Should I get induced to reduce risks caused by a big baby?
There are several reasons to get induced for labor, but baby's size is not one of them.
An increase in cesarean birth is one risk, and oxygen deprivation is another. Estimating fetal size is not particularly accurate. The chance of having a slightly premature (called a late preterm) baby is much higher with induction. The March of Dimes warns that babies even a couple weeks early are twice as likely to die in the first year of life than babies that go to their due dates. Natural labor may protect babies that are a couple weeks early, but induced labor does not allow the fetus the same maturing hormones as natural labor. Several studies show that healthy babies are not more likely to die at 41 and 42 weeks as previously thought when looking only at one study that included some health problems. Induction does not protect against shoulder dystocia and may increase it. The common "reasons" for inducing a woman with a baby that is suspected to be large are not so reasonable after all. Find out if there is any medical reason not to go into labor on your own. Not because of statistics, but because of your own personal health status.
Mothers are concerned that the larger baby will hurt more to be born or cause more pelvic floor damage. Very large babies can be associated with higher rates of tearing as the head and shoulders come out, especially if you do have an episiotomy or give birth on your back. But tears and episiotomies (the vagina is cut open by the doctor or midwife) happen when birthing small babies, too. Patience and good skin tone allow many 11-pounders to birth with out a tear. Lying on one's back forces the head into the perineum, so don't birth on your back. A first time mom with a big baby may not want to be on her back, even semi sitting when the head comes out. Tears and cuts are more likely with obstetricians than family practice doctors or midwives. Urinary incontinence is said to be higher among women that gave birth vaginally. And that may be true, but not by significantly greater numbers. Pushing before the urge, having a pudendal block, and use of a vacuum or forceps each increases pelvic floor damage. Nuns and men also have urinary incontinence. A little leaking is more common among all groups of people who are over 50. And the term urinary incontinence doesn't mean you have to wear diapers to have the phrase applied to you. Just one sneeze and dribble gets you in the group of pants wetters.
Doctors are concerned that a large baby will have trouble birthing the shoulders. About 8 in 100 babies near 9 pounds can need help from the doctor or midwife for their shoulders to be born. When babies are over 10-pounds it may be one in ten babies experience shoulder dystocia (stuck). However, neither labor inductions nor preventative cesareans have been shown to reduce the number of cases of stuck shoulders.
After birth, studies show labor
induction for fetal size doesn’t prevent complications and may add
other troubles stemming from the intervention of induction. Inductions
are more likely to end in cesareans than spontaneous birth.