A first-time pregnant mom was understandably nervous at the beginning of her pregnancy. After a few prenatal visits, she became calm and was obviously enjoying her journey. However, as she got closer to her due date, she began to express some concerns and during her last prenatal visit, she asked me if I could tell how much her baby weighed. It’s a common question, however there are no magical answers. I informed her that the fundal height gives us reassurance that the baby is growing and an ultrasound’s estimated weight can be off by one to three pounds. She continued to look concerned and stated that a family member had just delivered a baby that weighed nine pounds and she needed a second operation because she had “torn” so badly. I silently cringed and my patient looked terrified. I asked whether her relative had been pushing for more than two hours at the time of birth and she replied that her relative had actually pushed for four. She continued to explain that she had witnessed her relative’s labor, felt something was wrong but was reluctant to voice her concerns because “the doctor knew best.”
This is the 21st century and that mindset has to change. First, I reassured my patient that the chances of her having a complication similar to her relative were extremely remote. The definition of an arrest of labor means that a first-time mom should not push for greater than three hours and a woman who’s had children should not push no longer than two. She was now empowered with that information and had the right to challenge ANYONE if faced with that condition. While there is no magic formula for predicting an accurate birth weight, Nature does give us signs. If a woman is adequately pushing for the prescribed periods and not making progress, there is a PROBLEM that usually requires an operative solution. Fatigue, distractions and sometimes incompetence can cloud a health care provider’s judgment. If you suspect that something is wrong while you are in labor, by all means, please speak up. Nature has endowed you with a gift called instincts. Please don’t be afraid to use it.