Big, small, round or even
pointed – pregnant bellies
come in all shapes and sizes.
Melissa Especkerman looks
at what it reveals about
your growing baby.

Available in all shapes and sizes – that is one way to appropriately describe any pregnant belly. Just take a look around you when you're out and notice just how different each baby bump is. Some are small and oh-so-cute while some are so huge that you can't help but wonder how any woman could bear all that additional weight. It's truly amazing.

With the many tummies and their mummies making their appearance everywhere you go – from around the neighbourhood and shopping malls to the big screens and pages of magazines – it might be a little daunting. And especially when they're all different, it begs the question – is your baby bump too big, too small or even the wrong shape? It's perfectly normal to wonder and chances are your bump is fine. After all, not only are baby bumps different from women to women but pregnancy-to-pregnancy as well. Dr Anita Kale, associate consultant at the Department of Obstetrics & Gynaecology, National University Hospital says, "The shape of the pregnant belly depends on the tone of the mother's abdominal muscles, the size of the foetus, the position of the foetus, the number of foetuses and the amount of fluid around the foetus among other factors." With all these factors playing a part, each pregnant belly is bound to be different.

Adds Dr Tan Thiam Chye, consultant at the Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, "Another contributing factor could be the pelvis cavity of the mother. A deep and broad pelvis can accommodate the baby so well that the bump can look smaller." Your weight plays a part as well in determining the size of your bump. "If the mother were overweight, she would be able to hide the

pregnancy bump better compared to a thin mother. Many unsuspected pregnancies occur in mothers who are obese and who may also have infrequent irregular periods," says Dr Lai Fon-Min, obstetrician and gynaecologist in private practice at Camden Medical Centre. And if you're carrying twins or even triplets, your bump may become much larger towards the end of your pregnancy.

Get In Shape

Ever heard the old wives' tale that you can tell the sex of the baby by looking at the mum's tummy? As long as you're pregnant you're probably subjected to many a discussion on what your bump reveals about the sex of your little bub. According to the superstitious, they believe that if you carrying low and out in front, you're expecting a boy and if your belly is high and wide, you can expect a baby girl. There is however, no medical proof of this.

But what could affect the shape of your growing belly is how your baby is lying. Adds Dr Lai, "If the baby is lying transversely (horizontally) because of obstruction of the birth canal from a low-lying placenta, the abdomen would be wider sideways. Also, if the baby's spine is lying next to the mother's spine, the lower portion the mother's belly would

be more exaggerated compared to the baby's spine lying next to the mother's abdominal wall." Does Size Matter? If you're still wondering if there is a right size for your bump to be, well, while there isn't a right size, the uterus or womb should expand in accordance with the baby's gestation. To assess if your baby is developing normally, the bump may be measured longitudinally from the bottom of the pregnant belly at the pubic bone area, to the top of the pregnant belly and this should correspond to the gestation. "This length is also called the symphysis- fundal height (SFH) and when measured in centimeters, it should correspond to the number of weeks' gestation," says Dr Kelly Loi,

obstetrician and gynaecologist at the Health and Fertility Centre for Women. That means when your baby is at 24 weeks of gestation, the symphysis- fundal should be about 24cm and this length should increase with each passing week and should not differ by more than one to three centimeters.

Sometimes a baby could be smaller or bigger than expected and this could be due to a number of reasons. For example, a big bump can be due to excessive fluid around the baby, a condition known as polyhydramnios. "Similarly, a smaller than expected bump may be due to growth restricted foetus or reduced liquor volume," says Dr Kale.

Babies who are big for their gestation age are known as large-for-date babies. Likewise small-for-date babies are those on the opposite end of the spectrum. If the symphysis- fundal length is shorter than what it is supposed to be, it could just be a miscalculation of your due date. An ultrasound would be able to

re-confirm your due date and rule out any possible problems. Most of the time, there will not be anything wrong. Your baby may just be small but is developing well.

Small-for-date babies develop more slowly for a number of reasons. It may be due to the mum's lifestyle, weight or any illness she might have. Dr Tan says, "Small-for-date babies could be because of the parents' genes or even medical conditions, such as certain viral infections, poor nutrition of mums or placental insufficiency to deliver the nutrients." These factors could lead to an increase in the likelihood of having a small-for-date baby.

Again, with large-for-date babies, an ultrasound will be carried out to find out any possible reasons your baby may be bigger than he should be, and as having a large-for-date baby sometimes points to gestational diabetes, you may also be tested for it.

When this happens, both mums-to-be and their unborn babies will also have to be closely monitored. And that's not all. Careful planning of the time and mode of delivery is needed as well.

What It All Means

With large-for-date babies, there might be a probability that you will need to have a caesarean section because of the disproportion between the size of the mum's pelvis and the baby's head. In many of the cases, there might be a need to induce labour. And thus, the premature baby may need special care regardless of his large size.

And even with a small-for-date baby, it is possible to improve your baby's growth but changes need to be made. Engage in a healthy lifestyle and give your baby a chance to catch up. And even if it is an illness related problem, eat well and rest well, and with safe

treatment, you could improve foetal growth. Mother of one, Jolene Tay remembers what it was like to have a big bump. "For the longest time, my bump was hardly noticeable. In fact, I was never one of those pregnant women that had the opportunity to be offered a seat on the train or bus. That was how small my bump was!" says the petite mum.

However, once she hit her seventh month mark, her bump along with her baby grew so much and so fast that her gynaecologist was worried. She even talked about having a caesarean section. "My gynaecologist was worried that my baby would not be able to fit through the birth canal and we discussed that I might have to go under the knife instead."

But Jolene was determined to have a natural birth and when it was time to push, she delivered her healthy baby boy the way she had planned – naturally – all 3.815 kilograms of him.

Baby Weight

Some women gain 10 kilograms while others gain as much as 20 over kilograms. But what exactly is the optimal weight to gain during pregnancy, without putting both you and your baby at risk? "A woman of average weight experiencing an average pregnancy, ought to gain an average of 10 – 13 kg in the total 40 weeks' gestation," says Dr Lai. And all that weight you put on is made up of more than just baby and all that you have been eating. About three to four kilograms goes to the weight of your baby at full term and about seven to nine kilograms is made of the baby's support system, which is composed of the placenta, amniotic fluid, increased blood, fluid, fat and breast tissue. Here's a look at your expected weight gain as measured by your Body Mass Index (BMI) before pregnancy. To calculate your BMI, use this simple formula:

BMI = weight before pregnancy (kg)/ Height2 (m). The following expected weight gain for various BMI is shown below:

BMI Expected Total Weight Gain (during pregnancy)

< 20 12 to 18 kg 20 – 24.9 11 to 15 kg 25 – 29.9 6 to 11 kg > 30 6 to 9 kg

"However, the exact weight gain may be difficult to control because of different levels of water retention for different mothers. Hence, women should focus more on eating healthily and getting all the right vitamins and minerals in the diet rather than the weight gain," advises Dr Loi. So it doesn't matter if your bump is bigger or smaller than a friend's or even if it's different in shape. What really matters is that both baby and you are healthy. In the meantime, enjoy this bump in your life!