One thing women often mention during their appointments is that they have been told by their friend/sister/aunt/work-mate/lady in the coffee shop that their bump is big or small for how many weeks pregnant they are. It has made me realise that the size of your bump, or what we really mean, baby, is a topic of much discussion and potentially concern.
It is true, the size of your baby is very important. Midwives and Obstetricians want to know that your baby is growing well, getting all of the nutrients they need and not growing more than they should be either. This is why your bump is measured regularly from 24 weeks and the measurement plotted on a growth chart.
Why is it so important though? Well, if your baby is smaller than expected, it could be a sign that your placenta is not working as effectively as it should be. You may be thinking “I’d like a smaller baby; it’ll be easier when I give birth!”, however, if a baby is not reaching is true growth potential, it means that it will have less reserves for labour. This can have implications for how you birth your baby.
In serious cases, your baby will prioritise ‘feeding’ the most vital parts during development. This means that areas that are not essential to survival, e.g. muscles, legs, arms etc, will receive less nutrients and so will not develop further. Your baby may stop moving, as it does not have the energy to do so. In the very worst case, if left, this can lead to stillbirth.
Your placenta not working effectively can be ‘just the way it is’, which is not your fault and you can’t change, but there are things you can do to help prevent this. The most important thing is to stop, or at least reduce, smoking. Switching to vaping over cigarettes or rolling tobacco has also been shown to be of benefit. Ask your midwife to be referred to a local smoking cessation service if this affects you, as evidence shows that having this specialised support can really help you in achieving your aim of giving up smoking.
At the other end of the scale, baby growing too much could be a sign that your baby is being exposed to too much sugar and therefore is putting on too much fat. This can be as a result of diabetes and is also not very good for baby’s, as if can affect their ability to balance their own sugar levels once they are born. Diabetes is a serious condition and it is really important to diagnose so that treatment can be given to maintain sugar levels within the normal range, both for you and your baby.
Another reason your bump may be measuring smaller or larger than it should be is the amount of amniotic fluid (waters) around your baby. Certain conditions can cause you to have less (oligohydramnios) or more (polyhydramnios) fluid. In either case, it is important that this is diagnosed so that appropriate care plans can be made to keep you and your baby safe.
Whilst the national recommendation is to measure your bump (symphysis fundal height measurement) regularly, evidence shows that this is not necessarily very effective at picking up problems, as it can be affected by how the measurement is taken and also maternal factors like the amount of fat your have on your tummy, or if you have fibroids. The most accurate way of estimating your baby’s weight is with an ultrasound growth scan, such as the fetal wellbeing scans with SHEcares.
Routinely, growth scans are not offered to low risk women during pregnancy by the NHS unless they have specific risk factors. If you would like to read more about fetal wellbeing scans with SHEcares, please visit: fetal well-being scan (15-18 and 23-40 weeks) – scans & holistic expert care in pregnancy (she-cares.co.uk)