Giving birth to a seven-pound baby can be a daunting and difficult task. Many moms can't even fathom all of the work and trauma that can happen with the average sized little one. But these days, more and more babies are coming out much larger, and that can make things even more complicated.
A baby born heavier than nine pounds is considered to have macrosomia, and there is a name for it because there are a lot of risks that come with it. A 10-pound newborn is just as likely to go to the Neonatal Intensive Care Unit with complications as a four-pound little one. They have a greater chance of sugar issues with their body, and they could end up with a birth injury. Even more so, the risks to the moms multiply. They could face problems with the baby fitting through the pelvis, which could mean that a C-section is required, and in a natural delivery, her body could go through some major trauma.
It's best to try to avoid a big baby, and we have some information about that. But a baby has to be born, no matter the size, and this guide might help a mom in preparing for the delivery of her big guy or gal. Here are 20 surprising truths about giving birth to a large baby.
20 Sometimes The Baby Doesn't Fit
A big baby can stretch the womb and give a woman a huge baby bump during pregnancy. But of course, the real problem comes when it's time for the baby to come out. Sometimes things seem to start okay, but the baby doesn't fit in the birth canal.
Hormones released at the end of pregnancy loosen the ligaments in the body and that can make the pelvis shift to give room for the baby. But it can only go so far. Some big babies get stuck in there, causing an emergency situation. Some women have given birth to 10 pounders with no problem, but it's a reality that the bigger the baby the more likely it will get stuck.
19 Labor Might Stall
Getting to 10 centimeters is really important, especially when the baby is big. But a baby with macrosomia is more likely to cause a stall in the labor. That can mean that it takes a long time to get to the point of pushing — and some might not even make it there.
The labor could stall no matter the size of the baby, but it's more likely for the bigger ones, according to Parents magazine. That might mean that the doctor tries interventions like induction meds or manually breaking the water. If it is so bad, it might mean that the doctor starts talking about a C-section.
18 Moms Should Try Squatting
Moms shouldn't feel like they have to lie down in a hospital bed to give birth. In fact, for bigger babies, an upright position is much better for a natural delivery. Standing, squatting or kneeling has the benefit of allowing gravity to help, and moms of big babies sometimes need all the help that they can get.
During the pushing phase, the upright position can give the baby a straighter shot down the birth canal, and it allows the pelvis to spread even wider to let the baby through. This position can be more difficult in a hospital and with an epidural, but it's a good idea to consider asking the doctor if you can squat.
17 Big Baby Doesn't Mean More Pain
There are a lot of things about labor and delivery that are the same no matter the size of the baby. According to Belly Belly, the truth is that it doesn't hurt any more to give birth to a big baby. After all, the uterus is doing the same work to try to get the baby out.
It's possible that it could take longer to give birth to a big baby, especially because of the possibility of a stall in the progression. And the pushing phase might be a lot more difficult, but it still hurts either way. The mom's postpartum recovery might be more difficult, but the pain during labor isn't necessarily any worse.
16 Diabetes Might Be To Blame
There are a lot of reasons that a mom might have to give birth to a big baby, and one of those is because of gestational diabetes or diabetes that developed before the pregnancy. The baby's size can be bigger if the mom has uncontrolled sugar levels, so she needs to follow the doctor's directions as best she can until birth.
Some moms can control their diabetes through eating habits, but others might need meds or insulin. It can be difficult to find the right combination, and in the meantime, the baby is getting bigger and other potential complications remain. It's especially important to control levels during birth, so make sure that the doctor is keeping an eye on things.
15 Increased Risk Of Hemorrhaging
Many moms go into labor and delivery with concerns about how the baby will do, but they also need to keep in mind that there are risks to themselves as well. It's not just about pain. Even in modern times, there is still a risk of maternal death, and that can be bigger with a bigger baby.
The possibility of hemorrhaging is greater when the baby has macrosomia, according to Parents magazine. That's probably because of the trauma that can happen internally when the baby is making the exit out of the birth canal. Doctors will watch the mom closely to try and control any issues for a while after the birth.
14 Estimates Can Be Off On The Ultrasound
It's really hard to predict if the baby is big, so moms shouldn't really fret about giving birth to an 11-pounder. More and more doctors are using ultrasounds to get an estimate about the baby's size, but they tend to be pretty inaccurate so there is no need to panic.
The estimate can be off by a pound or two, which means that a baby estimated to be 10 pounds might only be eight — and one thought to be eight pounds might turn out to be 10. The only real way to know how big the baby comes after the birth, when the nurse puts them on a scale and gives the mom the news.
13 The Trapped Shoulder Situation
Many times, the first part of the pushing phase is successful, but once the head is out, things can get even more complicated. That's because the shoulders are the hard part. With a baby with macrosomia, that can also be the dangerous part.
If the baby's shoulders get stuck, there is a risk of an injured collarbone or a condition called shoulder dystocia. That can cause the nerve to get hurt, and that could mean that the baby loses the use of a hand or arm for the rest of their life. It's risky, so moms should do what they can to avoid having a big baby.
12 Big Babies Struggle Too
Most moms think that a tiny baby is the most fragile, but a baby with macrosomia is also vulnerable right after birth. In fact, it might be harder for the baby to thrive because he has to gain in size from a pretty big starting point, and that is not an advantage for a mom still waiting on her milk to come in.
A big baby doesn't mean that the organs are developed any more than another newborn, so they could still struggle with breathing in the first few days and such. They could still get jaundice and have any other big issue that moms have to watch out for in newborns. So don't think that just because the baby is the size of a two-month-old that they are out of the woods.
11 Induction Isn't Always The Answer
A baby grows the fastest during the last month or so in the womb, and some moms try to stave off the baby getting too big by inducing labor. First, we want to forewarn moms that doctors do not recommend induction prior to 39 weeks unless there is a medical reason so that the baby's organs have had a chance to develop as much as possible.
While an earlier induction might save the baby a few ounces, it doesn't guarantee a better birth experience. Moms still face the possibility of getting a C-section because their body might not be ready to go through the delivery.
10 Trauma Down Below
The mom's birth canal doesn't change based on the size of the baby. She's still only going to reach 10 centimeters before starting to push. But when a bigger baby exits, the area down below is more likely to experience some extra tearing.
Some people swear by perineal massage, but it doesn't do enough when the baby is extra big. There can be some big trauma down below, but luckily the area usually heals up pretty well after a few weeks. Moms with big babies might need some extra stitches and some more TLC, but they will probably be fine in the end.
9 A Parent's Size Matters
A baby's size definitely comes from genetics, which means that the mom's and dad's size is a big factor in determining whether the baby—at least at full term—is big, small, or average. Just like the parents, the baby might be skinny but long or short and chubby, and they both might have different issues.
The biggest problems come when the mom is tiny and the dad is tall and big. The mom's pelvis might do it's best to loosen and expand, but there is only so far that it can go. Doctors might be concerned, but sometimes women can still be successful in having a natural delivery. It might be risky and difficult, but it can happen.
8 Baby Might Have A Hard Time Turning
One big issue might arise before the birth of a big baby. It's possible that the little one will get so big so soon that they won't be able to turn to the head down position, which is the safest for the birth.
At some point, every baby gets too big to turn around without some help, which means that the doctor might have to try an external cephalic version to avoid a breech birth. That has its own risks, and it might not work for the biggest babies, which means that the doctor might think that it's safest to go with a C-section.
7 Don't Worry, Their Head Will Be Okay
A lot of moms worry about getting the baby's head out of the birth canal, but even with a big baby, that's not as hard as they might expect. Don't get us wrong; it could take hours of pushing. But even the biggest baby has a skull with bones that move in order to help them get out of the birth canal.
Bigger babies might have to go through more shifts than a smaller baby, and they could end up with a big conehead. But it's normal for a newborn to have a misshapen head after a natural delivery. Usually, the bones will shift and the head will look better with a couple of weeks.
6 Sugar Issues At Birth
As we've mentioned, a lot of babies with macrosomia have moms that have diabetes. All women get tested for gestational diabetes, but there is a possibility that it could be undiagnosed because it could develop after the test. Because of the issue, big babies are in danger of having sugar crashes after the birth.
They get used to being in the mom's higher sugar levels while in the womb, and they could have trouble adjusting to their own natural level later on. The doctor will be watching out for that if the mom has a diagnosis, but all big babies are at risk for it as well.
5 Family Matters
We've already talked about genetics and how the size of the mom and dad can impact the size of the baby. But they also need to know about the family history because that can have a bearing on what they can expect from their little one. That does include how big the mom and the dad were when they were born, but that's not all.
Moms need to think about their previous pregnancies when trying to figure out how big their next little one will be. In general, babies get bigger with each birth, so a mom who had an eight-and-a-half pounder might expect a nine-pounder the next time around.
4 C-Sections Are Sometimes The Only Way Out
Every few months, it seems, news reports come out of 11-pound babies born naturally, and they show the mom looking exhausted but okay. Many times, she had no idea her kid would be so large. That's a best-case scenario, but it doesn't always happen like that.
Some natural birth experts try to dissuade moms from considering a C-section in the case of big babies, but doctors sometimes believe that it's the only safe option. The risks are huge, but sometimes a mom can try for a natural delivery. She just needs to know that often these cases end up in the operating room.
3 Long-term Impact On Mom's Back
The bigger the baby, the more the pelvis has to shift during the delivery. For some women, that might mean a long-term issue with their lower back, although that could also happen with the delivery of an average sized baby in the right conditions.
Hormones loosen the ligaments in the sacroiliac joints, which connect the pelvis and the sacrum, the base of the spine, as well as the pubic symphysis in the front. That area can be damaged, and if moms don't get treatments early, the pain could end up being severe. That's why we recommend postpartum moms experiencing back pain talk to their doctor, especially if the baby was really big.
2 A Trip To The NICU Is Highly Likely
Moms and dads of preemies and tiny babies might worry about their little one going to the NICU, but it's just as likely that a large baby could have a stay in the special care unit right after birth. In fact, many babies with macrosomia need extra care and observation in the first few days or weeks after birth.
All of the risks of birth, including any shoulder issues and sugar problems, make the stay likely. And big babies are more likely to have a low APGAR score at birth, according to Parents magazine. There is a good possibility that the issues will be temporary, but the doctors definitely want to observe the baby and make sure that everything is okay.
1 Evolutionary Truth
The average size of a baby has been increasing in recent years, and a research study has shown that it might be part of an evolutionary change. Doctors believe that the use of C-sections, while it has aided in saving lives, it has meant that moms' pelvises haven't evolved to keep up with the sizes.
That means that they think that more and more big babies will come, and a lot of them might have to be born via C-section. According to WebMD, the evolutionary truth is that bigger babies can be healthy—as long as they aren't too big—but that might just be tougher on the mom.
Sources: Belly Belly, Pregnancy and Baby, Parents, WebMD