17 March, 2008

Am I Too Small to Birth My Baby?

Unless you had a nutritional deficiency as a child, such that you have physically DEFORMED hips or you had a pelvic break that did not heal properly, there is no reason to think that your hips will not be big enough to birth your baby. Humans wouldn't be around if we grew our babies bigger than we could physically push out.

Trust your body. It knows what it's doing and all you have to do is be an active part of your labor throughout and let your body do what it tells you it needs to do.

Any tests that can be done to "make sure" your baby will fit are flawed to the point of uselessness. Only 18% of estimations that say a baby will be "big" are actually correct, and even when a baby is "big," that doesn't mean that the baby will have ANY trouble being born. Also, taking measurements of your hips and the baby's head do not take into account the drastic changes that occur during labor to both your hips and the baby's head to make sure everything fits. If anyone tells you that your baby will not fit, they are almost gauranteed to be completely and utterly wrong and they deserve no more of your time or attention.

Next, how to avoid a baby getting "stuck" is fairly easy:

1 - Do not lie on your back during labor, EVER. Lying on your back is completely unnatural for a woman to do during labor, especially while she is pushing out the baby. Lying on your back is so unnatural, in fact, that the best way to get a baby "unstuck" if the shoulders DO get stuck in the pelvis is to do this amazing thing... get onto your hands and knees. That's usually all it takes. So avoid the whole ordeal in the first place and push your baby out in a position other than on your back.

2 - labor at home for as long as you feel comfortable doing so. The longer you are at the hospital, the more interventions they will want to do to you and the more likely you are to just lie in bed and wait for the baby. Avoid this by staying home as long as you are comfortable doing so.

3 - hire a doula. Doulas are your constant support during labor, helping you get into active positions, reminding you of things you said you wanted to do during labor when you might not be thinking of such things, helping you ask the right questions to make informed decisions, and helping your partner be of the best help possible. Doulas have been found to reduce the chances of a cesarean by 50% (and shorten labor)!

4 - do not be induced unless you have a clear medical reason that makes waiting more dangerous than being induced. Induction has a slew of risks, one of the biggest being c-section. If the induction fails, c-section. If the induction is too painful (and inductions are considerably more painful than natural labor), you'll probably need pain medications, which increase your chance of a c-section. Induction tethers you to the bed because induction makes you high-risk... being tethered to the bed, as I said before, means you're more likely to have baby get stuck, and more likely to have a c-section.

5 - plan on using natural methods of pain relief and if you do want an epidural, waiting until AT LEAST 5 cm dilation. Better yet, plan on not having any pain medication unless your labor is extremely long (longer than 24 hours) or unnaturally painful. Epidurals cause you to stop moving, making it a lot more likely for baby to get stuck. Epidurals make it more likely for you to have a c-section in general. Epidurals make baby more likely to get stuck because your body cannot respond as it normally would to the cues that arise when baby needs you to move or take action. You can't feel, so you can't act.

All of these things are true, regardless of your size and your baby's size.

I also wanted to mention that only about a third of c-sections are necessary, let alone "emergencies." With over 30% of live births being delivered by c-section, it is important for ALL expectant mothers to take an active role in their care and their births. If you have a doctor or midwife with a low c-section rate, you are already in good hands. If your doctor's or midwife's rate is high (more than 25%), then you know you're already setting up for a cesarean section, regardless of your size, and you might want to think about changing to a provider who believes in the female body's ability to birth babies.

Studies have shown that planning a c-section because the baby is suspected to be "too big" is dangerous for mother and baby and does not improve outcomes versus allowing things to go on their natural course.

Trust your body and your baby. They know what they're doing. If you allow your body and your baby to do what they need to do without interfering unnecessarily, you will be amazed at what they can do.

Source(s):
Gonen Ron, Bader David, Ajami Maha. Effects of a policy of elective cesarean delivery in cases of suspected fetal macrosomia on the incidence of brachial plexus injury and the rate of cesarean delivery. American Journal of Obstetrics & Gynecology. 183(5):1296-1300, November 2000.Klaus, Kennel, and Klaus. Mothering the Mother: How a Doula Can Help You Have a Shorter, Easier, Healthier Birth. 1993.International Cesarean Awareness Network - http://www.ican-online.org

(My quick response to a woman on Yahoo Answers asking when her doctor would be able to tell if she would need a c-section because of her size.)