Is there a difference between just having a big baby and a baby growing too fast?

It is rare that a baby grows "too fast" although if a patient has diabetes, we of course worry about the baby being too big.

The most important question is to find out what the percentile growth is on ultrasound. In other words, is the baby's growth greater than the 90th or 95th percentile?

When they measure a baby, they look at the circumference around the belly as well as the measurement of the head and leg. In situations where the baby is big because of diabetes, the measurement around the belly will be greater than the other measurements. The percentile I mentioned usually is automatically calculated with most ultrasounds.

Is my baby too large? Will I need a c-section?

My stomach is measuring large. The doctor said it was 30 and it should be 24 at this point. Is this something I should be worried about? Will I need a c-section?

What you are speaking of the fundal height. This is where the doctor uses a tape measure to assess the baby's weight and size.

The centimeters on the tape measure equals the number of weeks that the patient is pregnant. The measurement can be greater if there is extra fluid or it's a big baby. If a baby is large at term, an ultrasound can be performed to estimate the fetal weight. However, even with the best doctor and ultrasound machine, this weight can be off about 15 percent (over or under). This is why we don't like to do a c-section because what you think will be a big baby is actually a normal baby and the patient had surgery for no reason. In fact, the baby's size alone should not determine a c-section. I have seen 10- to 12-pound babies slide out without a problem and 6-pound babies get wedged in the pelvis. The odds that the patient will have to have a c-section are about one in four.

The average weight for babies in our country at term is 7 1/2 pounds. So much of it depends on the type of pelvis the woman has, which of course is inherited. Certain races or ethnic groups are more likely to have c-sections than others. In my practice, I have found that asking the patient's mother, grandmother, sister, or aunt has provided a lot of information. Labor patterns tend to be similar within families.

Can intense fetal movement can cause internal injury?

I'm eight months pregnant with what I think will be a quarterback! Sometimes my baby kicks me so hard it takes my breath away. Once I even felt sore the next morning from a kick. Could my baby actually cause me internal injury from kicking?

Patients are always concerned about their baby's movement patterns. I have had patients tell me that the baby is moving "too much." Actually, this is a good thing! Happy babies inside the womb love to move (that's when they aren't napping, which usually lasts up to 45 minutes at a time).

Some women are more sensitive to movement than others and this movement can cause discomfort in the mother. Fortunately, fetal movement can't cause damage to your internal organs or ribs--it just feels that way!

What does the Doppler monitor do? What am I listening to?

The Doppler monitor showed two different sounds in the womb. Can you tell me what these different sounds are?

Using the Doppler machine, which looks like a small microphone, we can usually hear the heartbeat by 12 weeks. Of course, we can see it about six weeks before this with ultrasound.

To hear the baby's heartbeat with a stethoscope is usually more difficult and doesn't normally work until the third trimester.

The two different sounds that you hear on the Doppler most likely are the actual baby's heartbeat and your heartbeat, which is about half the rate of the baby's.

Also keep in mind that the sound you hear varies depending on where the doctor places the monitor. In other words, if the monitor is placed directly over the baby's heart, you will hear a cloppity-clop sound, like horse hooves. If the monitor is placed over the umbilical cord, you will hear a swoosh-swoosh sound. Both of these sounds are normal.

The only way to accurately diagnose twins is by ultrasound.