Remember my popular Episode 29 on big babies from five years ago? Today I'm diving into what's changed since then, spurred by Warwick University's Big Baby trial, new research examining whether early induction truly prevents complications in pregnancies where scans predict larger babies.

The most startling revelation? A whopping 60% of babies predicted to be above the 90th centile weren't actually that large at birth. This  margin of error should give us serious pause when recommending interventions based on third-trimester scans. 
What also troubled me was the study design itself. The "standard care" group still saw about 75% of women receiving some form of intervention rather than experiencing spontaneous labour. With only six days average difference in delivery timing between groups, is there really enough distinction to draw meaningful conclusions? The recorded times between head and body delivery (just over one minute in both groups) further suggests we might be rushing physiological processes unnecessarily.

For pregnant women hearing "your baby might be big," take these predictions with healthy skepticism. Having a larger baby doesn't automatically mean a difficult birth lies ahead. For healthcare providers, perhaps it's time we questioned whether we've trapped ourselves in a cycle of intervention based on imprecise predictions and exaggerated risks.

Listen to this update alongside my original Episode 29 Big baby and episode 102 Shoulder Dystocia. Subscribe, rate, and share if you found this valuable!

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00162-X/fulltext

Thank you all for listening, My name is Florence Wilcock I am an NHS doctor working as an obstetrician, specialising in the care of both mother and baby during pregnancy and birth. If you have enjoyed my podcast please do continue to subscribe, rate, review and recommend my podcast on your podcast provider.
If you have found my ideas helpful whilst expecting your baby or working in maternity care please spread the word & help theobspod reach other parents or staff who may be interested in exploring all things pregnancy and birth.
Keeping my podcast running without ads or sponsorship is important to me. I want to keep it free and accessible to all but it costs me a small amount each month to maintain and keep the episodes live, if you wish to contribute anything to support theobspod please head over to my buy me a coffee page https://bmc.link/theobspodV any donation very gratefully received however small.
Its easy to explore my back catalogue of episodes here https://padlet.com/WhoseShoes/TheObsPod I have a wide range of topics that may help you make decisions for yourself and your baby during pregnancy as well as some more reflective episodes on life as a doctor.
If you want to get in touch to suggest topics, I love to hear your thoughts and ideas. You can find out more about me on Twitter @FWmaternity & @TheObsPod as well as Instagram @TheObsPod and e...