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Labor and Delivery Experiences of Mothers with Suspected Large Babies

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Abstract

Objective

To characterize the prevalence of and factors associated with clinicians’ prenatal suspicion of a large baby; and to determine whether communicating fetal size concerns to patients was associated with labor and delivery interventions and outcomes.

Methods

We examined data from women without a prior cesarean who responded to Listening to Mothers III, a nationally representative survey of women who had given birth between July 2011 and June 2012 (n = 1960). We estimated the effect of having a suspected large baby (SLB) on the odds of six labor and delivery outcomes.

Results

Nearly one-third (31.2 %) of women were told by their maternity care providers that their babies might be getting “quite large”; however, only 9.9 % delivered a baby weighing ≥4000 g (19.7 % among mothers with SLBs, 5.5 % without). Women with SLBs had increased adjusted odds of medically-induced labor (AOR 1.9; 95 % CI 1.4–2.6), attempted self-induced labor (AOR 1.9; 95 % CI 1.4–2.7), and use of epidural analgesics (AOR 2.0; 95 % CI 1.4–2.9). No differences were noted for overall cesarean rates, although women with SLBs were more likely to ask for (AOR 4.6; 95 % CI 2.8–7.6) and have planned (AOR 1.8; 95 % CI 1.0–4.5) cesarean deliveries. These associations were not affected by adjustment for gestational age and birthweight.

Conclusions for Practice

Only one in five US women who were told that their babies might be getting quite large actually delivered infants weighing ≥4000 g. However, the suspicion of a large baby was associated with an increase in perinatal interventions, regardless of actual fetal size.

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Notes

  1. The most common means have been reported as walking or exercise, sexual intercourse and nipple stimulation; with the leading reason for trying to self-induce being a mother’s desire to “get the pregnancy over with” and to “avoid a medical induction.”

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Acknowledgments

Dr. Cheng was supported by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Research Training in Prevention and Care of Chronic Illness in Childhood (T32HD075727-01; PI: JA Finkelstein).

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Authors and Affiliations

  1. Division of General Academic Pediatrics, Harvard Medical School and Massachusetts General Hospital for Children, 100 Cambridge Street, 1570-B5, Boston, MA, 02114, USA

    Erika R. Cheng

  2. Department of Community Health Sciences, Boston University School of Public Health, 810 Massachusetts Avenue, CT430, Boston, MA, 02118, USA

    Eugene R. Declercq

  3. Department of Community Health Sciences, Boston University School of Public Health, 810 Massachusetts Avenue, CT429, Boston, MA, 02118, USA

    Candice Belanoff

  4. Department of Obstetrics, Gynecology, and Reproductive Science, San Francisco General Hospital, University of California, San Francisco, 3333 California Street, San Francisco, CA, 94118, USA

    Naomi E. Stotland

  5. Department of Obstetrics and Gynecology, Boston University School of Medicine, 10 Grove Street, East Boston, MA, 02128, USA

    Ronald E. Iverson

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  1. Erika R. Cheng
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  2. Eugene R. Declercq
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  3. Candice Belanoff
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  4. Naomi E. Stotland
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  5. Ronald E. Iverson
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Correspondence to Ronald E. Iverson.

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Cheng, E.R., Declercq, E.R., Belanoff, C. et al. Labor and Delivery Experiences of Mothers with Suspected Large Babies. Matern Child Health J 19, 2578–2586 (2015). https://doi.org/10.1007/s10995-015-1776-0

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  • DOI: https://doi.org/10.1007/s10995-015-1776-0

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