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The most powerful factor undoubtedly in the high induction rate of “obese” women is the fear of a huge baby. I cannot stress this strongly enough. In my opinion, fear of big infants is what’s really driving the high Cesarean rate in women of size. Doctors and many midwives have been trained to believe that a lot of big mamas produce big, “overly fats” babies, and therefore are strongly in danger for shoulder dystocia (where the baby’s shoulder blades get trapped and baby may be injured).
Because shoulder dystocia injury is one of the primary causes of professionals being sued, many practice defensive medicine. With macrosomia (big baby), this means many induce labor for women suspected of having a big baby early. They reason that bringing labor on a bit early, as the baby is smaller, may make it easier for the baby to be born without shoulder dystocia.
- 1 bowl upma with vegetables
- 2 Tablespoons Bacon Bits (or Crumbled Bacon)
- Positive impact on one’s hormones
- 1 box Sugar Free Pistachio Jello Pudding Mix
- Location: Ohio
Now, this seems logical–induce early while the baby is small to raise the likelihood of it coming out vaginally and safely–but however, research shows exactly the opposite effect. Studies show that inducing for a huge baby often worsens outcome actually. The Healthy Birth Practices handout on “Let Labor Begin alone” makes a spot of debunking the common idea that it’s important to induce early when a huge baby is suspected. Additionally it is important to learn that suspecting a huge or very large baby is not a medical reason behind induction.
Furthermore, it is very difficult to learn how big your baby is until he is born. Ultrasound is not good at predicting macrosomia (very large) infants. Simhayoff 2004 found inducing labor in women with macrosomic infants increased the Cesarean rate, not decreased it. The c-section rate in the induced group was 17.8%, vs.
11.9% in the group with spontaneous labor. Leaphart 1997 found that inducing for macrosomia more than doubled the Cesarean rates, from 17% to 36%, while not reducing make dystocia rates significantly. Combs 1993 found that inducing for macrosomia increased the Cesarean rate from 31% to 57%, and there was doubly much shoulder dystocia in the induced group.