Macrosomia, literally "big body;" in my world, babies over 9 lb at birth (greater than 90th %ile). B. delivered a "macrosomic" baby two years ago, 9 lb 15 oz. Uncomplicated vaginal birth. Concerned that a second child might be larger, an ultrasound was obtained yesterday, two weeks before her due date. Estimated fetal weight: 5000 grams, or about 11 lb. For most babies, the head is larger than the shoulders so once the head delivers, the baby slides out. But macrosomic babies may have larger shoulders that get stuck, an obstetrician's nightmare: injured nerves, fractured clavicle, paralyzed arms, stillbirth; I've seen them all. 
So one of my partners, who herself underwent two uncomplicated Cesarean births, gave her the option of skipping labor, going straight that same day to the operating room for a Cesarean delivery. She said yes. I was on call and delivered a 10lb 5oz baby boy. Would this baby have safely made it through the birth canal? Probably. Would I have counseled her differently? Probably. Would she still have chosen an elective Cesarean? ... Probably.
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