What You Need To Know About Birthing A Big Baby, Including Induction And Labor Techniques

If your doctor or midwife mentions your baby may be getting "too big," she may present information about inducing labor. While there's no right or wrong decision to make, there are some important things you should know about birthing a large baby.
Ami Burns

Birthin' big babiesHow big is too big?
The average size of a healthy, full-term newborn is 7-1/2 pounds. When a baby weighs at least 4000 grams (8 pounds, 13 ounces) or 4500 grams (9 pounds, 15 ounces) he is considered macrosomic, literally meaning "large body."

Your doctor or midwife may use ultrasound or fundal height measurements to estimate baby's size. These measurements are just that -- estimates -- and studies show they can be off by a pound or even more. (Find out more in our article, How accurate are fetal weight estimates?.)

Risk factors
Risk factors for having a big baby include genetics like the height and weight of mom and dad, ethnicity (Hispanic moms tend to have bigger babies), sex (newborn boys tend to weigh more than girls) and maternal or gestational diabetes.

Whether or not you fall into any of these categories, there is still a chance you may have a big baby.

Should you induce labor?
Inducing labor utilizes pitocin, the synthetic form of oxytocin, the hormone your body naturally releases when it's time for your body to go into labor. While there are medical reasons for induction, a suspected large baby is not one of them.

In fact, the American College of Obstetricians and Gynecologists (ACOG) does not recommend induction for a suspected macrosomic baby, and studies show that induction for this reason does not lead to better outcomes for the baby, but also nearly doubles the risk of having a cesarean section.

Talk to your caregiver to see if there is any other reason that she may be suggesting an induction -- and also check out our articles about labor induction -- so you can make an informed decision.

Labor and delivery
Whether you choose induction or allow labor to start naturally, there are things you can do to stay comfortable and help labor progress once it starts.

Getting into positions that use gravity and help open the pelvis are particularly helpful if you have a large baby. You can try squatting, kneeling, rocking your pelvis or sitting on a birth ball. These positions will give a big baby more room to rotate and may ease the intensity of contractions. When it's time to push, you may find that pushing in a squatting or kneeling position is more comfortable than laying on your back.

There are some risks associated with birthing a large baby. Labor may stall or your cervix may not fully dilate to 10 centimeters if the baby is too big to fit through your pelvis (or if the baby is in a position which does not allow him to descend enough to open the cervix).

In some cases, you may need an episiotomy or assisted vaginal delivery with forceps or vacuum extractor. A rare but serious complication can occur called shoulder dystocia, which means the baby could get "stuck" (usually on his or her shoulder) during delivery.

Real-life stories
Remember that many moms deliver "big" babies, and everything is just fine. Sometimes, a baby thought to be average size in utero gives mom -- and doctor or midwife -- a surprise when he's born!

Big baby on hospital scale Megan Trinter, a mother of two from Chicago, Illinois offers a great example. "Neither time did my midwife suspect a large baby," says Trinter. "With my first, I never had an ultrasound and the weight was guessed to be (via palpation) to be about 7 pounds. I had a biophysical profile at 41 weeks and 5 days with my second, and he was estimated at 9 pounds -- more than a pound less than he was."

Trinter's daughter was 9 pounds, 6 ounces, while her son was 10 pounds, 4 ounces She gave birth to both children at home without complication.

PregnancyAndBaby.com co-founder Nancy Price also welcomed four bigger-than-average babies -- none delivered by cesarean section. In fact, the biggest of the bunch (shown just after birth in the photo above right) was an 11-1/2 pounder who arrived so quickly, there was no time for medication at all!

"When they first called out the weight from the other side of the room, I thought I'd misheard it, and asked my husband to come closer to me to tell me again," Price wrote in her son's birth story. "The answer was the same: 11 pounds, 7-1/2 ounces. I was shocked... I expected a ten pound baby at the most."

If it looks like your baby will be big, remember the only way to accurately tell a baby's size is to weigh him after he's born. Talk to your doctor or midwife about the potential benefits and risks of inducing, allowing labor to start naturally, and birthing a big baby.

"I tell everyone who asks how I did it the same thing," says Price. "Have faith in your body! It created this amazing little person already. I think you need to give yourself every chance to finish the process as needed, and not according to a calendar."

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