Baby too big? It could cause CPD

Is your pelvis too narrow to accommodate your baby’s size during delivery?

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Mother of two Nadiah Rasheed, 32, had always yearned for a natural birth. But despite doing a course on hypno-birthing and reading up everything she could on how to raise her chances of giving birth naturally, she ended up undergoing a C-section when she delivered both her children.

“For my older son, now 4, I had been in labour for 13 hours, and he was showing signs of distress, so the gynae said he had to come out by an emergency C-section,” Nadiah recalls. For her now 7-month-old daughter, she was hoping to do a VBAC (Vaginal birth after C-section), but her doctor advised her against it.

“My gynae said that even though I was quite tall at 1.69m, my pelvic structure is quite small, and it was unlikely that Rina (her daughter) would be able to go through,” she notes.

Both Nadiah’s babies were relatively big ― they weighed 3.45kg and 3.55kg at birth.

Cephalopelvic disproportion, or CPD, happens when the baby is too big for the expectant mum’s pelvis.

“It’s not a labour problem, but a delivery problem,” explains SmartParents expert Dr Christopher Chong, a Gleneagles hospital obstetrician-gynaecologist.

It is one of the more common causes of an emergency C-section from a labouring mum, Dr Chong notes, though he adds that how common it is depends on how strict the doctor adheres to the definition.

“In some of these cases, the baby can even die under the doctor’s eyes. So, it’s important to recognise the problem before labour…”

“The head of the baby may not actually be large. At times, if the baby faces skywards, or if it has a hyperflexed* neck that causes the diameter of the head to be larger, it can make it hard to go through the pelvic bone passage, leading to CPD,” he points out.

What’s worse than CPD is shoulder dystocia, whereby after the head is delivered, the anterior shoulder of the infant cannot pass through. This can happen with large babies and diabetic mums, where “there can be extra deposition of fat around the trunk and shoulders of the foetus,” Dr Chong adds.

“In some of these cases, the baby can even die under the doctor’s eyes. So, it’s important to recognise the problem before labour and offer a C-section,” says Dr Chong. “About 10 per cent of C-sections are from CPD.”

 *Extended beyond the normal range of motion.