When faced with the possibility you might have an enormous baby, it's natural to exhibit the kind of avoidance behaviours more commonly exercised in the presence of life insurance salesmen and Jehovah's Witnesses: closing your eyes and hoping the moment passes.
It's tempting to think having a gargantuan baby won't happen to you. After all, bringing the average 7.5 pound baby into the world is enough of a messy and terrifying proposition. Nervous mothers who turn to pregnancy forums for reassurance will receive scant consolation. Birth, advises one mother, is like "shitting out a Smeg fridge." "I felt that my butt was gonna explode," opines another. A veteran recommends a narcotics-based birth plan: "TAKE DRUGS! Take everything and anything available."
According to the Royal College of Gynecologists, an estimated 11 percent of women come out of childbirth with a macrosomic baby, or a baby that weighs eight pounds and twelve ounces—or more. If that sounds like a stretch, consider the further 1.5 percent of women who deliver babies weighing over ten pounds. Those who deliver the latter (the weight of an average house cat or a medium sized bowling ball) are worthy of our respect, and sutures.
If pushing a domestic cat out of your asshole sounds like a remarkable feat of tenacity and endurance, spare a thought for the macrosomial Olympians of this world. According to the Guinness Book of World Records, the heaviest baby ever to be delivered and survive was born to Carmelina Fedele in Italy in 1955. The boy weighed 22 pounds and eight ounces, which is actually more than this Samsung 43 inch flatscreen TV. More recently, in 2009 an Indonesian woman named only as Ani gave birth to a baby that weighed 19 pounds and two ounces (to the relief of all, by cesarean section).
In 2014, Andrea Schrimp, 38, from California gave birth to her daughter Viviane Bliss: an 11 pound, 10 ounce whopper. "She was less painful than my other births," she tells Broadly. "It was actually like a storybook labor. I was having contractions, put my son to bed, had dinner downtown, got into the birthing tub and she was born two hours later."
Viviane was, incredibly, delivered without any pain relief. In a nice touch, she was born with her fists outstretched, like a plus-sized mini superhero.
"She came out with her head and fists together, so that was a huge chunk of baby-sized head and fist to get out. In the final push, I broke my tailbone. The midwife congratulated me on giving birth to the average-sized three month old." I ask about her post-birth situation. "Minor tearing, no stitches required. I pulled all my muscles from my waist down, though."
Dr Daghni Rajasingam of the Royal College of Obstetricians and Gynecologists explains that there are several explanations for high birth weight. "The biggest factor which increases the risk of having a large baby is gestational diabetes or pre-existing diabetes. Other risk factors include obesity, weight gain during pregnancy or in between pregnancies. Having a very large baby can put both mother and baby at greater risk of complications during labor and increase the likelihood of having a cesarean section or instrumental delivery."
Unless you've got a history of huge babies in your family or you've been diagnosed with gestational diabetes, it's hard to determine exactly how big your baby will be pre-birth. "Unless the midwife who's palpitating the abdomen has a long history with that patient and knows what they're feeling for, it can be very difficult [to tell]," says Michelle Lyne from the Royal College of Midwives. "If we suspect a larger baby we might refer women for an ultrasound scan which can do an estimated fetal weight, but even that can be unreliable."
I honestly felt that it was by God's grace we were both alive.
Annabel*, 27, from New Jersey is currently pregnant with her third child, but is terrified about the prospect of having an extremely large baby. "I had antepartum depression through my last pregnancy and my OB/GYN was negligent from the beginning." Annabel also had a history of diabetes that she says wasn't diagnosed until the 32nd week of her pregnancy. "At this point my OB/GYN shouted at me for not controlling my diabetes better and told me I was going to have a ten pound baby."
After being induced two weeks early, Annabel delivered her child. "She was on track to be nine pounds, eight ounces, and had shoulder dystocia [in which birth is delayed due to baby's shoulder getting stuck behind the mother's pubic bone] during birth." The birth itself was traumatic. "I felt terrified and helpless. After, I felt overwhelmed, isolated, and abandoned. I honestly felt that it was by God's grace we were both alive. I broke my tailbone delivering and I have pain during intercourse and numbness which affects my ability to empty my bladder and know when I need to urinate."
Read more: Women Describe Their Orgasmic Births
Annabel is now terrified about the prospect of delivering an even bigger baby. "I'd say my fear of having a large baby is about an eight out of ten. I feel like I'm getting all the support available now, having switched healthcare provider. But I'm still afraid. I often feel like it was a mistake to get pregnant again, despite the fact my husband and I wanted another child."
While tokophobia, or a pathological fear of childbirth, can affect all women, it's most commonly exacerbated by a traumatic earlier experience. "Often trauma hits a peak after they've recovered, several years later," explains Maureen Treadwell from the Birth Trauma Association. "They're thinking about having the next one and they go through all this. Especially if you've had a large baby, you're much more at risk of having another large one."
Parenting expert Sarah Ockwell-Smith has given birth to two babies, both of which were over 11 pounds. Her last baby weighed 11 pounds and three ounces, which is about the same as a gallon of paint ("no tearing, no problems," she informs me).
You've got brown stuff leaking out of your bottom all the time. It's horrible.
"Too many people think large babies are harder to birth," she tells Broadly. "I actually think as they are heavier, you have gravity on your side! You're just as likely to tear with a six pounder, as you are with an 11 pounder."
A spokesperson from the Royal College of Midwives says that this is not strictly true. "This is not medically correct—tearing during labor is not always dependent upon the weight of the baby but rather on how the mother's labor is progressing. Everyone women is different; her body and her labor will be also be different."
If your baby is Hodor-esque huge, there are a few options when it comes to delivery. The obvious: Have a C-section. Or, if you want a vaginal delivery, an episiotomy may be necessary (a surgical cut between the vagina and the anus which enlarges the area available for the baby to come out.)
Unsurprisingly, the procedure isn't much fun. "If you're having a larger baby, especially if you've had signs of fecal leakage from earlier pregnancies, you really need to speak to an obstetrician," says Treadwell. " Because if those symptoms become permanent, it can become unimaginably awful. You've got brown stuff leaking out of your bottom all the time. It's horrible."
Like a Beyoncé album release or a second plastic toy in a box of Lucky Charms, delivering a massive baby can be an unexpected, but not entirely unwelcome, surprise. For every traumatic labor there are many that pass off without so much as a chip in your tailbone. Amber Robohm, 25, from Sacramento delivered her ten pound and four-and-a-half ounce baby in an hour and 55 minutes—about the length of your average Hollywood blockbuster.
"My labor was so short I didn't even push, she came out quickly on her own. I had no tearing, no swelling, no complications as all." Curiously, Robohm didn't have diabetes or a history of large babies in her family, so is at a loss for why baby Emma was so big."
As increased obesity levels, a reduction in smoking, and generally improved diets mean more women are having bigger babies, birth advocates believe more than ever that women need to be educated about the possibility of having cat-sized offspring.
"Women need to be fully informed going into the birth," Treadwell says. "We shouldn't advocate either way—for cesarean or vaginal birth, for home birth or for hospital deliveries—but we do need to make sure women have all the facts."
*Name has been changed