Wondering if that big baby in your belly means you’ll surely need a C-section? Here’s what you need to know…

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One of your top concerns when it comes to giving birth is your baby’s size. If you are carrying a big baby, the thought of giving birth naturally may strike fear in your heart, since it could mean complications and pain. That said, doctors always point out that a person’s labour experiences can differ greatly. If you’re concerned, do speak to your doctor.

A big baby — otherwise known as macrosomia or large-for-gestational-age baby —weighs 4kg or more at birth, when the average weight of a baby is between 3 and 3.2kg. Here are noteworthy things to keep in mind if you’re delivering a big baby…

1) You may be the main reason why bubba’s larger

If you’re expecting a big baby, it is commonly attributed to:
*Genetics If you are large, your baby will likely be the same, too.
*Pregnancy diet Eating too much during pregnancy can also result in a larger baby. Women with a high body mass index are also more likely to suffer from gestational diabetes, which pushes excess glucose from your blood into the placenta. This triggers more insulin to be produced in your foetus, resulting in a larger baby.
*Going past your due date SmartParents expert ob-gyn, Dr Christopher Chong explains that the longer the gestation lasts, the bigger your baby will get. This is why your doctor may consider inducing labour if he thinks that your foetus is large. Dr Chong says, “Even if induction is done, it must be after 37 weeks. [Your] estimated due date is 40 weeks but from 37 weeks on, it is usually deemed full term.”
*Baby’s gender Male babies tend to be larger in size than female ones.

Eating too much during pregnancy can also result in a larger baby.

2) Post-delivery weight is the most accurate measure of baby’s size

Your doctor will be able to better estimate the size of baby only by your third trimester. Dr Chong explains, that’s because “any measurement of weight of the foetus is not accurate [before] 28 weeks of gestation.” Even then, it can be difficult to determine conclusively that your baby is indeed big. Only his recorded weight after birth can confirm it.

3) Natural birth’s usually out of the question…

Experienced doctors may decide if a vaginal birth is viable after doing a pelvic examination and studying foetus’ size. However, Dr Chong notes that this method isn’t foolproof, since one woman’s labour experience differs greatly from another’s.

Also, studies about predicting the suitability of natural vaginal birth have not provided conclusive results, especially among first-time mums, he adds. Such studies used methods ranging from taking X-rays to measure pelvic bone size to ultrasound scans to determine pelvic space. Dr Chong says that for the most part, the expectant mother will need to go giving vaginal delivery a try when she’s in labour to know for sure if she can proceed with this method.

So unless you have previously delivered even a large baby, your doc’s probably going to advise you to undergo a Caesarean section. Dr Chong shares, “Otherwise, there is an increased risk of ending up in a C-section after labour and no one wants to suffer twice.”


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4) … But not always

If you are considering natural birth despite having a big baby, Dr Chong says your ob-gyn will likely take into consideration these “3Ps” of natural vaginal birth:
*Power Refers to the power of your contractions leading up to labour. This can be managed by medication.
*Passage The natural condition, size and space around the pelvic bone. If your pelvis has suffered a prior injury, a C-section is usually in order.
*Passenger Refers to the size and position of the foetus in leading up to delivery.

The biggest risk for your unborn foetus is shoulder dystocia, where your baby’s shoulder gets stuck in the birth canal during delivery, resulting in trauma and even his death.

5) Birthing can pose serious health risks for both mother and baby

While mothers usually bear the brunt of the health risks, their baby also faces risks. Big infants are more susceptible to jaundice, low blood sugar levels and respiratory distress, Dr Chong points out ― most of which are closely related to the mother’s gestational diabetes. Newborns whose mothers have diabetes have been found to have delayed lung development, which gives rise to breathing difficulties.

The biggest risk for your big unborn baby is shoulder dystocia, where his shoulder gets stuck in the birth canal during delivery, resulting in trauma and even his death.

If you’re carrying a large baby, Dr Chong spells out your health risks:
* Pelvic-floor muscle trauma This causes pelvic organ prolapse. Your pelvic-floor muscles are responsible for holding all of your muscles, tissues and pelvic organs in place. The trauma sustained during childbirth causes these organs to droop. The condition is also common among woman who are delivering average-sized babies.
* Stress incontinence (accidental passing of urine when you cough or sneeze). Although mothers of regular-sized babies can expect to experience some form of incontinence, you are at a higher risk because of bubba’s larger size.
*Tears to your anal sphincter This results in a fistula (a narrow passage formed by injury) and worse, faecal incontinence.

6) Big babies are rare

Dr Chong points out that only 10 per cent of babies born weigh more than 3.7kg ― this number dwindles to 3 per cent for babies weighing 4kg or more.

If your doc opts to deliver your baby via an emergency C-section, you have a higher risk of infection and bleeding, can expect your recovery to be slower, and maybe even surgical damage to organs and other tissues. Since you won’t have had time to fast before this procedure, the anaesthesia can cause food, liquid or vomit to flow to your lungs when you breathe — a condition known as aspiration pneumonia.

Photos: iStock

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