One of the pet peeves I have as an Ob/Gyn is when patients come in inappropriately worried and fretting over something a friend, family member or stranger told them. There are usually two main things that inspire their worry: Either, “You look too small/big to be as far along as you are,” or the dreaded— “Oh honey, you’ve definitely dropped.”
So I’m going to discuss the phenomenon of dropping here. My ultimate goal is twofold:
- For people to stop making ANY commentary about how a pregnant woman looks and,
- For people to collectively alter how they think about “dropping”.
Why? When telling a pregnant woman she looks huge, about to pop, that she looks like she is carrying twins or that she is way too small for her gestational age, it makes her feel uncertainty and angst all because of some subjective blather that has no medical substantiation.
Look at any pregnancy photo gallery website and you’ll see that every one of us carries babies differently and looks different at different gestational ages. Just because a woman looks large, doesn’t mean her baby is 15 pounds. This may be her 2nd or 3rd pregnancy, in which case, it’s predictable that the uterus will shift outward more quickly and they may appear more pregnant, earlier on.
Other times, people can look minimally pregnant just based on their body type, even when their sweet in-utero-parasite is growing just right. Comments about fetal and maternal size only serve to make a mom worry: What if there’s something wrong? What if my baby is too big/too small? When can I find out if everything is OK?!?! The cyclone of worried thoughts gets set off so easily in a pregnancy. Commentary would be best limited to things like, “How are you feeling? You look great!”
So, regarding dropping, the same cyclone of angst gets initiated. What I see is this— my patient is worried. Wringing her hands or faking being calm, my patient says, “so umm, do you think I’ve dropped? I saw so and so the other day and she and 17 other people all told me that the baby has dropped.”
Dropping or “lightening” refers to a baby moving a bit lower in the pelvic canal. As the baby settles into the pelvic canal, this can sometimes be visually appreciated with the top of someone’s uterus (the fundus) looking like it’s farther from someone’s breasts. This can make women feel like they need to pee more and simultaneously feel like they can breathe more easily.
Dropping carries no predictive value. It’s not a signal of labor or any positive or negative outcomes. Similar to a mucus plug, which can happen hours or weeks before delivery, dropping or lightening can also happen hours or weeks before delivery. Let me repeat, dropping carries no predictive value.
Imbuing “dropping” with as much meaning as the random strangers at the shoe store will have you think it has, is problematic. It’s akin to someone reading their friend’s horoscope in the Onion, calling them up, with a furrowed brow, pursed lips, stressed tone of voice, and saying, “you saw your horoscope, RIGHT? You know what that means, RIGHT?”
The logical reply is, to thank this well meaning friend for their magical thoughts and concerns, and to go about your life without a second thought toward checking the Onion’s sarcastic words of wisdom.
Just as the horoscope is not predictive of anything with any certainty, nether is your mucus plug, your cervical dilation or your dropped baby. Isolated from the larger context of labor, they are small pieces to the puzzle that make up the pregnancy experience, but they don’t mean anything in particular.
However, in contrast, when you have the combination of a strong contractions every 5 minutes for an hour, +/- breaking your bag of water, +/-a bunch of mucus comes out, +/- your baby feels lower in your pelvis, you definitely could be in labor or heading that direction soon.
So, let this be a PSA for the world: If someone tells you that you or your baby have dropped, pay them no mind, smile, say “Thanks, you’re right!” and don’t let it bug you. If you are tempted to tell a pregnant woman that her baby has dropped, please take a deep breath, count to 50 and come up with something else to say. “You look great, how’s it going?” is almost always appropriate.