Your body is not broken.

Your pelvis is not too small, and your baby surely is not too big.

You just need somebody to show you how to navigate the system that tells you otherwise.

Surprise, it's me.

5 00:00:51,356.633 --> 00:00:57,326.633 Hello and welcome back to another episode of The Birth Lounge podcast.

6 00:00:57,626.633 --> 00:01:09,116.633 You guys, have you heard about my brand new course?

Birthing Your Big Ass Baby?

Well, it was highly, highly influenced by all of you because every.

7 00:01:09,376.633 --> 00:01:11,386.633 Single day, no lie.

8 00:01:11,386.633 --> 00:01:26,206.633 I get so many messages, either on email, text messages from friends in my life, or dms on TikTok or Instagram where people are leaving their prenatal appointments and they're being told a bunch of bogus stuff.

9 00:01:26,206.633 --> 00:01:39,16.633 Like, well, your baby is measuring a little bit big, so we're not sure if you're gonna be able to do this without an epidural, or, well, we might need to schedule a 39 week induction based on the size of your baby.

10 00:01:39,511.633 --> 00:01:42,661.633 But here's the truth, and here's what most people don't know.

11 00:01:42,991.633 --> 00:01:55,291.633 There are actually less than 1% of all US babies that are born to meet the criteria of Macrosomic, which is 4,500 to 5,000 grams.

12 00:01:55,716.633 --> 00:02:00,216.633 And here's the other thing that ACOG says, but they don't exactly shout it from the rooftop.

13 00:02:00,216.633 --> 00:02:18,231.633 So I will, the methods in which we use to predict or estimate these baby size are highly, highly off by like 15 to 20%, which translates to one to two pounds either way, which means that if you are having a reading done and it's.

14 00:02:18,566.633 --> 00:02:29,576.633 Says that your baby is measuring eight and a half pounds, then really you might have a six and a half to seven pound baby all the way up to a 10 to 10 and a half pound baby.

15 00:02:29,756.633 --> 00:02:41,456.633 So when we are making these decisions off of these really inaccurate methods, that means that we're actually intervening in a lot of cases.

16 00:02:41,521.633 --> 00:02:53,491.633 Unnecessarily, which obviously is responsible for thousands of unnecessary inductions and C-sections every year, and almost none of them are wanted, and nearly none of them are evidence-based.

17 00:02:54,241.633 --> 00:03:02,491.633 Now one other thing that gets thrown around when it comes to a, quote unquote big baby, is shoulder dystocia, which obviously is really real and very scary, but also.

18 00:03:03,256.633 --> 00:03:04,606.633 Super rare.

19 00:03:04,606.633 --> 00:03:19,696.633 We're gonna talk about it later in this episode, but I did wanna share another little quick stat with you, which is that in order to prevent one shoulder dystocia, we would have to perform 3000 C-sections, 3000.

20 00:03:19,726.633 --> 00:03:26,791.633 That is 3 0 0 0 C-sections to prevent one shoulder dystocia.

21 00:03:27,41.633 --> 00:03:30,941.633 Now again, just stick around 'cause I'm gonna dive into this later in this episode.

22 00:03:31,91.633 --> 00:03:42,671.633 But I really wanted to lay it out so clear for you that a big baby is not a reason to be induced or have a preemptive C-section unless you want to.

23 00:03:42,731.633 --> 00:03:45,101.633 And in that case, go for it.

24 00:03:45,101.633 --> 00:03:48,551.633 I've got so many resources to share with you.

25 00:03:48,761.633 --> 00:03:52,26.633 How can you actually have a positive induction.

26 00:03:52,26.633 --> 00:04:10,736.633 Our team supports so many inductions every single year because people want them, and we are able to help them achieve not only really nice and grounded calm inductions, but vaginal inductions, inductions that you don't have to push for hours and hours and inductions that don't leave you traumatized.

27 00:04:11,486.633 --> 00:04:17,456.633 You deserve to understand what's fact and what's fear, and that's exactly why I created Birthing Your Big Ass Baby Course.

28 00:04:17,456.633 --> 00:04:25,766.633 I promise you, this is not another fluffy birth class and this is not some class that's gonna teach you just to say No.

29 00:04:25,916.633 --> 00:04:33,661.633 I'm really giving you all the data and under every single video, not only do I spell out the data for you, but I link it for you too.

30 00:04:33,661.633 --> 00:04:35,311.633 So this does two things.

31 00:04:35,311.633 --> 00:04:48,301.633 It puts it right in your hand, but you can also print it out and take it to your provider so that when you're having these discussions, not only do you have it with you, but you can share with them how you've come to your conclusions.

32 00:04:48,676.633 --> 00:05:08,566.633 This course is truly a deep dive into what the research actually says about big babies, labor positions, how to protect your birth plan from being derailed by outdated protocols, and how can you avoid falling victim to fear-based tactics when there's absolutely no facts in the argument.

33 00:05:09,316.633 --> 00:05:17,506.633 So what you're gonna learn in Birthing Your Big Ass baby includes what macrosomia really is and how often it's actually misdiagnosed.

34 00:05:18,131.633 --> 00:05:31,811.633 Why ultrasound estimates can't be trusted for decision making and how they lead to actually increased numbers of unnecessary inductions and C-sections, how upright movement and gravity can make more space for your baby.

35 00:05:31,931.633 --> 00:05:45,771.633 Yes, even the really quote unquote big ones, the truth about shoulder dystocia and why it's almost always resolved safely without a C-section, and the fact that induction can neither prevent it nor predict it.

36 00:05:46,11.633 --> 00:05:46,41.633 Okay.

37 00:05:46,581.633 --> 00:05:51,141.633 Also, we're gonna dive into what ACOG really recommends about induction and C-section.

38 00:05:51,891.633 --> 00:05:59,451.633 And I am gonna give you advocacy phrases to use when you're feeling pressured, including how to say no without confrontation.

39 00:05:59,721.633 --> 00:06:09,741.633 I want you to be able to walk into your birth with evidence-based decisions and feeling confident, clear, and calm about those choices.

40 00:06:10,491.633 --> 00:06:11,991.633 Your body is not broken.

41 00:06:12,81.633 --> 00:06:16,371.633 Your pelvis is not too small, and your baby surely is not too big.

42 00:06:16,731.633 --> 00:06:21,411.633 You just need somebody to show you how to navigate the system that tells you otherwise.

43 00:06:21,501.633 --> 00:06:22,821.633 Surprise, it's me.

44 00:06:22,941.633 --> 00:06:29,421.633 I've spent over a decade supporting families through births that were labeled high risk, or too big, or too long, or too complicated.

45 00:06:29,421.633 --> 00:06:33,981.633 And I can tell you the difference between panic and peace isn't luck.

46 00:06:33,981.633 --> 00:06:36,561.633 It's literally the way that you prepare.

47 00:06:36,981.633 --> 00:06:45,956.633 If you've ever wondered what to say when your provider recommends an induction just in case, or tells you that your baby might be big.

48 00:06:46,136.633 --> 00:06:49,406.633 Then you need the birthing your big ass baby course.

49 00:06:50,156.633 --> 00:07:00,256.633 Right now we are still in the pre-sale phase, so that means the course is launched, but you get to still take advantage of a pre-sale price until November 1st.

50 00:07:00,496.633 --> 00:07:04,376.633 You can visit thebirthlounge.com/bigbaby 51 00:07:04,396.633 --> 00:07:06,736.633 and grab the course for just $99.

52 00:07:06,976.633 --> 00:07:11,26.633 Again, that is thebirthlounge.com/bigbaby 53 00:07:11,236.633 --> 00:07:15,911.633 and jump on that sale price before the investment increase on November one.

54 00:07:16,661.633 --> 00:07:30,251.633 Once you join this course, you'll be able to see straight through the fear and know exactly what's evidence-based, what's not, and how to stand in your power no matter who's in your room, no matter who shows up on call.

55 00:07:30,281.633 --> 00:07:34,156.633 And no matter what they present to you in labor, this is your birth.

56 00:07:34,826.633 --> 00:07:39,626.633 Your baby, your decision, and I'm gonna show you how to protect that power.

57 00:07:39,686.633 --> 00:07:41,876.633 I'll see you in birthing your big ass baby.

58 00:07:42,626.633 --> 00:07:52,436.633 All right, let's dive into the top six things that you need to know when it comes to a quote unquote big baby.

59 00:07:52,826.633 --> 00:08:00,326.633 Now, number one, I think it's really important for you to understand what macrosomia really is.

60 00:08:00,866.633 --> 00:08:01,956.633 So microsomia.

61 00:08:02,381.633 --> 00:08:12,551.633 Defined by ACOG is a baby that weighs more than nine pounds, 15 ounces all the way up to a baby that is 11 pounds.

62 00:08:12,911.633 --> 00:08:17,951.633 Now, those babies, they make up less than 1%.

63 00:08:18,441.633 --> 00:08:29,481.633 All US babies, so 99% of women are having average sized babies, which falls below that nine pound 15 ounce mark.

64 00:08:29,871.633 --> 00:08:40,781.633 So when you have a provider who is sharing with you that your baby might be big, that could be true, but there are a couple things you wanna ask.

65 00:08:40,901.633 --> 00:09:01,61.633 Number one, what's the likelihood that I'm in that 1%?

Number two, how are we diagnosing, quote unquote diagnosing, or how are we estimating the weight of this baby?

Because the truth is we literally don't even have an accurate way to estimate your baby's weight.

66 00:09:01,451.633 --> 00:09:03,221.633 Ultrasound is off.

67 00:09:03,771.633 --> 00:09:09,741.633 Belly palpations where your provider literally just feels around on your belly and they, they palpate it.

68 00:09:09,741.633 --> 00:09:18,801.633 They kind of squeeze your belly and push around and they estimate with their hands and their clinical experience, how big your baby is, is off.

69 00:09:19,551.633 --> 00:09:26,271.633 And then we all know that the age old methodology of Pel imagery is not only not evidence-based.

70 00:09:26,891.633 --> 00:09:28,601.633 It's just plumb off you.

71 00:09:28,601.633 --> 00:09:44,171.633 You can't estimate the size of a woman's pelvis by looking at her and you, you can't send her through an x-ray and then determine whether her baby is or is not going to fit through her pelvis during labor.

72 00:09:44,521.633 --> 00:09:48,436.633 Number one, our pelvis expands 30% in labor.

73 00:09:48,436.633 --> 00:09:58,606.633 And number two, your baby and your pelvis do this really beautiful, magical, dynamic dance in labor that we can't predict how that's going to go.

74 00:09:58,606.633 --> 00:10:08,506.633 And so when we think about how we're gathering these estimations and in which way we're trying to predict whether this baby is going to be big or not.

75 00:10:08,846.633 --> 00:10:11,606.633 We don't actually have an accurate way of doing that.

76 00:10:11,606.633 --> 00:10:24,296.633 So if that is true, then that lends me to the question of why would we be making decisions preemptively while you're still pregnant based on methodologies that are not accurate.

77 00:10:24,326.633 --> 00:10:26,126.633 Not even a single one.

78 00:10:26,366.633 --> 00:10:29,186.633 It actually makes no sense.

79 00:10:29,486.633 --> 00:10:41,576.633 So now that we've described macrosomia, and you know what it is now, it's really important for you to understand just how often it is over diagnosed.

80 00:10:42,326.633 --> 00:10:49,176.633 Many of these, quote unquote diagnosis of a big baby are actually just a guess.

81 00:10:49,196.633 --> 00:11:04,716.633 And oftentimes it's used as a way to justify induction or even scheduling a C-section, even though the data shows an ACOG says that they're actually really terrible at predicting the size of a baby.

82 00:11:05,466.633 --> 00:11:12,606.633 We also know that there's no improvement with growth curves, longitudinal scans, or 3D ultrasounds.

83 00:11:13,356.633 --> 00:11:32,406.633 Now, one thing to know is if you have had a big baby before, so a baby that's over nine pounds, 15 ounces, then your odds do increase about five to 10 times to someone who hasn't had a big baby before in having another big baby.

84 00:11:32,676.633 --> 00:11:37,176.633 However, again, regardless of your birth history or not.

85 00:11:37,741.633 --> 00:11:44,386.633 We can't diagnose it until after birth because every single thing is an estimate.

86 00:11:45,136.633 --> 00:11:50,446.633 So remember the phrase, oh, your baby might be big, is not a medical diagnosis.

87 00:11:50,536.633 --> 00:11:54,46.633 Rather, it's an invitation to ask better questions.

88 00:11:54,286.633 --> 00:12:06,851.633 Number one, I would ask, how big do you estimate my baby is and what's the margin of error in the method that we've used?

And then second, I would ask for the ACOG Bulletin or the data that they're basing that decision on.

89 00:12:06,851.633 --> 00:12:12,101.633 Now, you don't have to go look that up if you're in the Birthing Your Big Ass Babies course I've linked it for you.

90 00:12:12,101.633 --> 00:12:24,431.633 That way you can have it, you can screenshot it on your phone, you can print it out, but you do want to make sure that your provider is referencing actual data points when they're making clinical recommendations to you.

91 00:12:24,611.633 --> 00:12:26,591.633 So that would be my first starting point.

92 00:12:27,341.633 --> 00:12:27,671.633 All right.

93 00:12:27,671.633 --> 00:12:33,461.633 Number two is understanding shoulder dystocia, because obviously that's super real.

94 00:12:33,551.633 --> 00:12:38,351.633 It's super scary, but it's also super rare.

95 00:12:38,591.633 --> 00:12:52,391.633 Now, ACOG estimates that it happens in less than 3% of all birth, so again, you've got a 97% chance that you don't have a baby that experiences shoulder dystocia.

96 00:12:53,366.633 --> 00:13:00,746.633 Now we do know that there are some things that influence the likelihood of shoulder dystocia happening or.

97 00:13:01,436.633 --> 00:13:02,246.633 Not happening.

98 00:13:02,606.633 --> 00:13:04,166.633 Number one, your birth position.

99 00:13:04,166.633 --> 00:13:11,906.633 So if you're on your back, you're increasing the chance of shoulder dystocia because we are immobilizing your pelvis.

100 00:13:11,966.633 --> 00:13:21,926.633 We are closing off the space in which your baby has to navigate the pelvis, and we're making it more likely for that shoulder to get a little stuck.

101 00:13:22,256.633 --> 00:13:23,336.633 So instead.

102 00:13:23,651.633 --> 00:13:24,461.633 Get up.

103 00:13:24,551.633 --> 00:13:27,11.633 Labor upright, birth upright.

104 00:13:27,491.633 --> 00:13:30,911.633 We also know that gravity plays a huge role.

105 00:13:31,61.633 --> 00:13:42,11.633 So if you're laying on your back, think about how gravity is impacting not only the path that your baby has to take to get out, but in which way is gravity pulling your baby.

106 00:13:42,251.633 --> 00:13:52,471.633 Well, it's pulling them towards your spine, towards your tailbone, down towards the ground, but your vaginal opening is actually perpendicular to that.

107 00:13:52,501.633 --> 00:13:57,181.633 So we are really not using gravity in a smart way.

108 00:13:57,181.633 --> 00:14:00,151.633 It's working against us, not with us.

109 00:14:00,181.633 --> 00:14:05,41.633 And then finally, you're pushing technique all influences this as well.

110 00:14:05,41.633 --> 00:14:10,441.633 And so that's something I teach you in the secret sauce to pushing, which is another course you can grab.

111 00:14:10,441.633 --> 00:14:15,571.633 Or if you're in the birth lounge, then you just have access to all of these courses automatically.

112 00:14:21,391.259 --> 00:14:31,591.259 Have you heard about the baby soap debacle that happens in the L&D rooms across the us?

Well, if you haven't, then let me let you in on a secret.

113 00:14:31,621.259 --> 00:14:38,941.259 The hospital system often will use something like Johnson and Johnson's baby soap as lubricant.

114 00:14:38,941.259 --> 00:14:40,316.259 In labor.

115 00:14:40,586.259 --> 00:14:46,766.259 So remember when we were all little girls and we were told not to put soap in our vaginas because it can throw off the pH.

116 00:14:46,766.259 --> 00:14:53,816.259 And even now as adult women, we're told that we don't need to wash our downstairs lady because she is self-cleaning.

117 00:14:53,816.259 --> 00:14:59,61.259 She can do it herself, but then in labor they're gonna put Johnson and Johnson's of all soaps.

118 00:14:59,416.259 --> 00:15:04,966.259 In your vagina to what help your baby be more slippery, which they don't even need.

119 00:15:04,996.259 --> 00:15:14,596.259 But I understand if you might want a little extra lubrication down there during the pushing period, and I have a much better option for you.

120 00:15:15,226.259 --> 00:15:34,396.259 Coco Nu, and if you haven't heard of Coco Nu, it is one of my favorite lubes Coco Nu's Products are made with all organic coconut oil, organic coconut water, and other natural ingredients like organic bees wax, organic cocoa butter, organic sunflower oil, and organic shea butter.

121 00:15:34,576.259 --> 00:15:40,431.259 Because you know what?

What you put in and on your body specifically for your vagina.

122 00:15:40,641.259 --> 00:15:42,171.259 The details matter.

123 00:15:42,231.259 --> 00:15:42,771.259 I love that.

124 00:15:42,771.259 --> 00:15:50,421.259 Coco Nu uses plant-based non GMO ingredients, which are also USDA certified organic whenever possible.

125 00:15:50,481.259 --> 00:15:55,431.259 And their packaging is plastic free and it's made in the.

126 00:15:55,431.259 --> 00:16:06,411.259 Coconu offers oil-based and water based, because if you use toys in the bedroom, you shouldn't be using oil-based lubes with those only water based.

127 00:16:06,411.259 --> 00:16:08,331.259 So they wanted to give you both options.

128 00:16:08,331.259 --> 00:16:14,61.259 But I gotta be honest, my very favorite product that they offer are the singles.

129 00:16:14,61.259 --> 00:16:14,241.259 These are.

130 00:16:14,766.259 --> 00:16:25,146.259 Single packets that you can literally order a box of, put them in your birth bag, and then if you need extra lubrication during labor, you take the box out, use the single packets.

131 00:16:25,146.259 --> 00:16:26,76.259 You can use one.

132 00:16:26,76.259 --> 00:16:30,186.259 You can use all of them that come in the box, and I just love it.

133 00:16:30,186.259 --> 00:16:30,461.259 I think it is.

134 00:16:30,901.259 --> 00:16:40,921.259 Such a better option for you to not only give you that extra lubrication if you want it, but you don't actually need it during labor.

135 00:16:41,131.259 --> 00:16:52,681.259 It helps you have healthier, better sex during pregnancy because obviously we wanna make sure that everything you put in and on your body and pregnancy is organic and safe for you and your baby.

136 00:16:53,91.259 --> 00:17:01,911.259 And it's much better than Johnson Johnson baby soap, which is gonna disrupt the pH of your vagina, which who wants a yeast infection and postpartum Yuck.

137 00:17:01,941.259 --> 00:17:02,541.259 Not me.

138 00:17:02,631.259 --> 00:17:04,611.259 What an actual nightmare that would be.

139 00:17:04,671.259 --> 00:17:06,591.259 So head to coco new.com.

140 00:17:06,591.259 --> 00:17:09,831.259 That's C-O-C-O-N u.com 141 00:17:09,831.259 --> 00:17:13,921.259 and use code HeHe to save 15% coconu.com.

142 00:17:13,941.259 --> 00:17:20,151.259 Use code hee he HEHE to save 15% and protect the pH of your downstairs kitty meow.

143 00:17:32,11.7013265 --> 00:17:44,821.7013265 When it comes to pushing out your baby, especially one that is suspected to be on the larger side, we really wanna see you engage in what's called open glottis pushing, which really means that your knees are in.

144 00:17:44,821.7013265 --> 00:17:49,336.7013265 Now, this could feel very foreign to your medical staff.

145 00:17:49,336.7013265 --> 00:17:57,946.7013265 A lot of times they are used to and trained to have your knees wide open and to have you on your back.

146 00:17:58,186.7013265 --> 00:18:17,16.7013265 But open glottis pushing means that we're actually opening the outlet of your pelvis, which is that bottom part of kind of where your sits bones are, which is going to help accommodate your baby's exit through your body by making the exit of your pelvic bones wider.

147 00:18:17,436.7013265 --> 00:18:22,386.7013265 When your knees are wide, the outlet of your pelvis is small.

148 00:18:22,836.7013265 --> 00:18:32,506.7013265 When the opening in your knees is small, then the opening in your pelvic outlet is big, it's opposite.

149 00:18:32,686.7013265 --> 00:18:33,796.7013265 It is.

150 00:18:34,66.7013265 --> 00:18:49,876.7013265 They work together, right?

And so we want to close those knees so that we can actually have a nice, wide outlet, especially for a baby who is quote unquote big or expected to be big.

151 00:18:49,876.7013265 --> 00:18:57,586.7013265 Although we know that obviously big babies are pretty rare and that most likely you do have an average size baby coming through there.

152 00:18:58,336.7013265 --> 00:19:07,546.7013265 The other thing that I find absolutely fascinating, and again, this is all linked for you in the Birthing your Big Ass Babies course so that you can see it straight outta the horse's mouth.

153 00:19:07,546.7013265 --> 00:19:12,496.7013265 ACOG says that most cases of shoulder dystocia.

154 00:19:12,841.7013265 --> 00:19:16,51.7013265 Actually happen in babies of average size weight.

155 00:19:16,51.7013265 --> 00:19:27,751.7013265 So this ideation that shoulder dystocia is so much more dangerous with a big baby, or that a big baby almost guarantees shoulder dystocia is literally just faults.

156 00:19:27,751.7013265 --> 00:19:29,401.7013265 It's just this.

157 00:19:30,151.7013265 --> 00:19:32,371.7013265 Completely inflated narrative.

158 00:19:32,491.7013265 --> 00:19:39,361.7013265 I don't know where it came from, but it certainly is used to scare women and I think it's really important for you to know that.

159 00:19:39,361.7013265 --> 00:19:47,371.7013265 So if you have a provider that is saying, well, this baby is big and I, I don't want you to have shoulder dystocia, so we should indu, so we should have a C-section.

160 00:19:47,641.7013265 --> 00:20:01,361.7013265 Do know that, none of that is evidence-based, not the fact that a big baby could cause shoulder dystocia, not the fact that an induction could prevent it, and not the fact that a C-section is better.

161 00:20:01,661.7013265 --> 00:20:05,261.7013265 Absolutely none of those are backed up with the data, per ACOG.

162 00:20:06,11.7013265 --> 00:20:11,756.7013265 And then finally, the other thing to know about shoulder dystocia is it is incredibly manageable.

163 00:20:12,26.7013265 --> 00:20:17,846.7013265 All providers, healthcare providers, are trained in how to resolve shoulder dystocia.

164 00:20:17,846.7013265 --> 00:20:27,101.7013265 There are a a number of maneuvers and I actually go into them in depth in the birthing Your Big Ass Baby course, and I show you what they all look like.

165 00:20:27,281.7013265 --> 00:20:35,291.7013265 So not only do you know how to have conversations about these, but you also will know what to expect should you experience a shoulder dystocia.

166 00:20:36,377.6534715 --> 00:20:41,717.6534715 So just remember that the incidence rate of shoulder dystocia is actually quite low.

167 00:20:42,77.6534715 --> 00:20:53,417.6534715 They're almost always very manageable, especially if you have a team that can remain calm because of their training rather than panicking.

168 00:20:53,507.6534715 --> 00:21:11,777.6534715 And then finally, a episiotomy induction and C-section doesn't avoid shoulder dystocia, which leads me to my next point, which are the ways that the hospital system can sometimes present to you to prevent or predict shoulder dystocia.

169 00:21:11,807.6534715 --> 00:21:14,627.6534715 Now, we've got three different things that they will often suggest to you.

170 00:21:14,747.6534715 --> 00:21:18,17.6534715 Number one, an induction at 38 or 39 weeks.

171 00:21:18,287.6534715 --> 00:21:21,347.6534715 Number two, a scheduled C-section.

172 00:21:21,497.6534715 --> 00:21:26,87.6534715 And number three, you might have a provider that talks to you about a episiotomy.

173 00:21:26,627.6534715 --> 00:21:32,867.6534715 Super important to understand that none of these things are actually evidence-based.

174 00:21:33,347.6534715 --> 00:21:45,257.6534715 ACOG actually says that a episiotomy does not give any more benefit, and it actually has been shown to cause more harm.

175 00:21:46,7.6534715 --> 00:22:01,922.6534715 Interestingly enough, people who did not have a routine, a episiotomy, had fewer severe tears, they reported less pain in postpartum, and they were less likely to experience incontinence or sexual dysfunction later on.

176 00:22:02,672.6534715 --> 00:22:14,312.6534715 So, in other words, routinely cutting your perineum doesn't actually improve things, but it does make recovery, especially long-term recovery, way worse.

177 00:22:14,394.255034 --> 00:22:23,784.255034 Now I do wanna note that there are some really rare and specific situations where a episiotomy might be helpful, and ACOG does recognize this.

178 00:22:24,84.255034 --> 00:22:28,44.255034 I actually lay them all out in the Birthing Your Big Ass Babies course.

179 00:22:28,44.255034 --> 00:22:28,104.255034 So.

180 00:22:29,154.255034 --> 00:22:31,804.255034 You can head to thebirthlounge.com/bigbaby 181 00:22:31,824.255034 --> 00:22:33,294.255034 if you wanna hear about those.

182 00:22:33,294.255034 --> 00:22:49,524.255034 And of course, as always, the data is linked so that you can dive into that to see if it is actually applicable to you and how likely you are to maybe meet an app episiotomy as an individual, but not with blanket statement Healthcare.

183 00:22:50,274.255034 --> 00:23:01,374.255034 The other thing that you should know is that when you're having a conversation with your provider and they say something like, well, we should just induce you or, or schedule a C-section because your baby might be big.

184 00:23:01,584.255034 --> 00:23:07,494.255034 Well, the research doesn't actually support routine induction or C-section for a suspected big baby.

185 00:23:08,244.255034 --> 00:23:22,104.255034 Actually, these two things are quite a myth now in ACOG Practice Bulletin two 16, which is behind a paywall, but I've paid for it and I've downloaded it, and I've given you access to it in the Birthing Your Big Ass Babies course.

186 00:23:22,104.255034 --> 00:23:22,914.255034 That way you have it.

187 00:23:23,249.255034 --> 00:23:25,919.255034 You can print it out, you can screenshot on your phone.

188 00:23:25,919.255034 --> 00:23:28,559.255034 You can take it in to talk to your provider about it.

189 00:23:28,769.255034 --> 00:23:50,129.255034 They actually literally say in black and white words, suspected fetal macrosomia alone is not an indication for induction of labor, so why not?

Well, because induction doesn't actually reliably reduce shoulder dystocia, but what it does do is increase the chance of a C-section for you.

190 00:23:50,879.255034 --> 00:24:11,219.255034 So you're kind of taking this hypothetical, we kind of think it may, even though the data doesn't show, it does benefit and you're trading it for a very real data backed, totally proven risk of increasing your chances of having a c-section.

191 00:24:11,969.255034 --> 00:24:17,339.255034 Now, obviously there are some good medically indicated reasons to have an induction.

192 00:24:17,339.255034 --> 00:24:19,199.255034 I'm not saying an induction is never needed.

193 00:24:19,379.255034 --> 00:24:29,444.255034 What I am saying, and ACOG says the same thing, is that if your only indication is that your baby is big, then that's actually, that would be an elective induction.

194 00:24:29,444.255034 --> 00:24:33,554.255034 That's not a medically necessary reason, and again, not my opinion.

195 00:24:33,734.255034 --> 00:24:37,204.255034 Acog straight up says it in bulletin 216.

196 00:24:37,204.255034 --> 00:24:46,414.255034 One other thing they say about macros, soia in bulletin 216 is prophylactic C-section is not recommended for suspected fetal macros.

197 00:24:46,414.255034 --> 00:24:50,464.255034 Soia with estimated fetal weight of less than 5,000 grams.

198 00:24:50,464.255034 --> 00:24:53,74.255034 So remember, that's an 11 pound baby.

199 00:24:53,74.255034 --> 00:24:54,184.255034 I mean, that's a huge baby.

200 00:24:54,184.255034 --> 00:24:58,924.255034 That's basically a kindergartner walking out of you in women without diabetes.

201 00:24:59,294.255034 --> 00:25:07,424.255034 Or less than 4,500 grams, which is that nine pounds, 15 ounces in women with diabetes.

202 00:25:07,424.255034 --> 00:25:18,14.255034 So ACOG stands very strongly against C-sections, solely for the reason of a quote, unquote, estimated big baby.

203 00:25:18,434.255034 --> 00:25:36,979.255034 Well, why is this?

Probably because C-section is a major abdominal surgery and they recognize that it carries higher risk of other complications like hemorrhage, infection, longer recovery, and also complications with future pregnancy like uterine rupture and placenta accreta.

204 00:25:37,279.255034 --> 00:25:48,439.255034 A C-section is not without risk, which neither is a vaginal birth, but C-section certainly comes with much higher risk than a vaginal birth Does.

205 00:25:49,189.255034 --> 00:25:56,269.255034 So I know I've said it before and I'm just wanting to clear it up one last time so that you really, really take it to heart.

206 00:25:56,689.255034 --> 00:26:10,159.255034 But a C-section and an induction, neither predicts nor prevents shoulder dystocia, and they are not evidence-based ways to handle macrosomic babies.

207 00:26:10,909.255034 --> 00:26:35,479.255034 So just remember whether your baby is big or not, your body was designed for this, and evidence-based physiological birth is still the safest path for most families because we know that 99% of families are going to have an average size baby and 97% of women are going to have a birth that doesn't involve complications like shoulder dystocia.

208 00:26:36,4.255034 --> 00:26:51,754.255034 So what does matter?

How?

How are you going to get this big baby quote unquote big baby out of you?

Well, number one position matters way more than size, and I'm talking about your position as well as your baby's position.

209 00:26:51,964.255034 --> 00:27:06,199.255034 So I mentioned earlier that upright labor is super important, and I would say that if you're looking at a you know, diagnosis or an expected big baby, then it's even more important for you.

210 00:27:06,379.255034 --> 00:27:11,239.255034 We want you to be laboring upright, so stay off your back.

211 00:27:11,239.255034 --> 00:27:17,179.255034 And this isn't just for people who choose unmedicated birth in the Birthing Your Big Ass Babies course.

212 00:27:17,179.255034 --> 00:27:23,449.255034 I actually take you through a ton of birth positions for unmedicated and epidural birth.

213 00:27:23,449.255034 --> 00:27:32,129.255034 I want to actually show you how do you engage in upright labor no matter what your labor goals are?

'cause you know me, I don't care how you birth.

214 00:27:32,459.255034 --> 00:27:37,319.255034 I just want you to know what your options are so that you can choose what's best for you.

215 00:27:37,439.255034 --> 00:27:44,9.255034 And remember, if you have hospital staff that's discouraging you from being upright in labor.

216 00:27:44,289.255034 --> 00:27:47,769.255034 You should probably ask for a new nurse or a new doctor.

217 00:27:48,9.255034 --> 00:27:55,929.255034 We know that upright labor not only helps facilitate an easier and faster birth, it helps your uterus contract better.

218 00:27:55,929.255034 --> 00:28:07,129.255034 But if you're looking at a suspected macrosomic baby, this is the key to helping you avoid further interventions and an unnecessary c-section.

219 00:28:07,519.255034 --> 00:28:14,959.255034 So as far as your baby's position goes, that upright labor is going to be what achieves that.

220 00:28:15,289.255034 --> 00:28:24,649.255034 Don't forget too, that late in pregnancy you can be doing other things to help encourage your baby to get in what we call optimal fetal positioning.

221 00:28:24,949.255034 --> 00:28:27,859.255034 So spend time on your birth ball.

222 00:28:28,609.255034 --> 00:28:39,469.255034 Prioritize things like walking upstairs, curb walking, things that really get your hips uneven, cat cows, windshield wipers.

223 00:28:39,649.255034 --> 00:28:50,59.255034 If you visit my Instagram Tranquility by HeHe, I actually show you a ton of exercises that you can do to help get your baby in optimal fetal positioning.

224 00:28:50,299.255034 --> 00:28:51,379.255034 For labor.

225 00:28:51,469.255034 --> 00:28:54,829.255034 And then finally, we really wanna push upright as well.

226 00:28:55,69.255034 --> 00:29:08,569.255034 Like I talked to you in the opening of the episode, when we have your tailbone immobilized by being on the bed, it really does hinder your baby's ability to navigate your pelvis.

227 00:29:09,49.255034 --> 00:29:16,959.255034 So again, regardless of whether you are medicated or unmedicated in the Birthing Your Big Ass Baby course.

228 00:29:16,959.255034 --> 00:29:29,139.255034 I actually show you different upright birthing positions that you can use with or without an epidural that are going to help facilitate your baby's navigation of your pelvis.

229 00:29:29,469.255034 --> 00:29:54,39.255034 These are the things that you really want to know going into the hospital system because it's kind of hit or miss and it really is based on who's on call, what nurse you get, and what the facility units culture is like of where you're birthing, that will determine how open your staff is and also how knowledgeable they are of these things.

230 00:29:54,39.255034 --> 00:30:03,349.255034 So your best bet is to have the knowledge yourself so that you can go in there and say, actually, I appreciate you suggesting that I side lie.

231 00:30:03,639.255034 --> 00:30:08,769.255034 I would like to drop the foot of the bed, raise the back of the bed, and get into a throne position.

232 00:30:09,9.255034 --> 00:30:19,479.255034 Now your nurse may not know what that is and that's Akay, but you and your partner will know what that is and you'll be able to help your nurse facilitate getting your body into upright positions.

233 00:30:20,229.255034 --> 00:30:30,939.255034 And my last point, in true HeHe fashion is helping you understand true informed consent, autonomy, and your freedom of choice in this experience.

234 00:30:32,49.255034 --> 00:30:39,9.255034 It's super important that you are the one that is making decisions throughout this journey.

235 00:30:39,849.255034 --> 00:30:55,554.255034 The way that we prevent birth trauma is really keeping you in that driver's seat because we know that so much birth trauma is actually avoidable by very simplistic ways actually.

236 00:30:55,764.255034 --> 00:30:59,814.255034 It's just really making sure that you are the one who's calling the shots.

237 00:30:59,814.255034 --> 00:31:04,284.255034 Are you the one that is making the choices about your body.

238 00:31:04,284.255034 --> 00:31:22,914.255034 Are you the one that has the final say?

Making sure that no one in your room is telling you what you can and can't do, that you're not being dismissed, that your healthcare team isn't talking around you and about you, but rather with you and to you.

239 00:31:23,719.255034 --> 00:31:31,939.255034 Being included in your healthcare decisions is really one of the easiest ways that we can help prevent birth trauma.

240 00:31:32,479.255034 --> 00:31:36,79.255034 So I wanted to teach you a couple of advocacy phrases.

241 00:31:36,79.255034 --> 00:31:39,619.255034 I've got three here that I want you to walk away with this episode and then.

242 00:31:40,79.255034 --> 00:31:47,789.255034 In the Birthing Your Big Ass Babies course, I actually give you questions and phrases in every single module.

243 00:31:47,789.255034 --> 00:31:54,239.255034 So there are 10 modules, so you're walking away with a ton of questions for every single situation.

244 00:31:54,689.255034 --> 00:32:00,59.255034 Number one is I'd like to understand all of my options before making a decision.

245 00:32:00,779.255034 --> 00:32:05,759.255034 Number two is I hear your recommendation, but I don't consent to that at this time.

246 00:32:06,509.255034 --> 00:32:15,44.255034 And number three is I would like to try, insert an alternative that you want to try before we do X, Y, and z.

247 00:32:15,794.255034 --> 00:32:31,964.255034 Now, I know that you've probably heard this before, but your provider's philosophy and their belief in you of whether or not you can actually birth your baby matters way more than almost anything else.

248 00:32:31,994.255034 --> 00:32:38,714.255034 Not only is their energy going to carry into your room, but the language that they use as well.

249 00:32:39,124.255034 --> 00:32:48,424.255034 Plus the options and the discussions that they have with you are going to reflect these beliefs and these preferences, and these philosophies too.

250 00:32:49,174.255034 --> 00:32:57,724.255034 So one of the most important things that you can do when it comes to setting yourself up to have a positive.

251 00:32:58,169.255034 --> 00:33:11,579.255034 Trauma free vaginal delivery, especially if your baby is suspected to be big, but actually regardless of the size of your baby at all, is to find a provider who is aligned with you.

252 00:33:11,939.255034 --> 00:33:18,114.255034 And when I say aligned with you, I mean that when you walk into their office or their clinical space.

253 00:33:19,4.255034 --> 00:33:22,604.255034 You don't feel like you need to lie to them.

254 00:33:22,664.255034 --> 00:33:24,914.255034 You don't feel like you need to shrink.

255 00:33:24,944.255034 --> 00:33:28,604.255034 You don't feel like you're headed into a fight.

256 00:33:28,604.255034 --> 00:33:32,444.255034 You don't feel like you're always having to defend yourself.

257 00:33:32,714.255034 --> 00:33:35,144.255034 Instead, you feel collaborative.

258 00:33:35,174.255034 --> 00:33:36,794.255034 You feel like you can tell them anything.

259 00:33:36,794.255034 --> 00:33:38,864.255034 You feel like you trust them, and when you leave.

260 00:33:39,524.255034 --> 00:33:41,144.255034 You feel warm and fuzzy.

261 00:33:41,144.255034 --> 00:33:42,344.255034 You feel supported.

262 00:33:42,344.255034 --> 00:33:44,54.255034 You feel heard.

263 00:33:44,54.255034 --> 00:33:56,924.255034 You feel like the things that you shared with them, they really understood and they met you where you were, and they genuinely care about helping you have a good birth.

264 00:33:57,674.255034 --> 00:34:14,664.255034 Now, obviously, you know, I would be remiss if I didn't mention healthcare deserts in our country, and it's super unfortunate that we've got whole counties that don't have a single OB GYN, and it's very tragic that sometimes you have to drive two or three hours to.

265 00:34:15,174.255034 --> 00:34:22,614.255034 Get to an OB GYN, but here's what I will kind of gently and lovingly nudge you to consider.

266 00:34:22,944.255034 --> 00:34:33,234.255034 If you're already driving two to three hours to the east to see an OBGYN, and you don't like this person, and they don't make you feel supported, and every time you go you're like, Ugh.

267 00:34:33,294.255034 --> 00:34:34,284.255034 Just filled with dread.

268 00:34:36,54.255034 --> 00:34:46,614.255034 What's the harm in driving two to three hours to the west?

Or the north or the south to a different town to find a better OBGYN.

269 00:34:46,674.255034 --> 00:34:47,814.255034 And listen, I get it.

270 00:34:47,814.255034 --> 00:34:49,134.255034 It's a pain in the ass.

271 00:34:49,404.255034 --> 00:34:50,574.255034 I understand.

272 00:34:50,574.255034 --> 00:34:59,604.255034 I totally understand the mental load of being pregnant and having to make all these decisions and trying to think through all these things.

273 00:35:00,114.255034 --> 00:35:02,124.255034 Which is why I put together the birth lounge.

274 00:35:02,214.255034 --> 00:35:05,934.255034 I wanted to take that mental load off of you and that that is what I do in The Birth Lounge.

275 00:35:06,324.255034 --> 00:35:15,264.255034 I take it off of you because I've already thought through all of these things, and your only obligation, your only responsibility is to sit down, consume the information.

276 00:35:15,264.255034 --> 00:35:17,724.255034 I've given it to you on a silver platter and now.

277 00:35:17,839.255034 --> 00:35:21,109.255034 You just need to make sure that you're making the decisions that feel good to you.

278 00:35:21,109.255034 --> 00:35:22,699.255034 I also have linked the data.

279 00:35:22,969.255034 --> 00:35:24,649.255034 We have resource list.

280 00:35:24,649.255034 --> 00:35:27,139.255034 I've thought about the questions you need to ask.

281 00:35:27,139.255034 --> 00:35:34,69.255034 I've thought about all the things that you need to consider, so all that extra mental load, I already did it for you inside The Birth Lounge.

282 00:35:34,399.255034 --> 00:35:37,159.255034 Nevertheless, it's still a lot.

283 00:35:37,909.255034 --> 00:35:45,439.255034 However, I really do understand how much of a daunting task it can feel like to change providers.

284 00:35:45,439.255034 --> 00:36:00,19.255034 But what I will say is when you find a provider that supports you in a way that you deserve, that makes you feel heard and seen, you will realize just how good it can be.

285 00:36:00,679.255034 --> 00:36:06,649.255034 You deserve a birth that is joyous and grounded and calm and supported.

286 00:36:06,919.255034 --> 00:36:32,974.255034 One that uplifts you, one that leaves you entering motherhood Feeling so supported and loved and empowered, and knowing that you are so informed and you have the confidence and the skills to mother, this baby to do the right thing to make the decisions that are best for your family without relying on outside sources.

287 00:36:32,974.255034 --> 00:36:35,704.255034 Everything you have is already right inside of you.

288 00:36:36,454.255034 --> 00:36:38,49.255034 You just need somebody to remind you of that.

289 00:36:38,799.255034 --> 00:36:42,459.255034 So remember, you can do this, your body.

290 00:36:43,129.255034 --> 00:36:48,829.255034 Is capable of birthing your baby regardless of their size.

291 00:36:48,979.255034 --> 00:36:56,449.255034 Your pelvis isn't too small, your baby isn't too big, and big babies are not to be feared.

292 00:36:56,989.255034 --> 00:37:01,604.255034 A system that tries to convince you otherwise is.

293 00:37:03,289.255034 --> 00:37:07,759.255034 Alright you guys, I would love to see you in the Birthing Your Big Ass Babies Course.

294 00:37:07,879.255034 --> 00:37:11,179.255034 It truly is changing the game for so many women.

295 00:37:11,659.255034 --> 00:37:32,839.255034 We're reducing the induction rate, we're avoiding unnecessary C-sections, and we are helping women all over the world achieve their ideal birth by avoiding things that don't feel aligned to them and are completely unnecessary and not founded in any sort of evidence, and I want that for you as well.

296 00:37:33,499.255034 --> 00:37:37,439.255034 You can head to thebirthlounge.com/bigbaby 297 00:37:37,609.255034 --> 00:37:40,639.255034 to join me in the Birthing Your Big Ass Babies Course.

298 00:37:40,639.255034 --> 00:37:44,699.255034 Again, that's thebirthlounge.com/bigbaby 299 00:37:44,919.255034 --> 00:37:47,739.255034 And I will see you in the next episode.

300 00:37:48,129.255034 --> 00:37:51,189.255034 Be sure to follow along with me on social media.

301 00:37:51,189.255034 --> 00:37:56,79.255034 You can find me at Tranquility by HeHe and at the Birth Lounge.

302 00:37:56,259.255034 --> 00:38:05,739.255034 Until next time, head to your app store and download the Birth Lounge app for evidence-based childbirth education and data-driven postpartum support delivered straight to your phone.

303 00:38:06,159.255034 --> 00:38:07,119.255034 Bye.

304 00:38:08,19.255034 --> 00:38:09,639.255034 Thank you so much for tuning in today.

305 00:38:09,639.255034 --> 00:38:14,919.255034 I love hanging out with you, and it is an honor to be your go-to gal when it comes to preparing for your baby.

306 00:38:15,129.255034 --> 00:38:21,729.255034 If you've enjoyed today's episode, please leave a five star review and tell others why they should be listening to the Birth Launch podcast too.

307 00:38:22,89.255034 --> 00:38:31,779.255034 You deserve to have a birth that you love with a provider that values your autonomy and respects form consent without all the trauma that you so commonly hear about on social media.

308 00:38:32,19.255034 --> 00:38:34,599.255034 New episodes, air every Wednesday and Friday.

309 00:38:34,674.255034 --> 00:38:37,194.255034 Hit that follow button so you never miss an episode.

310 00:38:37,284.255034 --> 00:38:40,104.255034 I'm Hei and this is the Birth Lounge podcast.