Short, tall, fat, thin… does your physique play a part in your birth experience? According to our expert, yes.
Pre-pregnancy, child-bearing hips probably weren’t top of your wish list. But once you’re faced with the prospect of pushing your baby into the world, chances are you’d gladly sacrifice your low-rise skinny jeans if it meant less of a struggle during labour.
Here’s how your figure and fitness level affects your labour, and what you can do about it all.
“My mum and I are both only 155cm tall. She had a very difficult labour – am I destined to follow in her footsteps?”
According to Dr Maggie Blott, consultant obstetrician at the Royal Victoria Infirmary in the UK, many short women also have a small pelvis.
“If you have an average or larger than average sized baby, you’re at an increased risk of cephalo-pelvic disproportion (where your baby’s head is too big to come through your pelvis) and needing a caesarean,” Dr Blott explains.
Although you can’t increase the size of your pelvis, keeping mobile and trying different positions in labour can help. Squatting, in particular, opens up the pelvis – for support, get your partner to sit on a chair and squat between his knees, with your back to him and your arms over his legs.
But don’t assume that just because you’re petite, you’ll have problems pushing your baby out naturally. “Some tiny women have big babies with no problem at all,” says Dr Blott. “We wouldn’t offer a woman a caesarean just because she’s short. Give a natural delivery your best shot – but be prepared if you don’t progress.”
“I’m medically obese, and it’s too late to lose weight now. Will my size make it harder to give birth?”
“Obesity is one of the biggest risk factors in just about every labour complication,” says Dr Blott. “Big women tend to have big babies, and they also have lots of fat in their vaginal tissue, so the birth canal is obstructed.”
Many hospitals class obese women as high-risk, and won’t allow you to give birth in a midwife-led unit or at home. You’re also more likely to develop complications such as diabetes and pre-eclampsia, which can lead to your baby being delivered early, by inducing labour or by caesarean.
“It’s best to plan your pregnancy and lose weight first,” says Dr Blott. But what if you’ve left it too late? Dieting isn’t advised in pregnancy, but aim for a small weight gain of around 6.5kg, instead of the average 12-16kg. Exercising may also help.
If you’d feel self-conscious in the gym, a brisk walk is the perfect pregnancy alternative – go for a good walk around the park (or the shops) every day, and you’ll boost your chances of an easy labour.
“Do thin women have tough labours? I’ve always been skinny, and I haven’t gained much in pregnancy.”
You may not look like the child-bearing type, but being slender is a big bonus in the birth stakes. “Slim women labour very well,” explains Dr Blott. “You’re likely to have a normal sized baby, are probably fit and healthy, and haven’t got excess fat to cause complications. If I see a slim, reasonably tall woman in the antenatal clinic, I’m usually fairly confident that she’ll give birth naturally.”
Good news all round, then. But even slim women can struggle if they’re not properly prepared, so make sure you eat healthily, keep active and get your body and mind ready for labour, for example by practising breathing exercises and birth positions. You’ll be glad you made the effort.
“I’ve got really slim, boyish hips. Could they be too narrow for the baby to come out of?”
In a word, no. “If you’re very tiny, you may also have a very small pelvis, but external appearance doesn’t correlate very well with internal functions,” explains Dr Blott. It’s entirely possible that even though you have snake hips, your pelvis is nice and wide, in which case there should be no reason not to deliver your baby naturally.
A better indicator is your shoe size. “It’s not just an old wives’ tale – women with small feet often have small pelvises, which increases the risk of needing a caesarean,” says Dr Blott. “But keep as active as possible in labour and try different positions, and you’ll increase your chances of a natural birth.”
“I’m so unfit – if labour is like running a marathon, I’m not going to make it past 2km! What can I do?”
“You’ll certainly have more difficulty giving birth if you’re unfit,” confirms Dr Blott. Labour is a test of endurance, so you’ll need plenty of stamina, good cardiovascular function to help you keep on top of all that puffing and panting, and strong muscles to see you through the pushing stage.
It’s never too late to get in shape for labour. “Pregnancy isn’t the time to start doing two-hour workouts at the gym if you’ve never done them before, but even gentle exercise is very effective,” says Dr Blott. Speak to your midwife about antenatal exercise classes in your area, log onto aquanatal.co.uk and birthlight.com for details about aquanatal and pregnancy yoga respectively, or just grab your cossie and go for a swim, starting now.
“My friend had a very long labour, and she thinks it was because her stomach muscles were so toned, it actually restricted things from progressing as quickly. I’m super-fit, too, and have exercised throughout pregnancy – am I in for a long, hard slog?”
“I’ve never come across that,” says Dr Blott. “Fit women do very well in pregnancy and labour, and recover better afterwards.” So there’s no need to stop exercising now you’re pregnant, although you may have to modify your regime.
It makes sense to avoid anything that puts you at risk of a fall or a blow to the stomach – horse-riding, cycling, martial arts and competitive sports like hockey or football are out.
You should also avoid doing sit-ups and crunches as these involve lying on your back, which puts pressure on your vena cava (the major vein that carries blood from your lower body to your heart and can make you faint and cause dizziness.
Otherwise, just be sympathetic to your changing body – don’t get too hot, and stop if you experience any nausea, dizziness or pain. Think of it as a well-earned break!
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