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What happens when a doctor predicts the wrong birth weight?

My article last week about birth weight predictions and the impact they have on childbirth generated a lively online discussion, drawing responses from over 1,100 mothers with a wide variety of birth experiences.

Many women identified with Katy Clemens, the mother I interviewed for the article who said she felt “bullied” to have a planned cesarean after doctors inaccurately predicted she was carrying a large baby.

Emily Malstrom said her doctor also pressured her into having a planned C-section after a scan predicted a 10-pound baby. The doctor “told me my baby could die, used every scare tactic out there,” Ms. Malstrom said.

Chandra Dash, a Baltimore mother, whose baby was predicted to weigh 9 pounds, said doctors told her “I would probably kill my baby if I tried a natural birth.”

Alexandra Harper of Northampton, Mass., said her doctor determined the baby would be larger than expected while she was in labor. She recalled being told “they would only give me 30 more minutes to try and push the baby out and then I would have to get a section. They didn’t present it as a choice to me.”

She had a cesarean, and the baby was of average size, she said.

Doctors pressuring – and even threatening — patients to convince them to agree to a cesarean was a common and troubling theme among our reader comments.

“Doctor insisted on Cesarean or neither he nor anyone in his practice would assist in delivery,” said Andy Francke, of San Jose, Calif., who was told her baby would weigh 12 to 15 pounds, though the baby weighed just under 10 pounds.

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Emily from Alabama said her doctor encouraged her to take medication during the delivery “to make it easier on everyone.”

When she refused, she said that he told her, “All those little tombstones in the graveyards are from women who didn’t listen to their doctors.”

Another mother whose baby was predicted to be large said her doctor “described in detail how my baby could die and be injured and scared me into a C-section.” While she was trying to deliver vaginally, he told her his shift was almost over “and he was getting tired so I should choose now or he would be worn out.”

Despite those troubling stories, many women also described frightening complications that occurred because ultrasound had inaccurately predicted a lower birth weight baby.

“My son and I almost died,” said Gena McGuire, now of New Haven, Conn., who delivered an 11-pound baby vaginally after an “agonizing” 36 hours of labor. She had been told the baby would weigh 8 pounds, though she gained an enormous amount of weight during her pregnancy and believes she may have had undiagnosed gestational diabetes.

All of the accounts are a reminder of how varied, precarious and unpredictable childbirth can be.

Some mothers said they had been through several very difficult deliveries and wished they had been offered the option of a cesarean, while a startling number of women recalled resisting pressure from obstetricians to have a cesarean, and successfully delivering babies that were quite large.

A great number of women praised their physicians for supporting their choices. Many put in a good word for midwives who gave them the confidence to have natural vaginal deliveries.

The online conversation about big babies also revealed a deep divide among women on the subjects of C-sections and the value of a natural vaginal birth. While many women regretted consenting to cesareans they felt were unnecessary, others belittled the concerns as “such a first world problem,” as one reader put it.

“C-sections saved two of my babies’ lives and mine. Get over it,” wrote Pam Christman-Greiner.

“Quit acting like having a baby is like buying a designer hand bag,” wrote Susan Pruitt. “Vaginal birth is not the holy grail,” said Elizabeth Charbonneau of Omaha, “You have a baby either way.”

But others, like Susan Moray, a certified midwife, noted that there are risks associated with C-sections. She brought a different perspective to the conversation.

“Women are telling you that they had an experience that did not leave them whole,” she wrote. “They are not you and their experience does not detract from yours. If women cannot listen to other women’s experience, how can we expect medical professionals to do it?”