renewed emphasis on the psychobehavioral preparation of nulliparous women for the realities of labor.

PMID: 17467588 [PubMed - indexed for MEDLINE]


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## dflanag2 (Oct 4, 2005)

I think that eating 'native' or 'whole' foods rather than white flour/sugar is more nutritious and therefore gives more nutrients to the baby.

My midwives recommended eating 85 grams of protein each day. I believe their average birthwieght for their practice is significantly higher than average because of this diet monitoring.

For my first pregnancy, I was hungry all the time and probably ate too much, but a lot of what I ate was rich in protein and nutrients. I (a size 4-6) gained almost 50 lbs and had a 10 lb 1 oz baby with a 14.5 inch head (natural labor at birth center, pushed for 2.5 hours...) And no GD was diagnosed.

For second pregnancy, I ate *significantly* less (few snacks, just moderate healthy meals 3x per day) I wa also chasing a toddler and working out 3x per week. I STILL gained 50 lbs but I wasn't worried bc I felt fantastic. DD was born after 2 hours of labor in 3 pushes and weighed in even BIGGER at 10 lb 8 oz (still with 14.5 inch head.)

I notice that my babies have the same measuremwnts as my youngest brother (my mother's largest baby at 8 lbs 14 oz) same head, chest, length, etc, but my babies come out looking more like chubby 1 month olds. Can it really be so difficult to squeeze out a few extra pounds of soft squishy chubs? I think it's mors about the bone structure.

Also, don't doctors know that your pubic bone pulls apart when birthing? I know mine did in both cases, and ached a bit for months while knitting back togetherbut feels fine now.

Anyway, with regard to OP question, so long as the docs believe what they believe and birthing mothers trust everything the doctors say, these are the birth stories that will result, and unless the mom is open to confronting her negative emotions, I doubt you'll get anywhere with her.

-dflanag2
nak w the 10.5 pounder who is 15 months and 29 lbs now...


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## ~*~MamaJava~*~ (Mar 7, 2004)

Quote:


Originally Posted by *Gilby* 
There's that midwives tale about shoe size... Take the size of your shoe (mine would be size 9) and add 1, you can easily birth a baby of that weight (which would be 10lbs for me). I'm sure it's been defied though!

















I wear a size 11







but my biggest babe was 7lbs 3oz. I _wish_ I could find a way to grow a nice plump one and test that out!


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## Storm Bride (Mar 2, 2005)

I tend to think that women don't grow babies that are too big...then I think of that woman in Russia (I think) who recently had a baby who was taken by c-section, and weighed 17 or 18 pounds at birth. Even allowing that I think head size is more significant than body weight, I'm guessing most women would have problems birthing a baby that big...


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## Dov'sMom (Jan 24, 2007)

Quote:


Originally Posted by *~*~MamaJava~*~* 







I wear a size 11







but my biggest babe was 7lbs 3oz. I _wish_ I could find a way to grow a nice plump one and test that out!

How does that work for European mamas?









I'm a size 13 (11 mens) so I guess I don't have to worry, right?

But I did worry, quite a bit, because my mother had 5 c-sections. Her first she was in hard labor for 24 hours, no epidural, no progress for hours (stuck around 7 or 8 centimeters, baby's head still -) when the baby went into distress and they did an emergency c-section. They had suspected CPD earlier and done some X-rays that left the doctor sure it wouldn't work, but she was determined to try. With her second (me) she tried a VBAC. Her doctor told her to labor for more than 3 hours could be a risk of rupture, so the plan was that after 3 hours of hard labor they would switch to a c-section...well, they made the decision after 3 hours, but her doctor didn't show up for ANOTHER 9 HOURS so a total of 12 hours, in which there was no progress. Also no epidural. The next they did the c-section as soon as she told them she was in labor, and the next two were scheduled. So, was it real CPD?

Now, I had no trouble birthing my 7 lb 1 oz son (other than 50+ hours of labor because he was face up...), and my sister has had no trouble with her two (7 lbs 8 oz and 7 lb 2 oz), but I don't know that I'm eager to try 14 lbs!


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## Turquesa (May 30, 2007)

Quote:


Originally Posted by *mwherbs* 
I wanted to pass along this journal abstract-- a bit to the point to some degree

J Midwifery Womens Health. 2007 May-Jun;52(3):216-28.

A review of factors associated with dystocia and cesarean section in nulliparous women.
Lowe NK.

Oregon Health & Science University, Portland, OR 97239-2941, USA. [email protected]

The primary indication for cesarean section in nulliparous women continues to be clinical diagnoses that fall under the rubric of dystocia. These diagnoses account for approximately two-thirds of all cesareans experienced by otherwise healthy nulliparous women. Contemporary research evidence suggests that this clinical phenomenon is complex and multifactorial. This review explores factors associated with the phenomenon of dystocia in the context of a conceptual model that considers women's physical and psychological characteristics, fetal factors, intrapartum care and interventions, assessments and clinical decision-making of health care providers, the sociopolitical environment, and the social and physical environment of childbirth. Clinical recommendations include emphasis on
the maintenance of normal weight and weight gain during pregnancy, delaying the admission of nulliparous women to the hospital until active labor is established, avoiding elective induction for nulliparous women, keeping women well-hydrated and well-fed during labor, providing high-quality supportive care during labor, staying the course with effective treatment when dystocia is encountered, and a renewed emphasis on the psychobehavioral preparation of nulliparous women for the realities of labor.

PMID: 17467588 [PubMed - indexed for MEDLINE]

Thanks for the abstract! If I were at the campus library, I could post some abstracts about the Gaskin maneuver (i.e. birthing on all fours), an evidence-based alternative to cesarean for cases of shoulder dystocia. Appallingly few doctors have heard of the Gaskin maneuver.

In "Born in the U.S.A.," Marsden Wagner cites research indicating that shoulder dystocia is likely to happen REGARDLESS of a baby's size. I can get my hands on the citation if anybody is interested.

In response to the OP, a doula's role is to enhance the father's participation, not inhibit it. Our doula assumed the role of memorizing my birth wishes and guiding me through labor. My husband, relieved of all of that pressure, was still able to provide moral support while wholly experiencing the birth.

Doulas often compel women to question the most questionable of obstetric practices, so it's no surprise that the OB in question was anti-doula. Even my crunchy midwives lifted brows when I told them I'd be bringing one along. (Fortunately, they ended up liking her!)


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## mwherbs (Oct 24, 2004)

the only thing I am a bit troubled about in the abstract (that is a review) I sent along is the info on weigh gain-- and what I think about that is like another poster wrote a "healthy" whole foods diet that has a good deal of veggies and fruits- as well as some whole grains- and plenty of protein -- little to no processed sugars not so much for size of baby but for mom's health--- so the studies do stack up against over weight moms but if you think about it many providers would be treating/over treating a perceived condition and actually not ending up with good results like more c-sections which ends up making for a statistic that you have to work at understanding--


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## WillowBrook (Nov 24, 2007)

Quote:


Originally Posted by *PoisonousBlonde* 

As for the OP, my cousin had a baby and her Dr. said her pelvis was way to small for her daughter to pass through and her baby started to go into distress, so she had to have a C section. Her baby was 7lbs 3oz.

From what I understan (from a laypersons point of view) it's not necessarily the size of the baby alone which determines CPD, but the size of the baby relative to the size of the pelvic opening. For someone with true CPD giving birth to a 5 pound baby may be just as impossible as giving birth to a 10 pound baby simply because it depends on the size of the pelvic outlet.

Quote:


Originally Posted by *dflanag2* 
Also, don't doctors know that your pubic bone pulls apart when birthing? I know mine did in both cases, and ached a bit for months while knitting back togetherbut feels fine now.

They only stretch/pull apart so far though, just to use myself as an example because of the malformation of my pelvis I would literally have to dislocate both my hips and tear myself in half in order to give birth vaginally. For women with true CPD caused by pelvic malformations it makes no difference whether or not the pelvic area stretches or opens up, it still won't make it big enough for a baby of any size to pass through.

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To the OP - If you're cousin has accepted and is happy with how she gave birth then, and I don't mean for this to sound as rude or blunt as what it's going to come out, what business is it of yours to insist she feels differently? It sounds as if you have far more of an issue with this than she does, perhaps you are projecting your own feelings about birth onto her? Not all women are traumatised by a C-Section and not all women feel they were robbed of a certain experience by undergoing a birth process that was highly medicalised. Your cousin may have liked the idea of a "natural" birth and looked at it as her ultimate ideal of birth, but at the end of the day understood that sometimes our ideals are out of reach for whatever reason and been perfectly accepting of that fact.

Before I found out about my particular pelvic formation issue I had always wanted to have a waterbirth, preferably at home with a midwife attending. Once I discovered that was going to be impossible however; that indeed vaginal delivery fullstop was impossible for me, I was fine with it. I didn't mourn the loss of a particular birth experience at all. To me it was like well ok I'd really ideally like to live in a 2 storey bluestone mansion overlooking the ocean, but that doesn't mean I won't be just as happy and satisfied to live in a 2 bedroom house in the suburbs.


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## UrbanCrunchyMama (Aug 7, 2007)

Quote:


Originally Posted by *WillowBrook* 
If you're cousin has accepted and is happy with how she gave birth then, and I don't mean for this to sound as rude or blunt as what it's going to come out, what business is it of yours to insist she feels differently?

Three months have passed since my original post, and I haven't seen my friend since, so I don't know "where" she is right now.

Why does this effect me so deeply? Because she may represent many of the 31% of women in this country who did not need a c-section. I'm not against c-sections altogether, just the unncessary ones.

It's heart-wrenching to know that...
- she dreamed of a gentle, candlelit birth amongst loved ones and was dissuaded from getting the support she needed to make that happen.
- in all likelihood, her OB does not know how to truly support a healthy pregnant woman and her baby.
- that her situation sounded like the domino-effect that so many of us on this forum try to avoid and help others to avoid.
- on some level (whether conscious or not) she thinks that her body isn't meant to birth babies the way God had created it.
- when she is pregnant again, she will likely be convinced that a c-section is her only option (when she's twice a likely to die on the operating table during a second surgery). We do have another friend who nearly died during her second surgery because she lost so much blood. This woman has squelched her heart's desire to have a third child because she's afraid of really dying during a third surgery.

My friend may fall into the 1% of women who have CPD. My friend's baby may have never come out vaginally after any amount of pushing (after the epidural). But 68% of our friends and family (in various parts of this country) have given birth via c-section. This is insane!









Yes, the feelings around our births are as unique as the individual and at the same time, equally valid.

But how much longer do we "let" this happen to the people we care about?


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## flapjack (Mar 15, 2005)

The sad fact is that the political is personal. At some point, women will start challenging their own birthing history and rewriting their own stories, but as long as maternity care is determined by a third body (the insurance company, or in our case the NHS) then "let" will not take its true place as the nasty little swearword that it truly is.


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