A ‘Big Baby Trial’ Found 1 Way To Help Women Birth Larger Babies Safely

When Eve Morgan was diagnosed with diabetes during pregnancy, it came as a huge surprise. As she inched closer to her due date, monitoring predicted that her unborn baby could reach 9lbs at full-term. To put that into perspective, the World Health Organisation (WHO) suggests the average male baby born at full-term weighs 7lbs 6oz, while the average female baby is around 7lb 2oz. At the time, Morgan learned of The Big Baby Trial – led by The University of Warwick, University Hospitals Coventry and Warwickshire NHS Trust (UHCW) and the Perinatal Institute – and decided to enroll. “Because diabetes and big babies are linked, I thought it was a good idea to join the study and get extra monitoring throughout my pregnancy, although I wanted a natural birth for my baby,” she said. “I didn’t want to be induced with hormones, but I was happy to try the ‘stretch and sweep’ method as this can trigger labour and you can stick to your birth plan.”A stretch and sweep – or membrane sweep – is where a midwife or doctor sweeps a finger around the cervix in an attempt to separate the membranes of the amniotic sac from it. This separation releases hormones which can kickstart labour.After a second sweep, she ended up giving birth to her son Magnus 10 days early. She had a water birth and her baby was born weighing 7lbs 8oz (3.4kg).The findings of The Big Baby Trial, which Morgan was a part of, have been published today in The Lancet.One key finding was that women predicted to birth bigger babies could benefit from giving birth seven to 10 days earlier to reduce the risk of injury to themselves or their baby.Why are some babies bigger than others?Certain factors can influence how big a baby is, including genetics, maternal obesity, or having pre-existing diabetes or gestational diabetes.Some large babies are at risk of shoulder dystocia, a birth complication where the baby becomes stuck as a shoulder is caught under the mother’s pelvic bone.This is rare, however it can cause birth injuries including fractured collar bone or upper arm nerve damage.There is also an increased risk of needing an emergency caesarean section or interventions such as forceps; experiencing postpartum haemorrhage; and vaginal tearing linked to giving birth to a larger baby.It’s worth noting that some babies predicted to be larger may not be, however. The NHS Gateshead Health states the accuracy of predicting a baby’s weight is reduced as the pregnancy progresses, and in 10-15% of cases can be inaccurate.What did the Big Baby Trial reveal?Between June 2018 and October 2022, almost 3,000 women in 106 hospitals across Britain consented to be randomly allocated to induction of labour or standard care.The Big Baby Trial – led by The University of Warwick, University Hospitals Coventry and Warwickshire NHS Trust (UHCW) and the Perinatal Institute – found a slightly earlier delivery (7-10 days) reduced the risk of shoulder dystocia.It also reduced the need for emergency C-sections and didn’t increase the risk of tearing for mums. The authors of the study said it provides evidence for clinical management options that increase choices for women with large babies to choose a birth plan that can include: Waiting for labour to start naturally without worrying about increasing risk to babies if delivery occurs on a labour ward with highly trained staff;Choosing a planned Caesarean section, orInduction at 38 weeks to reduce the risk of the baby’s shoulder being caught, without having to worry that this increases the risk of emergency Caesarean section or mother’s tearing during delivery.The study’s lead author, Professor Siobhan Quenby, said: “I am delighted that this trial has provided data that empowers women to choose how and when they want to deliver their baby.”The trial was funded by the National Institute for Health and Care Research (NIHR).Katie Morris, NIHR National Clinical Specialty Lead for Reproductive Health and Childbirth, said: “Large babies can present complications at birth which injure both mother and baby.“The findings of this world-leading trial offer crucial evidence that will help improve the chances of a safe birth and help expectant mums and medical staff make the most informed choices.”Related...Why Can’t We Remember Being Babies? Here’s What Science SaysIs A Bit Of Screen Exposure Really That Bad For Babies?So THAT's Why Babies' Eyes Change Colour

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