Pregnancy over 42 weeks - what are the risks?

[LorenaAZ]

Does anyone know the specific problems that develop when gestation goes over 42 weeks? I know 1 is placenta aging - how does that affect the baby? Is that the only issue that crops up and then has different ways of affecting the baby? Or are there other problems that increase in frequency after the 42nd week?

Has anyone gone over 42 weeks and had healthy babies here? My dr wants to induce and I still want my homebirth. Baby and I are both completely healthy.

[JamieCatheryn]

Sometimes the reason babies aren't born in the typical timeframe is that they have problems already, and it's not that going late caused a problem. Then in labor they go into distress of some form, or pass away. That's the main cause of the poor statistics on postdates babies I'm almost certain. Yes sometimes placentas start to calcify or not work as well also. Babes are more likely to pass meconium before birth if they are "late", that's not much of an issue though. Usually going late is just because individual kids just take longer to finish up in the womb. It's more of a CYA issue for health care providers than an issue of saving anybody from anything.

[FiveLittleMonkeys]

My first was finally induced at 42+4 days. She was a perfect baby in every way, other than there was a little meconium when my water broke. My midwife currently has a policy of letting women go until 43 weeks if everything else looks good.

Things that can happen postdates - placenta aging, so the baby isn't getting enough nutrients and oxygen, decreased fluid - which if severe enough can cause cord compression.

Have you had a biophysical profile and NST? Those were my OB (with my first baby) and my midwife currently recommendations after 40 or 41 weeks. With reassurance from those, your OB might feel a little bit better about waiting to induce.

Good luck!

[Mommy StormRaven]

I totally understand that you really want your homebirth but honestly there are risks with postdate babies. Some significant.

As an example one of the moms on this board recently got irate enough with her OB who wanted to induce at 42 weeks (becuase she didnt' want it) that she fired her OB. Found a homebirth midwife - her NST's had all been fine as well as her BPP's too. Well long story short - she got to the point in herr homebirth that she wanted to transfer for pain meds, lost fetal heart tones in transit and had a stillbirth.

I wouldnt' wish tha ton anyone - homebirth is wonderful but when it comes to postdates I'd much rather be safe than sorry. Just because you cant' detect it does not mean that there isnt' a problem lingering somewhere you cant' see it.

[tak]

The three things that pop into my head are:

1)deteriorating placenta
2)unsafe drop in amniotic fluid levels = traumatic birth & potential cord compression
3)extremely large baby = increased risk of shoulder dystocia & c-section

All of these have pretty ugly consequences.

[DreamsInDigital]

Originally Posted by Mommy StormRaven

I totally understand that you really want your homebirth but honestly there are risks with postdate babies. Some significant.

As an example one of the moms on this board recently got irate enough with her OB who wanted to induce at 42 weeks (becuase she didnt' want it) that she fired her OB. Found a homebirth midwife - her NST's had all been fine as well as her BPP's too. Well long story short - she got to the point in herr homebirth that she wanted to transfer for pain meds, lost fetal heart tones in transit and had a stillbirth.

I wouldnt' wish tha ton anyone - homebirth is wonderful but when it comes to postdates I'd much rather be safe than sorry. Just because you cant' detect it does not mean that there isnt' a problem lingering somewhere you cant' see it.

The rate of stillbirth goes up dramatically at 42 weeks. I would not personally feel comfortable continuing a pregnancy beyond 42 weeks and 1 day, which is when my 3rd son was born. He was fine, but I sure as heck couldn't live with myself if one of my babies was not fine. I was actually planning on going to the hospital for an induction that night, but he was born early that morning.

[TopHat]

I UCed a baby at 43 weeks. 8.5 pounds very healthy.

There's an "overdue" thread here: http://www.mothering.com/discussions...7#post13028337

[bri276]

how sure of your dates are you? sometimes 42 wks is actually 41. I had a 41w1 day baby with kind of a lot of vernix and even some languno

[Full Heart]

All mine were 42 weeks and beyond. All but 1 was a hb. All were perfectly healthy. There is tons of good info around here, check over on the birth and beyond forum I know there has been lots of threads about this.

I do not believe that the risk of still birth increases dramatically. From the reading I have done typical stillbirth rate at 40 weeks is 2-3 where in post dates its 4-7 in 1000. But stillbirth increases starting at 38 weeks. 42 weeks is not the magic time at which still birth begins to increase. Stillbirth at 40 weeks is higher than 39 and 39 higher than at 38.

[mwright]

Baby's come when baby's are GOOD and READY. I would go with your gut and know that you and baby are healthy and let baby pick his birthday. Any kind of induction is an intervention that can lead to the next and it just dog piles, and there are many risks that come with that path.. Trust your body, trust your baby to come when he is ready. I'm not sure what the percentages are with post dates and still birth but I remember it being extremely low. You wont be pregnant forever and you may want to head over to the UC forum for some support on this.

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[LorenaAZ]

Thank you ladies!! I was hoping to get some positive feedback and I did! : I'm heading over to read about all those "over due" babies on the other thread.
Going to the dr today for a NST to stay on top of things. I also think my due date may be off by a as much as 4 - 5 days. I always had 28 day cycles and the cycle before I became pregnant was 32 days. My EDD was based on a 28 day cycle.

[Mommy StormRaven]

PLEASE read this thread Can my OB fire me?

This is the thread the mom I mentioned started back in October.

[Malva]

There is very little research on pregnancy over 42 weeks and what there is probably can't be trusted because of small sample size. Get monitored frequently, trust your body and you should be fine.

[Jilian]

Personally I'm one of the people not comfortable going past 42 weeks. It feels too risky for me. With that being said, I chart so I know my exact due date - if I were not positive I may think differently. I'd start to get nervous around 41 weeks and start natural induction methods (EPO, sex, nip stim, castor oil) and likely even move on to less natural methods closer to 42 weeks (cohoshes, stripping membranes, and possibly even pitocin if my bishop score was favorable). Just my opinion thought and I respect women who feel otherwise. The risks of distress, placenta breakdown, dystocia, and cord compression feel too risky to me.

Unfortunately I've seen post-date loss happen to a few people close to me, one of those people being my own mother.

[tofutti]

i went 42 weeks and a day.......but i had to be induced anyway which did indeed lead to a lot of crap like water breaking by the doc, leading to fever (iv antibiotics), pitocin leading to crazy pain and unwanted epidural and not being allowed to move, eat or shower. on the plus side i had a fairly quick vag. birth and a super healthy kid. 9 pounds. placenta looked good. he had low blood sugar and needed some formula at first (and tons of blood tests argh) which felt like the end of the world but made no difference in the end, either, he went on to a stellar nursing career that continues to this day

looking back i think i made way too big of a deal about (not wanting to be) induced, including fights with my OB. lots of worry and drama. now i think its better to err on the side of caution.

this time i would go a bit under 42 weeks for my own sanity/peace of mind.

[bemommy]

I agreed to an induction with my first at 10 days "postdate" . There was some calcification of my placenta but more troublesome was my extremely low amniotic fluid level (so low that there was not a pocket large enough to measure). Thankfully it ended up a quick, uneventful, and otherwise unmedicated birth. It was worrisome at the time.

[NaturalMindedMomma]

Originally Posted by tak

The three things that pop into my head are:

1)deteriorating placenta
2)unsafe drop in amniotic fluid levels = traumatic birth & potential cord compression
3)extremely large baby = increased risk of shoulder dystocia & c-section

All of these have pretty ugly consequences.

Whats an extremely large baby? Mommy's grow babys the right size. Shoulder Dystocia is rarely a complication that NEEDS a C section. In the hospital, Dr's may feel it is undignified to have a butt in their face, but turning over on all fours almost always solves shoulder dystocia.

Where have you seen "pretty ugly consequences" with shoudler dystocia? Most likely hospital births. Physicians are so busy inducing that a baby over 7 lbs is HUGE and you need a C section. That's sad.

[NaturalMindedMomma]

My mom carried me to 45 weeks and my bro to 44. We came out at 7 lbs with no signs of being late. Imagine is they induced her?


I'm a big believer in baby's come when ready. That said, I am not sure how comfortable I would personally be going much over 42 weeks. I would be getting screened and I may agree to an induction at that point anyway. It all goes to what you are comfy with really.

[SquishyBuggles]

I had to be induced at 42 weeks due to extremely low levels of amniotic fluid. If it had just been at the cusp of it I would have gone longer, but my levels were super, super low so I had the induction. Really, all they did was break my water and labor started immediately.

[tak]

Originally Posted by NaturalMindedMomma

Whats an extremely large baby? Mommy's grow babys the right size. Shoulder Dystocia is rarely a complication that NEEDS a C section. In the hospital, Dr's may feel it is undignified to have a butt in their face, but turning over on all fours almost always solves shoulder dystocia.

Where have you seen "pretty ugly consequences" with shoudler dystocia? Most likely hospital births. Physicians are so busy inducing that a baby over 7 lbs is HUGE and you need a C section. That's sad.

My sister's baby was over 10 pounds, his head got stuck after over 3 hours of pushing, he went into distress and pooped in utero, ended up in ICU for a week and my sister hemmorhaged for 4 hours after the c-section. It was not an ideal birth situation.

Shoulder dystocia -- friend's stepmom had a baby die during birth. It wasn't a hospital birth.

My doctor, and most doctors I know in Canada, would NEVER say a baby over 7 pounds is large. That's actually on the small side of average. And not all moms grow babies the perfect size to deliver vaginally. There are always exceptions.