Large Baby Risks & Vaginal Delivery: A Guide for Petite Mothers

Question
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Followup To
Question -
My husband and I are considering having another child.  Our concern is that I would have difficulty delivering another baby as my babies tend to be large.  I am about 5'3" and 120lbs.  I am not diabetic. My last child weighed 10lbs 3ozs.  She was delivered at 38wks 3 days as the result of an induction. We would like another baby but I don't want a c-section.  I do not use anesthesia during labor and delivery and would prefer not to be in a hospital.  I think I would need to be upright to deliver another baby and hospital staff argues. Are there any risks to myself or the baby if the baby is large?  Would you recommend finding a home birth attendant or should I stay in a hospital?
Answer -
Hello Michelle. It would help me to know how much you gained in your previous pregnancy- try to get back to me with that info. I WOULD urge you to find a midwife with whom you feel comfortable. You are correct that your chances of an upright delivery are much better in the hands of a midwife at home. A midwife would also be skilled at guiding you in your food plan to avoid a baby that would cause difficulty. The most common worry with a too large baby is shoulder dystocia- shoulders are very wide and difficult to deliver. However, midwives have great strategies for such deliveries that drs. do not use. Your last baby was really not all that big by midwifery standards- about average. A home birth is a wonderful experience for both you and your baby- I hope you are able to find midwifery care in your area. If you need more help with that, get back to me. All the best- Cheri.
Cheri,
Thanks for getting back to me.  This is my fifth child.  I had my first three children in my early twenties.  From first to third, they weighed 7/12, 8/8, 9/10.  With each pregnancy I gained about forty pounds.  I remarried in my thirties. My fourth child weighed 8/12.5. I also gained forty pounds with him.  I gained closer to 50 pounds with this last one but I was quite swollen.  The last three or four weeks I was packing on three/four pounds a week and I couldn't get my shoes or rings on anymore.  Daughter will be 4 months old tomorrow and I only have about ten pounds to go to fit in my jeans. I don't think my weight gain has very much to do with the size of my babies as gain has remained steady but babies get bigger. Third and fifth deliveries complicated by "slight" shoulder dystocia.  Moved to this state 2 months before baby born knowing nobody -- hard to find doctor much less midwife amenable to home birth. (Actually had one prspective dr. warn me that nursing no. four when pregnant with no. five was dangerous to unborn.)Would appreciate any information regarding midwives you may have. Thanks again,
Michelle  

Answer
Hello Michelle. You certainly are a good candidate for midwifery care. The swelling during your last pregnancy can be avoided with nutritional guidance. I assume that you are in the US, so you can go to a website called MANA- Midwives Alliance of North America. They should be able to guide you to find midwives in your state and area. I would urge you to seek out several, interview them and establish a relationship before you even conceive the next baby. Hope that helps- Cheri.