C section due to baby's size?

A friend of mine in Sydney had a c section on Friday as her baby was "looking" to be really big. It turns out the little boy was a bit big at 4kgs but am wondering if this is a common reason to have a c-section?

If so why is it done? I thought that the birth canal would strecth to accomadate a baby no matter what the size? Or am i naive??? (again!!!)

TIA.

Percy, I have heard of this before. Maybe the woman would have been able to deliver vaginally but maybe not. Ultimately, if a person is given information like that it is their choice what they do with it.

Percy, this is quite common and very sad, I remember there was an article about it not long ago at the soaring caesarean rates and it made reference to the 'big baby' excuse. One Ob piped up that it was evolution, babies were getting bigger and pelvises weren't catching up *rolls eyes*. Aren't you creating evolution by heading down a future path of extremely high surgical birth?! Bah. And I know LOTS of women who have been told that they have huge babies and ended up with a small bubba, off by several pounds - 9lbers ended up as 6lbers and so on. Not always the case but I see and hear it all the time. Have supported mums who have been told this. You can even see an example in the induction link in my signature, where a midwife was there for an induction of a so called big baby, which almost got admitted to NICU it was that small. Even if the baby is bigger than 'average' it takes big babies and small babies to make an average baby and our bodies are designed to birth these babies. People diagnosed with CPD (cephalo pelvic disproportion or small pelvis) is actually rare, where they have had rickets or a bone injury to their pelvis - I actually know someone who had an injury but was fine.

I believe in the importance of a second opinion and self-education - and the right knowledge will give you confidence. Caesarean is convenient, easy and its exactly as David Vernon commented the other day when someone was told they couldn't birth their baby breech with them (despite baby being in the most favourable position for breech and that the Royal College Ob/Gyns guidelines saying vaginal birth is favourable in this way) - ironic that we pay these people squillions for their 'experience' yet we go to them for something which requires extra skills and they do not have it or refuse it. They should be using these skills so women have choice. We all argue for choice for everything, but the choices people are making now are a result and at the mercy of the information or skills our Obstetrician has and how willing they are to be patient and allow you to have the birth you want. If you had an estimated 4kg baby and your Ob said you could do it, would you believe it? Of course you would, and many women do birth these babies perfectly fine. So lots of issues involved in this - the risk that the Obstetricians learn, those who are our primarly carers in this day and age, has rubbed off on society. Fear of birth is so high, because those who are prodominantly caring for normal, healthy pregnancies are trained in things that go wrong in birth.

Thank you for this Kelly. I appreaciate your viewpoint. :)

I'm pretty anti-medical intervention where possible - probably due to me having to use it to concieve! - so was curious if this was a usual thing or not. Knowing the mother involved its highly likely she would've just listened to her obs and not gotten further advice or researched any other avenue.

Will talk to my midwife tomorrow and will be making it clear that I don't think this is a reason for a c-section for me anyways! :)

Thanks again.

My son James weighed 4.3 kgs when born. I was told around 6 months pregnant with Madeleine that she was going to be huge, around 12 lbs (5.44kgs) and that I would need a c/s. I was in tears, but I stood my ground and refused. I knew I had successfully birthed a large baby, and I could do it again. As it turned out, she weighed 3.5kgs. I am glad I didn't listen to the c/s suggestions.

I was told nothing about Matilda's size & she was 4.02kg. When she came out alot of people said "geez thats big" but I don't really think its big, I actually think its within the "normal" range. I did have to have a c/s with Matilda, but not for size reasons ;)

I talked to my m/w about this this morning and ironically enough last night she delivered vaginally a 4.6kg baby so was very relieved to hear that she thought the idea of having a c/s just becuase the baby might be large is rubbish! :) Happy about that! :)

Percy, good luck for whatever mode of birth you choose.

Hi Percy,

I am not a believer in listening to experts as they can get it wrong sometimes. My ob told me i was having a big baby but he never said i would have to have a c/s. If your baby is really big and you are petite yourself or you have a small structure then you may have too. Alot of phillipines women have to as they are so fragile and small. It really depends on you personally and even when you are in labour. If the docs can see there is problems they will opt for an emergency c/s.

Don't stress at all i gave birth to a beautiful baby girl who weighed 4.686kg (10pound 5), i had a natural birth and only had one shot of pethadine and gas, it went smooth and i was in labour for 12-13 hrs... Yeah!!!! It is easier to have a big baby and easier to look after as they are not so little and fragile, thats what i have found anyway. Hope this helps.

jen
xx :hug:

I personally would do anything to avoid a CS. I hate the thought of them. I get really nervous when i think of them coz of the needle. I already told DF that if i have to have one i am getting completely KNOCKED OUT. No needle is going into my back!
I think ultimately it is up to you, and what ever you do decide it will be right for you.
Goodluck..

I wonder, are OBs even trained in vaginal birth anymore? It just seems like more and more OBs are finding 'excuses' to give a woman a c/s, rather than deal with a vaginal birth. It does seem like sometimes OBs tell women to have a c/s for their own reasons, and not for the good of the mother. No wonder so many of us are scared of vaginal birth - how can we feel confident if our own doctors don't want to do it?

I post this knowing full well that I will cop an earful but here goes.

Bon of course obstetricians are trained to birth babies vaginally. The fact that they have to pay large amounts of insurance each year in case someone sues them probably factors into their recommendations more often than not. If someone presented with what could be construed as some kind of risk factor, they are going to be offered other options.

This situation in modern obstetrics has arisen because people are unwilling to accept an adverse outcome. Someone must always be to blame if something goes wrong.

That is the real reason it happens ... not because doctors are incompetent and don't know how to deliver babies.

Absolutely agree with the litigous stuff. But what I dont understand is why are they doing caesareans in situations where there is clearly more risk to do so? Why are they not even giving this woman a chance to birth a 4kg baby when its not really HUGE at all - instead go straight for a ceasar? Why are women with normal, healthy pregnancies having caesars? Why are women wanting the expertise of an Ob being denied a birth that even their profesional organisation says is safe? Breech or bigger babies are only labelled 'riskier' because they have made it so. Even Lionel Steinberg admits there's a medical convenience epidemic... However this will backfire, there was recently a big case in the US or Canada where a mum was awarded $1-2mil for an uninformed caesarean which her Ob performed. Insurance companies will also get smart about this as they are the ones forking out the big bucks for these procedures so it makes sense for them to kick a stink about this and they are starting to stir. Rhea (my teacher) reckons about 4 years time will be interesting...

If a woman wants a caesarean then its a different ketle of fish to those who really dont want one and are being railroaded into one. Who has the options? Not those who want a vaginal birth.

Wow, $1-2 mil is a great baby bonus! Or am I missing the point.....:)

Kelly as you know, I agree with you in theory on many of these points. Though, from a personal perspective (and my own research) I do not agree that in some situations there is more risk with a caesar than with a vaginal delivery. In cases such as vbac, the jury seems to be out as to whether one course of action is riskier than another. It depends on who is giving you the information I have noticed.

From the perspective of a person involved in the birth industry: do you feel that birth in a non-medical environment will have a significant impact on a woman's perception of an adverse outcome? How do natural birth practitioners deal with insurance and other thorny issues? Not asking to be difficult. I really want to know.

Mel - Of course I know that OBs are trained in vaginal birth. I was being sarcastic. I also did not say, or was trying to suggest that OBs are incompetent. I have certainly been grateful to have them around when I delivered my babies and had complications afterwards.

I know that OBs have issues with insurance and litigation, but there are risks associated with both types of birth, I don't understand why some OBs are so quick to offer or recommend c/s. And if, as you say, the cost of insurance and the fear of being sued factors into their recommendations sometimes, this just proves my point that in some cases they recommend c/s more for their own reasons than for the good of the mother.

Bon,

Did I say anywhere that you suggested obs were incompetent?

My point exactly is that birth is a risk. I cannot blame a person for wanting to protect themselves against litigation and recommending what they think is the best option under the circumstances. You would possibly see that as self-interest. The job of the obstetrician is also to ensure the safe delivery of a live baby. I don't see how that can go against the mother's best interests but that may be just me.

I have to dash out now for the day (more flippin expo bag packing) but quickly if you have a caesarean you are vulnerable to more infections (you wouldnt otherwise be cut open & tools used which expose you) and with each caesarean, you are more likely to rupture, have a hysterectomy, more complications etc. There is much documented evidence about this and I have posted some of the media releases in here. Even in practices where notes were taken on those transferring, Ina May Gaskin's 'the Farm' and another GP run birth service in Europe where he & his midwives saw something like 10,000 in his career (or could be 40,000 forget) there was a c/section rate of 0.5%. Intervention extremely low etc. They note the transfers and factor them in, but the reality is, normal birth is extremely efficient and safe, and caesareans are only needed a very small percent of the time. As the WHO states, only up to 15% of caesareans, all factors considered may be medically necessary. We're a loooooong way off with most private hospitals in excess of 30% and growing. You'd be shocked if you truly knew how much the wool was being pulled over our eyes. As part of my training we were taught about psychological aspects of birth - its a big part of birth. Back later ;)