Hi. I'm pregnant with my first baby and due at the end of September. Last week I had an ultrasound that said that my baby's growth is in the 95th percentile. My doctor wants to get another ultrasound in two weeks but says that if the baby still seems very big, she wants to induce me. She's worried about the possibility of "shoulder dystocia" during the birth if the baby gets too big. I really want to avoid pitocin because I'm trying to give birth naturally if possible. I also feel like if the baby is really getting too big, that will be my body's sign to go into labor on it's own. I'm not diabetic, I generally eat well and I have had a perfectly healthy pregnancy so far. I'm not even sure if my OB will let me delay or refuse an induction, but I'm considering trying to. But of course I don't want to put my baby or my self at risk. And I don't want to end up having a c-section because the baby doesn't fit. Can you help me sort out the real risks of waiting versus going along with an induction? By: Kyra

So here's the deal: The research does not support inducing labor for suspected big baby. Contrary to what you would think, you don't get better infant outcomes, but you do get more cesareans. For documents supporting that statement, go first to Tips for Avoiding Induction of Labor on the Lamaze site. If you want more detailed information, you can link from my own website to an article of mine by going to www.HenciGoer.com/articles and clicking on "Big baby: Is induction of labor necessary?"

The other problem is that you say this is your first baby. Inducing labor, apart from any reasons why labor was induced, will roughly double your chances of cesarean section. We know this from studies of elective (non-medical or convenience) induction. You can link to an article on elective induction from my website as well ("Elective Induction of Labor").

You also express concern about whether you can refuse induction and about not wanting to make any decisions that put you or your baby at unnecessary risk. Tackling the first issue, you should know that you have the right to informed refusal as well as to informed consent. The key word is "informed," though. When you make an informed choice, you will be making the best decision for you and your baby. Here are two sites that will teach you what questions to ask in order to get the information you need to make an informed choice: The Rights of Childbearing Women and Making Informed Decisions

You may want to find out your obstetrician's cesarean rate if you don't know it already. The research doesn't support cesarean rates over 15% in a mixed-risk population (some women are high risk, most aren't) in which some women are having their first baby and others already have children. Fifteen percent is the World Health Organization's recommended maximum as well. If your obstetrician's rate is substantially higher than this, then your obstetrician isn't practicing according to the best research. I hesitate to say this seeing as you are due in a few weeks, but should that be the case, you may want to think about finding someone more in tune with what you want for your birth and whose judgment you know you can trust when push comes to shove. If you want resources on what to ask should you decide to do that, here are a couple: How do I choose my caregiver? and Coalition for Improving Maternity Services resources (scroll down to "Having a baby? Ten questions to ask.")

-- Henci

P.S. Some women prefer to leave all decisions in their care provider's hands. That's fine too--just as long they are doing that as a conscious choice, not because think they have no alternative. By: Henci Goer

Kyra, please tell me if you are still waiting for your baby's birth. There are several aspects to your question that may be easily handled with your obstetrician once you know and understand her point of view, and she understands yours. Remember, one cannot debate unless they know both sides of the issue at hand.

Just to put you at ease, if you have not had the information you need or the baby by now, remember that if you are under stress it certainly won't help your smooth muscles to relax. smile. So, relax, and know that many women have healthy large babies and give birth to them every day for hundreds of thousands of years---we're still here on earth as a continuing species. The longest clinical trial in history! smile ( again).

Email me if you want to do that. By: Childbirth Today

I'm curious as to the birth weight of this "big" baby! From my research, ultrasound in the last trimester does not accurately forecast the baby's weight, and I have heard many stories about ultrasounds foretelling large babies, but they become much smaller babies at birth! By: missy