Are Maternity Measurements Serving You? Finding Balance in Birth Choices

The Impact of Measurements During Pregnancy and Birth: Are they Serving You?

When numbers and charts enter the realm of maternity care, they can shape your pregnancy and birth experience far more than you might expect. We are not machines, and treating our bodies as such—through constant measurements—doesn’t always make sense. Though metrics like growth scans, bump measurements, and CTG readings are offered to track progress, it’s essential to consider how much they truly serve you. After all, pregnancy is a deeply personal journey that extends beyond what can be quantified on a chart.

Why Are These Measurements Offered?

Measurements like maternal weight (BMI), blood platelet or iron levels, growth scans, fundal height measurements (Bump size), vaginal examinations (VEs), and CTGs are routinely offered during pregnancy and labour. They’re tools that healthcare professionals use to monitor well-being, ensuring that both you and your baby are on a path deemed safe and healthy by standard protocols. While these measurements are often well-intentioned and can be helpful, it’s worth understanding that they are not foolproof and might not always be necessary for everyone.

The Potential Impact on Your Choices

Measurements can sometimes lead to unnecessary interventions. For instance, if your bump measurement or a growth scan indicates a size outside the average range, it may prompt recommendations that could limit your options or lead to additional interventions. It’s crucial to recognise that these metrics, while helpful, are not absolutes. By viewing them through the lens of personal relevance, you maintain more control over the choices that impact your birth experience.

Asking the Right Questions

When presented with these measurements, consider whether they serve as a reassurance tool for healthcare professionals alone, or if they genuinely aid in your own decision-making and peace of mind. Will knowing your baby’s estimated weight change how you feel about your birth plan? Does accepting a CTG reading help you feel more informed, or does it add unnecessary stress? By asking these questions, you center your own needs and well-being in the decision-making process.

Navigating Trust and Empowerment

It’s important to remember that this approach doesn’t mean disregarding medical advice or distancing yourself from your healthcare providers. Instead, it’s about fostering a balanced, informed partnership. Healthcare professionals offer valuable expertise, but you are the one who ultimately understands your body and your birth preferences best. By weighing up the relevance of these measurements, you’re actively participating in creating a birth experience that aligns with your priorities.

Is there any evidence to this?

You might be wondering about the evidence supporting the implications of various measurements in maternity care. Here are three examples and supporting information to give you a further idea of what I may be talking about when I say 'unnecessary interventions': Implications of Continuous Cardiotocography (CTG)

Continuous CTG monitoring during labour can lead to increased interventions and potential adverse outcomes. Evidence suggests that over-reliance on CTG can result in unnecessary caesarean sections and negative impacts on maternal and neonatal well-being. For a deeper understanding of the potential risks associated with measuring in this way, refer to this article from Dr Rachel Reed.

Vaginal Examinations

Vaginal examinations, particularly in assessing the 'magical number' of cervical dilation during labour, can contribute to a “cervix-centric” birth culture. This focus is said to sometimes lead to unnecessary interventions, increased anxiety, and can be linked to adverse outcomes, including higher rates of unplanned caesarean sections. For more information, see Dr Rachel Reed's Article and this Evidence Based Birth Article/Podcast.

Fundal Height and Growth Scans

Estimating a baby’s weight through fundal height measurements (a tape measure over the bump) and growth scans - Misestimating fetal size may prompt unnecessary interventions, such as early inductions or caesarean sections, based on inaccurate assumptions. For a more detailed examination of these risks, visit Dr Sara Wickham's blog here.

The Bottom Line

The bottom line is that it’s crucial to remember that everything offered by your midwife, doctor, or other healthcare professional is just that—an offer, not a requirement. When deciding whether to accept these measurements, ask yourself if the answer serves your needs. If it doesn’t, it might not be worth the risk. Your decision should align with your own priorities and comfort, ensuring that you’re making informed choices that feel right for you as an individual.