An Iowa mom gave birth a few days ago to a nearly 14 pound baby– the baby was born vaginally; mom had no epidural or pain medication. She wanted to avoid a c-section. Her caregivers knew the baby would be on the large side but hadn’t predicted this. Her first baby was 12 pounds at birth (and apparently harder to deliver).
I know all labors are challenging and all moms are triumphant no matter what happened, but I reserve a little extra Hurrah for this mama. Seriously. Though many women, understandably, think their babies are “too big” this baby is most definitely, most sincerely, and even officially very large!
Since many women fear giving birth to a huge baby and there’s some confusion about what exactly having a big baby means… I thought I’d throw out some fun facts. I think some of these can be reassuring:
*The official weight of a “big baby” (fetal macrosomia) is either 8 lb 13 oz or 9 lb 15 oz, depending on whom you ask. Based on these weights, macrosomia affects 1-10% of all pregnancies.
* Most babies are born weighing between 6 and 8 pounds. Only one tenth of one percent of babies are born weighing over 11 pounds.
* Estimates of a babies weight via ultrasound can be off by a pound in either direction and are not considered reliable.
Recommendations based on good and consistent scientific evidence (Level A):
- The diagnosis of fetal macrosomia is imprecise. For suspected fetal macrosomia, the accuracy of estimated fetal weight using ultrasound biometry is no better than that obtained with clinical palpation (Leopold’s maneuvers).
Recommendations based on limited or inconsistent scientific evidence (Level B):
- Suspected fetal macrosomia is not an indication for induction of labor, because induction does not improve maternal or fetal outcomes.
- Labor and vaginal delivery are not contraindicated for women with estimated fetal weights up to 5,000 g in the absence of maternal diabetes.
- With an estimated fetal weight more than 4,500 g, a prolonged second stage of labor or arrest of descent in the second stage is an indication for cesarean delivery.
Recommendations based primarily on consensus and expert opinion (Level C):
- Although the diagnosis of fetal macrosomia is imprecise, prophylactic cesarean delivery may be considered for suspected fetal macrosomia with estimated fetal weights of more than 5,000 g in pregnant women without diabetes and more than 4,500 g in pregnant women with diabetes.
- Suspected fetal macrosomia is not a contraindication to attempted vaginal birth after a previous cesarean delivery.