In my experience, many pregnant people FEAR THE BIG BABY! I myself fell prey to this when pregnant with my first child. I went to an OB visit that happened to be on my due date. My doctor said to me, "Are you ready to get this over with? Because I think he's getting kind of big." In my mind, there was nothing scarier than THE BIG BABY! I didn't want THE BIG BABY! I had read in "What to Expect When You're Expecting" (or as I refer to it, "What to Expect When You're Paranoid"), that doctors don't induce unless it's medically necessary. At that time I figured if it came from my doctor's mouth, that meant it was medically necessary. And because I was afraid of THE BIG BABY, I agreed.
What can we keep in mind about THE BIG BABY?
1. Many professionals agree it is more about the position of a baby rather than the size of a baby. Babies who are face-up (posterior) can make labor longer and harder. For more about this, check out the Spinning Babies website.
2. Ultrasounds measure the length of bones, not the squish of fat. You can't tell from bone length how much your baby will weigh. There are actually different formulas for measuring and each formula produces a different estimated weight -- do you know what your doctor is using?
3. Ultrasounds have about a 15% margin of error. This could be a pound and a half either way. That pound and a half number also changes the smaller your baby is. For example, if you were told your baby would be 9 and a half pounds and your baby was 8 pounds, that's about a 16% margin or error. If you were told your baby would be 8 pounds and your baby was 6 pounds, that's a 25% margin or error.
4. The size of a baby does not tell us if the baby's lungs and other systems are mature enough to be up and running on their own. It's actually the baby who decides when to be born by releasing a hormone the placenta responds to, and then triggering labor. Read Kim James' "Close to Due Date" for the breakdown on how all of this works.
5. My experience as a doula and childbirth educator tells me most women are afraid of having THE BIG BABY! This fear is often used by professionals to get us to agree to be induced, even though this is not recommended. The American College of Obstetricians and Gynecologists states inducing for a "suspected" large baby is not evidence-based. "In cases of term patients with suspected fetal macrosomia, current evidence does not support early induction of labor. Results from recent reports indicate that induction of labor at least doubles the risk of cesarean delivery without reducing the risk of shoulder dystocia or newborn morbidity."
My first baby was induced. And he wasn't small -- he weighed 9 pounds, 8 ounces. But was he more than my body could handle? With my next baby I passed over an OB for a Certified Nurse Midwife. I remember wanting desperately to go into labor on my own, but I was also petrified of having THE BIG BABY MARK-II. In a conversation with my midwife at around 38 weeks, I said to her, "You know, if I go over my due date, I'm just going to stop eating." She looked at me wisely and replied: "His HEAD is not getting any bigger. He's just putting on fat. And fat is very squishy."
Wow. As that sank in, I had an amazing realization that more often than not, our bodies know what they're doing. My second baby kick-started an 8-hour labor at 41 weeks and 2 days. Not only did he weigh 9 pounds, 9 ounces, he came out fully face-up and with his head tilted to the side (posterior and asynclitic). Granted my doctor was right about THE BIG BABY, and then THE BIG BABY MARK II came along next. But baby three (8 pounds, 4 ounces) and baby four (8 pounds, 1 ounce) proved I could have smaller babies. Either way, there's no need to fear THE BIG BABY.
Sometimes a cesarean is necessary and a family knows this before labor begins. This gives them a chance to prepare in ways they may not have thought of during a regular labor-turned-cesarean birth.
1. Bring easy carbs to snack on -- fruit, cheese, crackers -- bring what you and your partner like to eat. Aside from the surgery aspect and the fact that you usually can't eat until you pass gas (to ensure everything is moving as it should), I suggest you just take care of yourself like you do every other day of your life -- pretend you are staying at a hotel; what would you bring food-wise to eat when you weren't able to go out? Like that 2 am snack?
2. While none of my local hospitals have mini fridges for patients and family, it is possible to bring a small ice chest for things like yogurt or drinks that you'd like to keep cool.
3. More often than not people bring too many things. Bring your own pillow, pajamas (maybe nursing night gown so no waistband to put pressure on your belly). Bring small comfort items that help you feel better -- again, things you would bring on a trip. Most hospitals provide you with a belly binder after a cesarean birth, but you should call and find out for certain. This would be a wise purchase ahead of time if you don't get one from the hospital.
4. Some families like to dress their babies in the hospital, others keep babies in the hospital shirt/diaper and just do lots of skin-to-skin...that choice is yours. Everything your baby needs during the stay will be provided. If you want your baby in special diapers, then bring those (if they are cloth, bring the necessary wet bag to store the used diapers in).
5. I suggest packing in levels -- everything you will need before your cesarean birth in one bag, everything you need for your stay in one bag, then everything you need for going home in one bag. This way you don't have to dig through the going-home outfits to find your slippers, etc.
6. They will not take your baby to give you a break, even if you request it. I had a mom who had twins and had to stay at the hospital alone as she had other children dad needed to stay with. She was exhausted and asked if a nurse would just take one baby for one hour, and the nurse said sorry, babies only leave mom if they are ill and need to be in the NICU. You can have your partner stay the night if you wish. If your partner can't stay the night, some families arrange to have a grandma stay with mom.
7. Although there are TVs in all the hospital rooms, many families do well with a tablet, phone, and/or laptop. This way you can share baby updates and pictures with family and friends, and you can watch movies or listen to music if you have a spare moment.
8. Advocate for yourself. This is a day you will never forget -- if you are receiving care that isn't up to your standards, address the situation or ask for a new caregiver. You are paying the bill and you deserve cheery, positive, helpful support, even if you choose to do things a little differently or decline traditional procedures. You can decline ANYTHING if you don't want it. Don't feel pressured, and be sure to start a conversation that is centered around shared-decision making. You are the expert of you, while your doctor is the expert regarding the medical issues. You have equal say and power in what is going on.
Women rate their birth experiences on 2 things: How in control they are, and how much support they get. This can happen in ANY kind of birth. I have seen women walk away from what looks like an amazing vaginal birth traumatized with PTSD, and I have seen women walk away from unscheduled cesarean births beaming with pride and happiness. It is mostly about how you are treated and how much say you have in how things go. Even in a cesarean birth you have options -- ask what those might be (things like listening to music during the birth, no outside conversation that doesn't relate to your baby's birth, having the drape lowered as baby is being born, etc.). Often families find they can have greater say in something because of FOMO -- the things they feel they might be missing out on during a vaginal birth. Bring these concerns up ahead of time with your provider and ask what accommodations can be made to shape this into the birth you dreamed about!
♥ four young boys and a boy dog (offspring)