Tell me about birthing a large head

[fatfingeredfran]

Hi,

I'm approaching my due date with DC1, and growth scans show that baby is large all over. Baby is 95th percentile for head and body measurements. I'm a little nervous about the birth and my worst nightmare would be forceps.

Anyone who has birthed a large baby vaginally have any advice? I've heard so many horror stories

Yep - both my kids had heads way off the charts (and still do).

Birthed both vaginally with no forceps or anything and only a small tear each time. Only thing I'd say is when I watch OBEM etc they always seem to have to slowly breathe the shoulders out and stuff - there was none of that for me. Their heads shot out and the rest of them followed.

Ds was my first and his head was a bit cone shaped but dd's head wasn't misshapen at all.

Was in (induced) labour for 6 hours both times.

My first had smaller head and was lightest but second, third and sixth were big babies with large heads (over 10lbs in case of second).

First was a forceps for a severe shoulder dystocia.
Others were easy with not a stitch in site. Head size isn't usually a problem. It's if you are exhausted, if the position isn't good or baby needs to be out quickly as the heart rate is dipping and not coming back up.

Shoulder dystocia here as well with my dc2 who was very large. In all honesty anything bigger than 9 pounds should be considered for csection in my opinion. Or perhaps induction before they get too big. It is safer to mother and baby in my opinion. I birthed naturally a normal 7.5 pound baby and my shoulder dystocia 9.5 pound baby. It was a very different experience with larger baby being stuck which was very painful and scarry.

My ds was tiny in terms of weight (6lb 5oz)but had a massive head (really big!). I had 2 second degree tears and a graze which needed a stitch too. I was very swollen and bruised which was uncomfortable but everything healed well and really didn't bother me too much at all. Tearing was something I had dreaded pre baby but in fact it wasn't too bad. Ds grew into his head when he was 2 ish!

Also, I'm not sure how accurate the scans are, ds was predicted to be around 50th centile for everything and was 5th for weight 9th for head.

Ended up with EMCS here. All was fine, and I recovered well, but DD was 9lb 11oz.

My boy had a 97th percentile head right from the get go, and still did at 40 weeks. He was born super fast with no issues getting him out - just a slight tear which was easily sorted. Try not to worry, I was told all sorts of horror stories but I'm confident that his excessively large skull made no difference to my actual labor experience Best of luck for a straight forward and healthy delivery!

My nephew had such a large head when he was born that he was referred to a paediatrician in case he had hydrocephalus. His mum (he was her first baby) delivered all 9 lbs of him vaginally after only 2 hours of labour and had an intact perineum!

No guarantees obviously, both my vbac deliveries were boys with enormous heads, both shot out with minimal tearing.
Only advice I have, is when the DC grows, buy tops with wide necks, poppers or buttons on the shoulders are fab...

DC3 was 9lb9oz and his head was on the 90-something-th centile.

It wasn't the most fun I've ever had in my life but it was also not too bad. I had no stitches. No epidural.

All my 4dc had huge heads. I didn't struggle with any of them dc3's was off the chart but he weighed 10lb8. I didn't have any stitches but I don't think it was anything I did I was just lucky.

My son was a whopper 10.6lb and 59cm long. He is my first baby and he came out absolutely fine after a 4 hour labour. His head and shoulders were fine they had to wiggle his hips out a little but I ended up with a small tear which healed quickly.

90something centile head with dd1 (measured physically after birth) and no issues. Try to remember it's not the circumference that crowns, it's a smaller measurement due to the birthing position of the baby.

Ds had a 38 cm head. Not sure where that is on the charts but is bigger than my other two by a whole 5cm so I assume is quite big. Didn't notice much difference during labour tbh, it hurts whatever. Did have a cervical prolapse but not sure if that was caused by the head size. He was only 7lb however.

Scans are rubbish though, I was told my ds would be under 5lb and my friend that hers would be 10lb. Both were around 7!

I had one the same size and it was my fastest labour, my smallest baby ended up as an emergency section. I think the difference was the big baby was in an ideal position and the smallest one was in a very awkward position. Size probably does matter but it isn't the only consideration. Good luck.

DD was 10lb with a big head and came out with her arm up first. No tears, no issues

Please don't worry (easier said than done!) big doesn't always mean bad

DS2 was a big baby with a big head. I thought I'd have a tough time as I tore badly with DS1 but I was fine. The midwife helped me breath and take that part quite controlled, I didn't need a single stitch.
That birth was particularly calm and straightforward at home, whereas DS1 had lots of intervention. I think that helped.

@Ithoughtyousaidgin I pictured this 😆

Both of mine were pretty big babies (over 9lbs) but with massive heads (my 2 year old was at one point 1cm over the 99.6th percentile line).

This probably isn't what you want to hear, and obviously many women do manage uncomplicated vaginal births for large babies, but for those of us with smallish pelvises and huge-headed babies: three cheers for the c-section! It really is what they were invented for...

@NC4now pretty much!

Thanks for the replies folks.

I'm petrified of forceps being used on my baby - at our hospital a baby has died due to an injury caused by forceps. I appreciate a lot of babies had had forceps and not died, but I'm so petrified of them harming baby that I don't think I could consent to their use. However, consultant has said I will be induced, I asked about c section and she said no, that it would be induction.

With a big head I'm just concerned that an induction could lead to an epidural which could lead to forceps in a cascade of intervention. I would rather not have a c section, but would prefer it over forceps or injury to our baby such as should dystocia.

DDs head measured on 91st centile (measured just over 50th centiles in both scans), had no stitches. I think in part due to the fact that her head was birthed very slowly.
DS, on the other hand, had head circumference on 50th centile and I had to have an episiotomy which resulted in 2nd degree tear. Although he did come out with his fist up by his head, which can't have helped.
So a big head doesn't always mean interventions.

Please try not to worry that will genuinely be really counter productive.

Like I say both my kids heads were off the charts for size and I was induced both times. No epidurals no cascade of interventions - all was fine. Dd was back to back which increased the pain involved but I managed.

Try talking to your midwife about your concerns. I really believe that if you go in worrying and feeling panicky it will have a detrimental effect:

Good luck

OP - there are two different types of forceps - worth reading up before you make a blanket no forceps decision perhaps. Also - head is much less likely to be an issue than presentation and/or shoulders. Do what you can (spinning babies website has some great resources on exercises you can do to help positioning) and remember interventions, if they happen, are rarely an issue in themselves.
Perhaps try reading some positive both books (Ina may's guide to childbirth and birthing without fear are good) and/or listening to some hypnobirthing tracks to help with your worries - fear does not help labour. Good luck

ds graduated recently, and had to send his head measurement in for the mortar board - reminded me of what a big head he has

Yes, I had forceps, but remember, the 'story' you hear is 'news' because it is unusual. Unfortunately there can be issues during childbirth for all sorts of reasons, but the overwhelming majority of babies and mothers come through just fine.