Most women quake in fear at the thought of having to give birth to a big baby. You might be crossing your legs just thinking about it. But is it really so awful, or are we the victims of the nocebo effect?
The nocebo effect (the opposite of the placebo effect) is when a negative expectation of something causes it to have more impact than it would originally. By instilling fear in women about the dreaded ‘big baby’, we are creating a situation in which it is very difficult to have a positive experience of birth.
This is not to undermine or minimise the experiences of women who have had a hard time birthing their big babies, although equally some have had a difficult time birthing a 7lb baby. What I want to do here is question our seemingly universal belief that a woman birthing a big baby will need assistance.
If we believe that giving birth to a big baby is impossible or agonising, then surely we also have to believe that there is a problem with women’s bodies. That our bodies just aren’t fit for purpose. And maybe this isn’t much of a leap for most of us to make, given that we are told all the time that our bodies are deficient. For many of us it’s like wallpaper, we no longer notice all the messages telling us we are too fat, too hairy, too sweaty, our boobs are too small/big, our cycles are too long/short.
I believe our bodies are perfectly designed to accommodate and birth our babies. During pregnancy, the body secretes a hormone called relaxin, which allows the ligaments of the pelvis to loosen, becoming soft and pliable, making more space for the baby to pass through. The baby’s head has overlapping plates that allow it to reduce in circumference during birth. This is the result of thousands of years of human evolution, and we are the pinnacle of that – if birth didn’t work, we literally wouldn’t be here.
Unfortunately, the medical community tends to collude with the idea that birthing a big baby is very likely to require assistance. Women who are ‘suspected’ (which makes it sound like a crime) of carrying a big baby are sent for growth scans to investigate. Unfortunately, ultrasound is not as effective in estimating the size of babies as many of us believe - medical professionals included. A UK government confidential report (CESDI) concluded that "the inaccuracy of ultrasound estimates have been well documented. Indeed, it is possible that estimating fetal weight by late ultrasound may do more harm than good by increasing intervention rates”.
Off the top of my head I can think of three friends who had babies well over 9lbs and had really positive birth experiences. So I decided to ask them more about their birth experiences. Sarah B gave birth to a daughter weighing 10lbs 11oz and she said, “Birth was perfect, I'd say the 'easiest' of all three babies (other 2 were 9lb 1oz and 7lb 14oz). I had a small tear, which could have been stitched or left but I opted for stitching to make healing time quicker.”
Sarah M also gave birth to a daughter, “The birth…was an absolutely amazing experience. One that I cherish and feel it helped heal scars from the birth of my first daughter (induction at 41+3). She was born at home on dry land. I had a small tear but no stitches.”
Both of Rachel’s daughters weighed 9lbs 10oz and were born at home – the eldest was born on the bathroom floor because Rachel didn’t realise how far advanced her labour was. I remember her phoning me and telling me the story, and it was the most amazing birth story I had ever heard! Her youngest was born in the kitchen before the midwife could arrive, caught by a very proud Dad.
All of these women were well educated about birth. They felt confident in their ability to birth their babies. They knew how to create the optimum environment for physiological birth to take place – which is for it to be dark, quiet and familiar – in fact all of them chose to birth at home so that it would be easier to create these conditions. Does that surprise you? Did you know that for women experiencing a low risk pregnancy, home birth is safer than hospital birth for second or subsequent births? However, if you feel safer in hospital, then go with your instincts. If this is the case then it can be useful to think about what you can do to make the hospital environment more homely. (But that’s another blog post.)
When you are pregnant, have you noticed how it seems that someone is always ready to make a comment about your bump or your body? Here are some real life examples of comments that have been made to pregnant women:
“You’re the biggest pregnant woman I’ve ever seen!”
“Are you sure there is just one in there because you’re huge!”
“Any day now!” (Usually when you have 3 months left to go.)
“Your boobs are massive.”
“Your baby is going to be huge – maybe you should you book a c-section?”
“I don’t envy you squeezing that one out, love.”
The last two comments, apart from being rude and insensitive, come from an assumption that birthing a big baby is harder than birthing a smaller baby. Can you see how our collective fear of ‘big’ babies creates a problem for the woman who is told she might be carrying a big baby? She ends up terrified of giving birth, worried about whether her body can handle it and about how painful it’s going to be. So when she goes into labour she is waiting for it to be excruciating, tensing up against each contraction, and because fear = tension = pain, she is in for a rough ride.
There is another way. Do you know anyone who had a great birth? Ask them what they did. This is the reason I used hypnobirthing for the birth of my daughters, and why I now teach it. I spoke to the people I knew who were positive about birth (admittedly not many). They all had one thing in common – they used hypnobirthing techniques during pregnancy and birth.
In fact you don’t have to spend long hanging out on Facebook groups about hypnobirthing to hear lots of positive birth stories – and plenty of them are about babies born weighing over 9lbs. These women aren’t any different to other woman on the planet, except for their lack of fear, knowledge about the process of birth, belief in their body and a whole host of hypnobirthing tools and techniques to keep them calm and relaxed. The bottom line is, when women are prepared to take responsibility for what they can control about labour and birth, which is quite a lot, they stack the odds of a positive birth in their favour, whether they are having a particularly big baby or not.
Photo by hugrakka, CC BY
I'm Liz Dew, founder of SheffieldHypnobirthing.com and I love a good chat about birth. This blog is where I explore some of the things that I find amazing, frustrating, or fascinating about birth and birth culture. Grab a cuppa and dive in.