Midwifery Today Community

 I am desiring to grow a strong, healthy baby but also wanting my baby to be on the smaller side, for me.  My smallest baby (that I was not induced before labor) was a daughter, 7 lbs. 6 oz.  My largest was my last daughter, 8 lbs. 5 oz.  I do understand this isn't a huge difference and she was not overly large.  However, here is my reasoning here, this could be a determining factor in my success at a VBAC this time around.  Here is why I think this...my first baby was a c-section, the dr told me my bones were deformed and more oval shaped and that unless I delivered around my 6th month of pregnancy, there was no way a baby would fit through my bones.  During my labor with my second child, they broke my water and I felt the baby suddenly shift down and then there was a horrific, sharp, terrifying pain in my pelvicy area.  I grabbed my husband's arms and had just enough time to panicky exclaim that something was NOT right when it was over.  My son (8 lbs. 1 oz.) was born with scratches down both sides of his face.  One of my daughters was posterior and "stuck" for a while before eventually turning and being born.  And my last daughter (8 lb. 5 oz.) was posterior, brow presenting and just did not fit through.  We stalled out at 7 cm and were eventually delivered by c-section.  Sooo...this leads me to be strongly suspicious that a smaller baby might have more wiggle room to work through malpresentations that I seem prone to.  Also, I tend to go past dates, usually during my 41st wk, I have gone to 42 wks twice.  My earlier babies were smaller.

How should I eat to limit birth weight while still growing a healthy baby?   

Hi,

As far as i know there isn't really a way to make sure you have a smaller baby that you'd want to actually try (nicotine and cocaine both interfere with how the plcenta works but carry many other risks too).  Even restricting your own weight gain won't make the head of the baby any smaller (fat is squishy and squezzes through even narrow spaces, it is bone which gets stuck) and you may just end up with a light baby who had a difficult birth and not enough fat reserves to cope well after birth.

If i were you i would work on two things - the first is foetal positioning.  Go to spinning babies website (google "spinning babies" to find it) - it has many many tips on how to make it as easy as possible for baby to get into the optimal position for birth.  You can begin working on the position from the middle of pregnancy and it can make a huge difference.  I know so many women who had 1 or 2 or even more posterior babies who gave up sitting on chairs or sofa's (instead sitting on backless stools, fitballs, or squatting/sitting on the floor) for the second half of a pregnancy and then delivered anterior babies next time around.

The second thing i would work on is how to work WITH your pelvic shape.  Unless you have been in a serious accident which fractured it, or suffered from polio as a child, your pelvis is NOT deformed.  That is such a powerful and demoralising word that doctor used!  It might not be the shape an Obstetrician feels is the best for baby-having, but the obstetric method usually has mama flat on her back and pushing uphill, many pelvises which work beautifully struggle to fit a baby out in this position.  A brow presentation is one of the few cases where many babies WILL NOT fit - this is not a fault with the pelvis, it is a malposition which is incredibly rare.  You were unlucky to have a babe come down brow first, that's all, it really isn't to do with your pelvis.  I have a friend who delivered her brow baby vaginally.  She has a very wide pelvis (the angle at the junction of the pubic bones is important and with her it's basically 180 degrees, there couldn't BE more room in there) and it took her SIX hours of pushing to get her smallest baby out.  I know there is a resource called "the pink kit" which focuses on different pelvic shapes and which positions and movements help during labour to ease the baby out.  It's an australian resource i think, but shoul be available online

I honestly think your BEST chance of VBAC will rely on helping babe to get into a great position before labour, you having excellent labour support from people who love you and believe in you and your ability to birth vaginally, and knowing the best ways you can help yourself during labour, far more than the size of the baby.

I'm unclear about the scratches.  The bones in the pelvis broke and came through the uterine and other pelvic muscles? You were surgically "repaired" afterwards? The baby had no other marks on his body, just his face?  (Excuse me if this was a girl. I can't see the original post when I reply.) The birth attendant said that the scratches were due to protruding broken pelvic bones?

Scratches made me wonder if two nuchal hands were forced down out of the way (scratching the face as they went) by the sudden descent into the pelvis following the AROM...?  That might also explain the initial sharp pain, of a head plus 2 hands trying to come through the bones...?

 No, nothing broke, just my son had scartches down both sides of his face.  The dr made some comment on it being a tight fit for him.

I have had smaller babies, but I ate differently, more according to the what to expect daily dozen way of eating.  But we don't eat so many carbs now and we tend to eat a lot more fat than that.  Like I drink whole raw milk, cook my eggs in butter or coconut oil in a cast iron skillet, etc. instead of pan spray in a teflon skillet like I used to.

I am also plagued by fear.  I did use the guidelines on spinning babies last pregnancy.  I was scrupulous to never lean back and faithfully did pelvic tilts and spent time on my hands and knees more than once a day, but faithfully every single evening before bed and slept mostly on my left side.  Sigh.  It makes me feel a bit helpless this time around.

THanks for the thoughts.

Scratches sound more like baby either scratched himself with his little nails or even the doctor could have scratched him if he was doing a lot of manipulating and fiddling to get him out. ??

I think you have hit the proverbial nail on the head when you mention fear and feelings of being helpless.  Are you able to talk about your feelings with a midwife?  Do you have to have an obstetrician attend you?  (I can't remember all the details of your previous situation from our old forums ... so sorry.) Are you able to take a comprehensive childbirth education class that is geared toward what you need rather than just the nuts and bolts of the stages of labor?  Something like Birthing from Within or Hypnobirthing is what I'm thinking. ??

Do you think the Brewer diet would help you stay healthy during this pregnancy?

Are you getting regular physical exercise?

Sorry for peppering you with questions; I'm just trying to get a better understanding.

Every baby and every birth is different BUT I think that some of the things I did differently with my last pregnancy allowed me to have a smaller (for me) but healthy baby :) My babies have been 9lbs 1oz, 8lbs 15oz, 5lbs 8oz (preemie), 8lbs 5oz, 8lbs 8oz, and 7lbs 11oz. My last baby was the 7lb 11 oz-er...a little bigger than the national average but small for me :) I don't have problems delivering my babies...the posterior ones were rough: one turned but one didn't and he delivered posterior-brow (ouch!!) but they do eventually birth just fine :) Anyway, with baby #6 I exercised 5x per week and made sure all of my calories came from high quality protein, raw fruits and veggies, and whole grain high fiber carbs. I avoided *all* junk food, caffeine, bottled juices, and dairy. My fats were from extra virgin olive oil, raw coconut oil, and flax oil. I used my plate as a guideline (read this somewhere on line)...1/2 of my plate was veggies (or fruit if breakfast), 1/4 my protein serving, and the other 1/4 carbs. I also drank 2qts of water with chlorophyll every day and a quart of red raspberry leaf tea (after my first trimester). I wasn't trying to have a small baby though...just a healthy one I could birth from a healthy body :) I was surprised that she was under 8lbs when she was born and the labor and delivery were incredibly easy (took Polly-Jean's 5wks formula...I've tried others and I love this one!). I also used a birth ball throughout my pg as a seat...I literally took it everywhere with me (even to church to sit on!!). The previous two babies had been posterior and I did *not* want to go through that again :) I think the biggest impact it had though was in my recovery. I usually flow for 12wks postpartum but only flowed moderately for 2wks and then lightly on and off for another 2wks. I also felt great and was walking daily again in less than a week postpartum and jogging within 3wks. I pray you can release your feelings of fear and anxiety and enjoy your pregnancy to the fullest. I pray too that you'll have a beautiful labor and delivery :) (((HUG))) Take Care!

Sorry, wanted to reply to a few other things you wrote :) I don't have a misshaped pelvis but it's very long and I'm also prone to "malpresentations". I felt that same sharp pain in my pelvis when my daughter who was posterior turned...I thought for sure my pelvis was going to break in two and I told my husband so :) She delivered within 5mins of turning but it was after a very very long difficult labor (she was born at home...8lbs 8oz)). My son who delivered posterior brow also stalled out at 7cm...for 13hrs (born at home also 8lbs 5oz)!! His labor altogether was 26hrs..13hrs to 7cm and another 13 to delivery. Now that you've delivered a couple of babies through your pelvis I would think it's more likely you'll be able to do it again :) On a slightly different note, I have a friend who has a teeny pelvis and huge babies. Because her first birth (at home) had a traumatic outcome she delivers in the hospital with a midwife who induces her 2wks early and she births just fine...healthy mama and healthy babies. 2wks early and her babies are *still* 8lbs+ (she's only about 5'2" and 110lbs with a very small frame)!! If you're going past dates (which contributes to bigger babies obviously) I'd seriously try Polly-Jean's 5wks formula...only I'd start it a week earlier around 34wks rather than 35...it's worth a shot and it's safe. Like I said in my other post, I've tried a few other formulas and really liked this one....for me, it was very effective. I wish you all the best though and will be praying :)

After reading about your diet (I would have suggested more protien and lower carbs...seems like you're doing that already), I would suggest regular exercise.  It might help.

 Thank you everyone, for your help!  I do appreciate it.

I have to see our family general practitioner for this pregnancy, but he has to be overseen my an OB.  I had 7 uneventful, uncomplicated VBACs between my 2 section.

I am not in the greatest health condition so feel very, very challenged this pregnancy.  I feel also like I'm just always making excuses.  I have not been walking this pregnancy, kind of a chain of events things...my last birth (baby stuck posterior brow presenting) pushed my pubic bone out of place and I also prolapsed everything at 2 wks postpart.  I've been seeing a PT and found my sacrum and pelvis were cocked and higher on one side.  I wonder if that was a strongly contributing factor to the malpresentation.  The PT said that my sacrum was 1 inch lower on the right side than the left (when laying on my tummy), it is better now, but not all better.  In a longshot attempt she did some heavy duty massaging on me that about killed me, and it gave me serious sciatica problems such that when I took a walk (because I'd read that helps) I was dragging my leg to get home.  PT told me no walks until it got better.  Next came all our canning and freezing which by the beginning of Oct I was exhausted, dh was concerned, my umbilical hernia was bothering my  anyway, so he "sentenced" me to pretty much bedrest for 5 days during which time the kids caught a respiratory based cold, gave it me and by the end of my 5 days, I was sick and told to continue staying in bed over the weekend.  I felt a bit better so was "released" on Mon and did some cleaning, by evening I was much sicker, full of green gunk, so dh told me to go back to bed the rest of the week, that turned into 2 wks as I got bronchitis and it seemed that I was doing better when I pretty much stayed in bed and got worse when I was up and about.  So here it is beginning of Nov and I've been on "bedrest".  Good news is I made it through this pregnancy so far, 27 wks, without my hernia actually popping out so that I have to pop it back in, which is great for me!  It is usually a major and painful issue.  Also, my sciatica feels MUCH better, better than past pregnancies.  And my back feels better.  I just feel really, really out of shape.  And...I'm still snotting up green stuff, even though I'm not coughing all the time.

Sorry to whine so much...I don't know if what my dh recommended regarding bedrest was a good move for me or not, but it's what I did.  So here I am 27 wks along, really out of shape, still sick, not sure if I should start walking again with just short, easy walks or wait until I'm all well.  What do you all think?

I have a feeling I am the sort of patient all doctors dread and that my midwife is happy to be not having to deal with me.  Over the phone she said she would come to our birth and be our doula and help us labor while refusing the c-section and to be support for us to make a decision if the drs try to scare us into a section.  But then she said she may not be available, gave me the number of another mw in my area, told me if I get my vbac and get pregnant again we can talk then, all such a far cry from the "I'll be there if I can make it, keep me posted, stay in touch, you can do it" I was expecting. 

Anyway, I guess I'm feeling pretty low and discouraged today.  Thanks for the advice and prayers. 

Hey, Littlemother.  You have been very busy!  Its hard to take really good care of oneself when there are so many other things that need to be done at the same time.  I'm feeling that pressure right now too.  I really want to take care of myself (like go to the chiro every week and put my feet up for an hour every day) but there's so much going on that its hard.

Your husband was sweet to want you to rest as much as possible.  I personally feel like moderate "movement" is better for chest ailments like bronchitis, than just being still.  Sure, you need rest at the same time, but getting up and moving about regularly, I think, helps get the "stuff" moving up and out.  I think you know what I mean.  :-)  So I think maybe taking the short easy walks might be good as long as its not too cold and nippy (if you're walking outside).  Who knows what's up with your midwife.  I'm sorry she left you hanging like that. 

I'm very interested in malpositioning as well because I've had two babies come out with cephalohematomas.  My last birth, I had searing pubic bone pain as I was pushing my baby down on hands and knees (maybe the hand that came out with his head?).  So I really would love to do something to help baby get into a really good birthing position this time.  On the other hand, I'm horrible with how I sit (right now I'm leaning back into a regular dining room chair with a foot up on the computer desk) mainly because my legs are so uncomfortable from varicose veins and swelling that I try to get my feet up even a little bit as much as possible.  That usually means that I'm not in the correct "spinning babies" position, unless I'm REALLY resting on the couch.   In that case, I'm on my left side with my feet propped up above the level of my heart (to help the veins and swelling drain).   Hmmm, what does one do? 

I thought kelly's advice about portions on your plate was great.  I did that tonight and its a really easy guideline to follow.

Take care and I hope you feel better.  BTW, we're almost the same.  I'm about a week ahead.  :-)

 

 Most of the advice already given hass been pretty good. I must take issue with whomever suggested the Brewer diet though. While being very good at preventing toxemia, it defininitely will NOT produce a smaller baby! Most of my shoulder dystocia's have been Brewer diet babies, God rest his soul, he meant well, and he did help many women, but his diet will not help your problem! Concentrate on vege's esp green leafy's, a little good quality protein & a few good quality carbs. forget pastas, make your carbs things like  rice, barley, potatoes & corn.

I agree with taking either Polly-Jeans, or Natures Sunshine (5-W), or Mountain Meadow Herbal's (Gentle Birth) last 5 week formula, except starting a week early. They are all good, I don't have a favorite brand. MMH is liquid, PJ & NS are capsules, if that makes a difference to you.

  You mention that your pelvis is misalligned, and getting PT for it, but I strongly recommend seeing a Chiropractor instead or in addition to the PT. having your pelvis alligned periodically through pregnancy and again in early labor will help trendously.

My d-i-l has a "strange shaped" pelvis (never had it x-rayed, so don't have an official dx) her 1st baby was a C/S for CPD, since baby was still not even engaged yet at 6 cm, with good strong ctx. The baby was almost 10 lbs.  Her next was born VBAC after an 8 hr labor, only a few oz less than the 1st. The 3rd was breech until 7 cms, the CNM's tried to get her into the hosp for a repeat C/S, she refused. Next morning, woke up w good strong ctx, 7cms dilated, still breech, so we headed for the hosp & the dreaded C/S. At arrival she was 9 cms & baby had turned head down, so was able to have VBAC after all. That baby was a little over 10 lbs, and was born after only 3 hrs of labor! 4th, was a 5 hr labor, and homebirthed a 11lb 5 oz baby. 5th she had a 11lb 8oz baby at home after a 7 hr labor.  All her babies stayed high until well into labor, and instead of coming out anterior or posterior, came out facing her left leg, like they had restituted on the way down, instead of after the head was born, as normally happens.  I recount this just to show you what is possible.  

Thank you, I am encouraged by the okay for the 5 W formulas.    I will do that!

Thank you also for the thoughts on the Brewer Diet.  My last two pregnancies, especially I ate a lot of protein.  My protein and albumin blood levels get very low by the end of pregnancy, so I was told to really really push protein.  My dh would make me a protein shake every bedtime that by itself was 53 gm protein!

But, is it too late for me?  I am 29 wks today.  Have I already grown a large baby?

When you say focus on grean leafies, what does that mean? 

What I've been doing is trying to have two nice full cereal bowl sized salads each day, one with lunch, one with supper.  Supper is meat of some sort, about 4 oz, the salad, and two veggies.  Lunch is usually soup (made with homemade stock) and the other salad.  Breakfast is either 2 eggs and 1 piece of toast or oatmeal.  I also have 1 qt of raw whole milk each day.  I try to have a piece of fruit each day, almost always either an orange or an apple.  We have a dessert once a week and I only have 1 cup of coffee Sat and Sun each.  Am I doing well or what would you recommend cutting out, adding, changing, etc.?  I am frustrated that I am gaining a pound a week even though I am already obese and do not need to gain anything.  Oh, and I drink 2 qts water and 1 qt RRL tea mix (RRL, nettles, alfalfa and oat straw mix).  I walk daily, my goal is to take a short walk (about 3/4 mile) with one of my younger ones in the morning and then take a longer walk (about 1 1/2 miles) with my older ones or my dh in the evening.  I was hoping this would help curb the weight gain as well as all the other benefits. 

I appreciate your thoughts on my diet and how to improve/change it and how much that might help this late in the game.  Thank you!

http://www.drbrewerpregnancydiet.com

This is a website which clears up many of the misconceptions regarding the Brewer Diet.  I'm in no way trying to argue Brewer vs not-Brewer.  But I do believe there's a lot of interesting misconceptions which arise from the diet when it's not followed correctly, particularly regarding protein and having midwives push protein without pushing the rest of the diet.

Edit by Admin: Thanks to Joy Jones for updating us with the new URL for her site, which is now corrected above. In addition, you can read here an article by Joy about the Brewer Diet:

http://www.helium.com/items/481613-pregnancy-nutrition-and-diet