A “Big Baby” follow up post – The second with many more to come
Many women with babies identified as big are offered induction in hopes of reducing a rare but serious event – shoulder dystocia.
There are risks associated with shoulder dystocia, and there are risks associated with induction.
It is really hard to compare and give medical advice on the chance of a small but serious event happening (shoulder dystocia) vs less serious but very common (complications of induction being that it is unsuccessful, the baby is born before it is ready, the experience is more painful, depending on how the process is discussed; a lack of autonomy if the woman feels like she didn’t have a say in the recommendation).
Interestingly women who are induced are most likely to have an epidural because of the absence of hormones associated with the physiological process, and yet most shoulder dystocia happens in the context of an epidural and induction. The baby is forced into the pelvis in a way that is harder for them to navigate the pelvis (membranes are often artificially ruptured), and women are less mobile making it more restrictive for the management of shoulder dystocia should it occur. NICE guidelines also suggest that induction for a “big” baby doesn’t reduce the risk of shoulder dystocia unless the estimated weight of the baby is over 5.5kg
How big was your baby?
Photo by Jan Canty @jancanty