Mother and Baby

A nationwide trial will decide whether it’s safer to induce mothers of bigger babies and deliver them early

Section: Labour & Birth

A nationwide study of 4,000 pregnant woman in 60 maternity hospitals throughout the UK is underway to determine if delivering bigger babies earlier will prevent complications during labour.

The clinical trial, led by University of Warwick, University Hospitals Coventry and Warwickshire (UHCW) NHS Trust and the Perinatal Institute, will decide whether it will be preferable to induce an earlier birth, rather than letting mothers of bigger babies going full-term.

"As well as being extremely traumatic and painful for the mother it can cause children to be born with conditions such as Erb’s palsy, is caused by damage to nerves in the neck during birth."

A baby larger than predicted by a mother’s size can cause complications at birth. One of the major problems connected to delivering a bigger baby is delivering the shoulders after the head has come out.  

Professor Siobhan Quenby of Warwick Medical School, University of Warwick and UHCW NHS Trust said: “As well as being extremely traumatic and painful for the mother it can cause children to be born with conditions such as Erb’s palsy, is caused by damage to nerves in the neck during birth. This condition can debilitate the use of a baby’s arm, which in some cases can’t be rectified.”

How will the study make a difference?

The size of a baby can be predicted by routine tape measurements of the pregnant woman’s abdomen followed by an ultrasound scan if a problem is suspected. The team will be conducting a study of 4,000 pregnancies in 60 maternity hospitals in England when the baby in the womb is suspected to be larger than average and therefore potentially at risk of problems with delivery of the shoulders during birth.

The team will be conducting a study of 4,000 pregnancies in 60 maternity hospitals in England.

Mothers who consent to be part of the trial will be allocated at random into either an early induction of labour group, with the aim to be delivered at around 38 weeks, or a control group where care is as normal and onset labour is awaited to start naturally. The team will then look at whether as a result of earlier birth there were fewer complications such as difficulty with the delivery of the shoulders.

The study will help decide what the safest method is to care for pregnancies where because of the large size of the baby complications may occur during labour. The trail will run over three and a half years.

One mum's experience

We spoke to mum Jackie Dewdney, whose son suffers from Erb’s Palsy as a result of a difficult birth. Jackie explains how her son Samuel weighed 9lb 14oz when he was born – which is much bigger than expected.

‘About three hours into labour in the last 20 minutes I knew there were problems when the midwife said he was ‘turtling’ that is his head had delivered but his shoulder was stuck and as a result his head disappeared back into my pelvis

‘My contractions had failed so I needed help to get Samuel out. I heard a nurse shout ‘press the emergency button’ and I was surrounded by medical staff who were manually trying to remove Samuel. To get Samuel out I had to endure the agony of a double episiotomy - that is I was cut twice to release him. And due to advanced stage of labour it was too late to give me an anaesthetic so I had just gas and air. My husband Adrian who was present said I gave out huge scream and I think I passed out due to the pain.

‘Now aged 13 Samuel still has the condition which has affected the nerves in his shoulder. He is due an assessment soon in Leeds and there is the chance of an operation that will allow him to use his wrist with more ease. It takes Samuel longer than other children to perform everyday tasks such as getting dressed and he has to take written exams via computer as he has difficulty using a pen. Other problems include cutting up food and putting on a clip-on tie.’

‘When I heard the study was to take place I was ecstatic because it meant someone was taking this condition seriously and looking into ways of preventing other mums going through the traumatic labour I went through. Even if this study prevents just one woman going through what I have it will be worth it.’

Read next: The early signs of labour to look out for

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1) Your waters break

Otherwise known as the moment the sac of amniotic fluid surrounding your baby ruptures.

This can happen as an all-in-one gush, or a slow trickle that lasts a few days.
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2) Heartburn relief

As your bump grows, your baby will push your stomach upwards.

This forces acid in your stomach into your oesophagus, causing heartburn.

In the weeks before giving birth, your baby will drop down into your pelvis, which means you might finally get some relief. 
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3) You have backache

An ache in your lower back can mean your baby is rotating into the right position for labour.

This can take a few days and might be painful. Put your feet up, ask your partner for a backrub and take a hot bath to relieve symptoms. 
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4) You have a ‘show’

A mucus plug covers your cervix in pregnancy and this may come loose up to a few days before labour starts.

A brown, pink or red-tinged stringy or jelly-like discharge, it can come out either in one lump or more gradually over a few days.
Early labour signs Expand Image Early labour signs

5) Your nipples leak

This can happen throughout the final few weeks of pregnancy, but you might notice it more in the last few weeks before your baby arrives.

The milk you’re leaking is colostrum, a nutrient-rich liquid that will nourish your baby until your proper milk comes in a couple of days after the birth. 
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6) Diarrhoea

The hormones that help your uterus contract can also sometimes cause diarrhoea in the hours before birth.
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7) Swollen down below

As your baby moves down into your pelvis, usually around week 37, the increased blow flow to this area can leave your vagina feeling swollen.

This is very normal and nothing to worry about, however if you are uncomfortable, try placing an ice pack in a tea towel and resting it on the area.
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8) Frequent toilet stops

One you're probably used to by now, as your growing bump has been pressing on your bladder for the last few months, but expect those toilet trips to increase in the last few weeks of pregnancy as your baby moves into your pelvis. 
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9) Sudden burst of energy

It's not one many women complain about, but it's usual to feel a sudden burst of energy those few days before labour stars.

Make the most of it while you can! 
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10) Walking differently

As your pelvis widens to get ready for birth, this can often affect the way you walk
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11) Contractions

The first thing to be sure of is that these are not Braxton Hicks, which feel like period pains and will come and go, or contractions, where the pain will get more intense and for longer as time goes on.

Remember you don't always have to go to hospital as soon as the contractions start - established labour is usually when you have three, one-minute contractions in the space of 10 minutes.

That said, always ring your midwife if you are unsure. 


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