Should I Be Induced Because My Baby is "Small"?
Understanding What "Small" Means, the Evidence Behind Induction, and Your Options
It can be worrying to hear that your baby might be “too small.” When this happens, many parents are offered induction of labour to reduce the risk of stillbirth or other complications. But what does “small” really mean? And is induction always the best or only option?
Let’s explore what the evidence tells us—and how you can make an informed decision that feels right for you and your baby.
📉 What Is a “Small” Baby?
In the UK, the term suspected small for gestational age (SGA) is usually used when your baby’s estimated weight falls below the 10th percentile for their gestational age. If the baby is below the 3rd percentile, or there are concerns about growth slowing down significantly, this might be labelled as fetal growth restriction (FGR).
These assessments are often made using growth scans and customised growth charts (like GROW charts), which take into account factors such as your height, weight, ethnicity, and number of previous babies.
📏 How Accurate Are Growth Scans?
Just like with big babies, estimated weights from scans can be off by 10–20% in either direction. A baby suspected of being “too small” might actually be perfectly average—and vice versa.
It’s also worth noting that some babies are small simply because that’s their normal. Just like adults, babies come in all shapes and sizes.
🚨 When Is It a Concern?
There is a difference between a constitutionally small baby (healthy but petite) and a baby who is not growing well due to problems with the placenta, which can restrict oxygen and nutrient supply.
Doctors might suggest induction if:
Blood flow from the placenta is abnormal (measured by Doppler scan).
Baby’s growth has significantly slowed over time.
Amniotic fluid is low.
Baby’s movements have changed or decreased.
In these cases, close monitoring is crucial—and sometimes induction is medically advised for safety.
✅ Possible Pros of Induction for Suspected Small Baby
May reduce the risk of stillbirth in true cases of growth restriction.
Allows early intervention if there are signs the placenta is not functioning well.
Gives a clear plan if monitoring is causing anxiety.
❌ Cons of Induction for Suspected Small Baby
Increased risk of interventions, including assisted birth or caesarean.
Premature birth if dates or growth are not accurately assessed.
Emotional stress from being told your baby may be in danger, even when that’s not certain.
Potential separation at birth if baby needs neonatal support (even if they’re actually perfectly healthy).
💬 Questions to Ask Your Care Provider
How confident are we in the growth estimate?
Are there any signs of placental problems (e.g. abnormal Dopplers)?
Can we continue monitoring with scans and CTGs instead of inducing now?
Is my baby small and well or small and unwell?
What are the risks of waiting compared to the risks of induction?
🧘♀️ What Are My Options?
If your baby is suspected to be small but otherwise healthy, you may be offered:
Regular monitoring (scans, Dopplers, CTGs)
Daily movement awareness—your baby’s movements are a key indicator of wellbeing
Individualised care planning—working with your team to decide the best course, based on your pregnancy
You also have the right to decline induction and request more frequent monitoring instead. Shared decision-making is your right.
🌿 Trust in Your Body, Trust in Your Baby
Being told your baby is small can feel scary—but remember, many small babies are born completely healthy. If there are no signs of fetal distress or placental issues, waiting for labour to begin naturally may be just as safe—and lead to a more positive birth experience.
Every pregnancy is different, and every baby has their own growth story. You deserve a care plan that reflects that.
Need support navigating a suspected SGA diagnosis?
Reach out for a one-to-one session or join our birth preparation classes to learn more about your options and rights during pregnancy and birth. You are not alone—and you have choices. 💛