Can a baby be too big for your cervix?

Okay...my DD was 4.27kgs and I birthed her naturally, no drugs.

My OB is expecting me to have another big baby this time, probably bigger than DD. This is getting on my nerves a little, because I don't think there is much I can do about it...DH and I make big babies (with big heads)! (DS was 3.83kgs).

I'm not afraid of another vaginal delivery of a big baby because I've done it before. I know all that stuff about how the pelvis opens up etc etc. Or at least I wasn't until...

...I read something the other week in a blog that is preying on my mind. Somebody was posting about how upset she was that she had to have c-section and her baby was 4.5kgs. Somebody else posted that she shouldn't worry, it would have been medically necessary because the cervix will only dilate to 10cms and the baby probably would have torn the cervix and caused internal bleeding.:o

I can't get it out of my head and I'm almost embarrassed to say that third time round, I'm getting scared! And I'm starting to wonder if I do have a bigger baby than DD will this happen to me? Is this a valid concern or complete rubbish? Can a baby be too big to fit through a cervix?

You should know from your time on BB that your body is perfectly capable of birthing the baby that it creates :) These two articles will reassure you....

Small Pelvis? Here's The Truth About Cephalopelvic Disproportion (CPD)
Big Baby? Then You Must Read This Article...

LOL I know! But it is messing with my head! Because I started thinking...okay well the pelvis is the skeletal structure, the cervix isn't really part of that...

Mate - is your OB KS? She told me when I was going with her about one of her VBAC clients who had an 11 pounder - so I'd be surprised if she suggests you need a section?

don't forget that your baby will not necessarily be bigger than your previous ones either.
my ds2 was a lot smaller than ds1, even though everyone told me to expect an 11 ponder.

Yeah it's KS. And she's not going on about it by any means, but DD's size has been mentioned in passing every single appointment I've had and I'm only 23 weeks now and certainly not looking like the side of house just yet. She was also most insistent I get a GD test (not that I wouldn't have) because having a previous baby weighing over 4kg is a risk factor.

I don't know if maybe she's trying to prepare me for having a whopper but that's okay, I already was prepared!

I've decided I'm going to hit her up next appointment about it, maybe I'm being overly sensitive! The GD test will have been done by then, which I'm quite sure will be negative.

I've got my first midwife appointment at the hospital on Wednesday so I'll ask them too.

Okay well even if your bub is an extra 200-300g - it aint gonna be all on it's head :p The weight will be evenly dispersed - and if you could see that much extra evenly dispersed on your baby - it wont be that much bigger really. Make the most of your body and pelvis, keep yourself upright and open, off the bed... and really focus on this because that sort of fear in labour can shut you down!

Remember, no-one can accurately guess baby's size - all forms of fetal measurement are inaccurate. Fundal height changes with baby's position, length of the baby, amount of fluid etc... and ultrasound is also inaccurate... but we wouldn't survive as a species if we weren't capable of birthing the babies inside us ;) My babies are getting smaller! :) 6lb10 down to 5lb15 - and the smallest was a boy too! Can never take anything into account, that baby is designed the way they are because thats what they are meant to be :)

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She was also most insistent I get a GD test (not that I wouldn't have) because having a previous baby weighing over 4kg is a risk factor.

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That kind of depends on the baby.
DS1 was 4.64kg, I had a GD test with him and it was negative.
Yes, he was 10lb 4 BUT he has not macrosomic, just a very long baby. If you'd had a large baby that was macrosomic it might be a risk factor, but not just on weight.

ETA: DS2 was 4.62kg, and I idnt have the test, or GD this time either.

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She was also most insistent I get a GD test (not that I wouldn't have) because having a previous baby weighing over 4kg is a risk factor.

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Yeah she was insistent on me getting one too cos DD1 was 3.95kg - so close to 4kg!!

I didn't have it, just make big babies! However - DD2 was 3.9kg - so a little lighter :D At least she didn't get bigger!! haha

I have read about some women vaginally birthing brow presentation and deflexed positioned babies - deflex isn't a brow presentation, but their chin isn't tucked into their chest, so the overall head circumference is larger. These women had a second stage that lasted a few hours because that's how long their body needed to be able to dilate that bit further. Also don't forget that a baby's skull isn't a solid piece of bone, it will mould and shape as much as it needs to so it can be born. My first bub had amazing moulding on his head - he looked like a conehead LOL and at birth his hc was only 34.8 but I reckon if they had of measured once the moulding had gone down the following day that his hc would have been a lot larger. Plus the second stage lasted for 1hr20mins and I think that I needed that long to allow his head to mould the way it did. Seriously hun, you will be fine!

:lol:

Thanks girls...I just needed some sense talked into me! I could feel this fear taking root, IYKWIM.

Arimeh, not worried about KS being pro caesarean...I know someone who was recently in labour for over 40 hours and was totally fed up and told KS to "cut this effing thing out of me" and KS talked her down and she went on to deliver the baby vaginally.

Maybe I am just more accepting of birthing a big baby than the average bear...I'd taken it as a given from the moment I got the BFP (not to mention my excellent BB education;))...and I've taken KS' gentle suggestions of me probably having another big baby to mean that I'm going to have some 5kg giant!

Hun, your body is amazing! You have succesfully given birth to 2 "large" babies vaginally. Your body has done it's thing twice before. You should trust that it can do it again. I think deep down you know that, but it's always good to get some encouragement.
Yes, it is possible for a baby to be too large. But it is extremely uncommon and often the result of other health problems (ie. GD, rickets) or malposition. If you are worried, it might help looking into OFP (Optimal fetal positioning) to give you and your bub the best chance.
I personally haven't had very large babies. (DD was 3.9kg, DS was 3.34kg) With both I was told they're gonna be small. They weren't. But they weren't whoppers either.
My babies have gotten smaller. Although I gained more weight the second time around. But my grandmother gave birth to 6 babies, all over 5kg, all at home with a midwife).

Try and focus on how well your body has served you the last couple of times. You will be fine.

All the best!
Sasa
xx

Hope this helps :D

I am only 5ft 2 and weigh 48kg..DS1 was 3.8kk my DS2 was over 4kg and a natural delivery :dance They aren't huge but big for me I think?? Like Kelly said, weight will be distributed..my kids get it all in their cheeks :lol:
I did use and epidural but I am a wuss when it comes to birth. My DD who is now 8wks old was nealy 4kg and natural..no suction, no forceps, just great help from my DH and OB and only a tiny little tear with no damage anywhere else.
Womens bodies are amazing and can do amazing things, I can see where you would second guess yourself when you read something like that.

Take care

x Heather

For sure if you've already had a larger baby then you aren't as worried about having another one. My 3rd was 4.32kg and my 4th was 4.56 and #3 was harder to get out than #4 by a long shot. #4 was still a lot of hard work but I would gladly have another one that size or bigger than give birth to #3 all over again.

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Also don't forget that a baby's skull isn't a solid piece of bone, it will mould and shape as much as it needs to so it can be born.

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Great point, Trill.

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it would have been medically necessary because the cervix will only dilate to 10cms and the baby probably would have torn the cervix and caused internal bleeding

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Hey Curly. I'm no MW, but to me this looks as though someone has taken this little gem right out of the PROMA study. (Pulled Right Out of My A...)
Forgive me if I am mistaken, but isn't the whole number of cm thing a bit of an estimate? No one has taken a ruler to me during labour. The reality is, the cervix dilates and effaces so that it is flush with the os. When you are fully dilated, I believe it is generally not possible to feel the cervix, so who knows how much 'give' is left in it?
Did you tear in your last births? Internal tearing is possible, but there are lots of things you can do to minimise that risk for yourself. Kelly has already spoken about positioning during labour and you can prep yourself to try not to 'push' as much as just let your body propel the baby out, KWIM?
If I were you, I would read loads of fabulous birthing articles to increase your confidence in yourself once again.

I have loads of links to inspirational you tube clips and images - there is one I think in the labour section, stickied, something like, think you're small? then check this out.... images of women who have typically small statured cultures birthing these sized babies and bigger :)

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I'm no MW, but to me this looks as though someone has taken this little gem right out of the PROMA study. (Pulled Right Out of My A...)

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ROFL!

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you can prep yourself to try not to 'push' as much as just let your body propel the baby out, KWIM?

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Ah yes, that aspect I have trouble with. I tore both times, first time DS was epidural and forceps so I couldn't feel a thing.

Second time with DD, they told me to get up on the bed and start pushing and it felt completely unnatural, I did not have the urge to push. The midwife told me I sounded like I needed to push and I told her I felt constipated but had no real feeling that I wanted to start pushing...but they told me it was time. The OB then told me I wasn't pushing hard enough and so DD's head wound up half-crowning and I had to wait for the next contraction with her head half poking out and the OB telling me that if I'd pushed harder she would already be in my arms. Helpful...not. He told me afterwards that his wife never felt the urge to push either and she'd had 5 kids.

It was only 3 little stitches after DD though.

I actually asked my OB (new OB this time) about whether it was true some women just don't get the urge to push and she looked very dubious and said it was very rare and that they'd probably made me push before I was ready.

The idea of the contractions helping push the baby out is still something I simply don't "get" because I don't know what the urge to push feels like.

See 'purple pushing' really isnt' good at all. It is the most important time during birth where I think you really need to listen to your body kwim? A lot of women don't get that strong urge to push and birth their babies just fine. I think it is our bodies way of doing what needs to be done.

The urge to push is feeling like you need to poo. I could still feel it even with an epidural. The pressure is in your behind and the MW can check. It does sound like in the past you have been told to push without being ready :dunno:
Everyone is different...

IMHO, if you need to push, you will know it. with both my babies I have never needed someone to tell me. I think I would have ripped their heads off. I honestly had NO Control over whether I pushed or not. My body just did it. I pushed like an Ox with DD as I felt that that's what I needed to do. Especially once she was crowning, I just wanted to get it over and done with. Her head kept going back and forth a few times and it hurt so much that I instinctively held bakc with the pushing a little. At some point I couldn't handle the burning sennsation any longer so I birthed the head with one almighty push. I tore my labia. Not badly, but I needed stitches. With DS I had planned to breath him out slowly to avoid tearing again as I found the stitches worse than labour pain. But I had no say in it the second time around either. My body told me to push, so I did :) I tore "along the dotted line". But it didn't bother me.

The concept of "breathing the head out" still appeals to me. But I found it impossible. DS came out like a freight train :D (didn't even make it to the car, let alone to the birth centre).

I do believe your baby will come out even if you never get the urge to push and never consciously push. The contractions are pushing for you.

Sasa

Yep, I liked the idea of breathing the baby out too for my 2nd but my MW wasn't aware or particularly supportive of my desire to stand to birth the baby. By that stage I was too tired (in transition when I arrived) to argue, plus I was already pushing because it felt so good. I feel like if I had've prepped DH better or had a doula that I would've been able to give it a go.
Curly, it sounds like your new OB is pretty cool and hopefully she will allow you to follow your body's lead and push when you are ready. Might be worth chatting to her and your support person/people beforehand and letting them know if you want to try certain positions or whatever. I found New Active Birth had some helpful suggestions for positions to try during 2nd stage. Either way, the only time I have heard of people damaging their cervices was when they were made to push before they were ready. And yours has made it through that unscathed, so take heart ;)