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Pregnancy over 42 weeks - what are the risks? - Page 2

post #21 of 32
Quote:
Originally Posted by Mommy StormRaven View Post
PLEASE read this thread Can my OB fire me?

This is the thread the mom I mentioned started back in October.
If she had gotten induced, would that have effected the cord being wrapped around the baby's neck? I'm not being snippy, I'm really wondering. I bawled my eyes out at the end of that thread...
post #22 of 32
well said, TAK.

Unfortunately, not every situation is ideal, and you just have to do what you think is best. Have the test run and that should give you some direction on what is safe, and what will work best for you and your baby.

Best of luck, and keep us posted!
post #23 of 32
Quote:
Originally Posted by ihugtrees View Post
If she had gotten induced, would that have effected the cord being wrapped around the baby's neck? I'm not being snippy, I'm really wondering. I bawled my eyes out at the end of that thread...
No. Cord around the neck is very common. About 1 in 4 babies has the cord around the neck at least once. Usually it happens earlier on in the pg when the baby can flip and move more freely. It has nothing to do with being post dates.

Drs have tried to manage shoulder dystocia for years. Nothing they have done has had any positive outcomes. Inducing to prevent a macrosomic baby that might have sd does not work. http://www.shoulderdystociainfo.com/ has some great info about that.
post #24 of 32
Quote:
Originally Posted by ihugtrees View Post
If she had gotten induced, would that have effected the cord being wrapped around the baby's neck? I'm not being snippy, I'm really wondering. I bawled my eyes out at the end of that thread...
There is just no way to know. It may not have been the cord that caused the cessation of heart tones. All of mine have had their cords wrapped twice with no consequence at all.

For me - I wouldn't feel safe going beyond 40 weeks - yes I did say 40 weeks. But that is because I tend to "cook" them fast it seems.

DS was born at 35 weeks and was 9.3lbs - no GD either his lungs wer enot fully mature at the time and his apgars reflected his gestational age.

DD#1 was born at 39 weeks and was 8.14 pounds, DD#2 born at 37 weeks and 8.9 pounds. This baby was 6 pounds - per palpation and ultrasound at 33 weeks and will likely be induced at 37 weeks becuase to be candid I've been on bedrest since 12 weeks and can hardly walk becuase she is already fully engaged and at 0 station. I'm on narcotic painkillers just to be able to get up and walk to the bathroom. No I will not argue with induction early given my current state. I know I can birth big babies, I also knwo I cook them "on high" as someone put it. So I wont' feel comfortable at all going past 40 weeks.
post #25 of 32
I keep thinking about this issue. I don't really know anything about it, but I'm wondering....what are the risks of being induced at 42 weeks, compared to the risks of not being induced? I mean if you're induced at 42 weeks, you know the baby isn't going to be premature right? Aren't you pretty likely to have a healthy baby? Sure you might not get a natural childbirth, but if the choice is between pit and an epi, or even a c-section.....or waiting too long and having a stillbirth....is there really any choice? I'm sorry if this sounds completely ignorant, I'm genuinely curious as to how the risks and benefits compare.
post #26 of 32
Quote:
Originally Posted by Malva View Post
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.
I had some good discussions with my MW about this recently when deciding whether or not to get induced. She worked on a study at Northwestern U in the 80s about post-dates. Mostly the outcomes were fine with meconium being the main problem. I believe the study someone cited on this thread about stillbirth rates came out in 1987 and that is when more and more practitioners stopped "allowing" moms to go past 42 weeks. My MW said they could no longer do studies about post-dates because there just are not enough people going past 42 weeks to constitute a reasonable sample. (I had to sign a waiver to go past 42 weeks with their practice. They have only had 3 people ever sign that waiver in maybe 10 years? The doctors who practice at the same hospital have apparently never had anyone go past 42 weeks? Hard to believe but that is what my MW said)

That said, I think you can only decide for yourself what is best for you. After I signed that waiver I still got induced at 42w2d. Also remember not all inductions are equal, although it is true that all involve intervention. Yes, some practitioners will just hook you up to Pitocin and hope for the best but there are other options to try. I was lucky enough that just Cervadil worked for me (did not need Pitocin) and was able to give birth quickly, easily w/o pain meds.
post #27 of 32
Thread Starter 
Well, we had quite a day today. I don't think the NST machine was working properly at my doctor's office - fetal beats per minute were on the 120s and dr wanted to see more spikes - there were also a lot of blank spots (when baby moved) on the paper. So dr said she didn't like what she saw, that after 40 weeks most babies pass miconium, that my baby may be under distress, the placenta ages, babies no longer get the nourishment they need, fetal death has an extremely sharp rise, etc. My DH panicked. I listened to her wanting to say a lot of things but just nodding on the outside. So she told us to go to the hospital for a NST and a biophysical profile. On the way I told my husband to trust me, that baby was ok. I've had her in me for over 9 months now and could just tell she's perfectly fine. Not to let the dr scare him.

We went out for breakfast and we went to L & D at the hospital. Her NST looked awesome, lots of peaks. My placenta has no calcifications or any signs of aging whatsoever - the ultrasound tech was genuinely surprised to see how healthy it looked, fluid looks perfect, baby's movements were wonderful, and they even measured her diaphragm movements (they were adamant about having her "practice her breathing" or they would take points off). She got a 10/10!!!! : With that info at hand Dr still asked if I wanted an induction (this is the same dr who told me months ago that baby could die in utero if I didn't get a flu vaccine she was pushing at her office, which I declined). I said I'd rather wait and now we're finally home. DH is relieved --- and of course I had to say "I told you so!!" With everything looking so good & healthy I'm really wondering about the accuracy of my due date and also wondering about how many women get induced without really needing to just because they passed the 40 week mark. My Mom is flying back to Spain tomorrow without having met her 1st granddaughter but I am relieved that she is perfectly healthy and that we can give her more of the time that she needs/wants.


Mommas for your support!!
post #28 of 32
Quote:
Originally Posted by Mommy StormRaven View Post
DD#1 was born at 39 weeks and was 8.14 pounds, DD#2 born at 37 weeks and 8.9 pounds. This baby was 6 pounds - per palpation and ultrasound at 33 weeks and will likely be induced at 37 weeks becuase to be candid I've been on bedrest since 12 weeks and can hardly walk becuase she is already fully engaged and at 0 station. I'm on narcotic painkillers just to be able to get up and walk to the bathroom. No I will not argue with induction early given my current state. I know I can birth big babies, I also knwo I cook them "on high" as someone put it. So I wont' feel comfortable at all going past 40 weeks.
Wow. I hope that you are feeling better soon, and best of luck to you.
post #29 of 32
Quote:
after 40 weeks most babies pass miconium

(this is the same dr who told me months ago that baby could die in utero if I didn't get a flu vaccine she was pushing at her office, which I declined).

uh.....are you sure this is the person you want delivering your baby???? I switched from an OB to a CNM at 36 weeks, it's never too late!!

congrats on the great NST and being so calm and collected in the face of fearmongering.
post #30 of 32
Quote:
Originally Posted by musiclady View Post
Wow. I hope that you are feeling better soon, and best of luck to you.

Thanks!
post #31 of 32
Quote:
Originally Posted by liliaceae View Post
I keep thinking about this issue. I don't really know anything about it, but I'm wondering....what are the risks of being induced at 42 weeks, compared to the risks of not being induced? I mean if you're induced at 42 weeks, you know the baby isn't going to be premature right? Aren't you pretty likely to have a healthy baby? Sure you might not get a natural childbirth, but if the choice is between pit and an epi, or even a c-section.....or waiting too long and having a stillbirth....is there really any choice? I'm sorry if this sounds completely ignorant, I'm genuinely curious as to how the risks and benefits compare.
The rise in stillbirth starts at 38 weeks so technically one can argue that the chances of having a c/s is better than the chances of having a stillbirth starting then. That study that just came out about waiting for c/s till 40 weeks was better for the baby and of course some dr had to mention still birth. That waiting till 40 weeks (not over due mind you, just the week of the due date) is not worth the risk of stillbirth. Everyone has to make their own decisions given the information they have and do what they feel comfortable with. Would we fault someone for having an induction or c/s at 38 weeks to avoid a stillbirth? Its not a black and white decision.

To the OP: So glad to hear the bpp looked so good. So sad though your mom has to leave! Thats a bummer! Maybe you will have the baby tonight?!
post #32 of 32
Quote:
Originally Posted by DreamsInDigital View Post
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.
This isn't really true. I'm trying to dig up a study, but what I have on my PC is


Postdates, by itself, is not associated with poor pregnancy outcome. Extreme postdates or postdates in conjunction with poor fetal growth or developmental abnormalities does show an increased risk of stillbirth. But if growth restriction and birth defects are removed, there is no statistical increase in risk until a pregnancy reaches 42 weeks and no significant risk until past 43 weeks. The primary "evidence" of a sharp rise in stillbirth after 40 weeks—often misquoted as "double at 42 weeks and triple at 43 weeks"—seems to come from one study based on data collected in 1958.(1)

The first question one should ask is whether neonatal mortality statistics from the 1950s should be compared to modern statistics, since labor anesthetics and forceps rates were very different. Early labor monitoring was scanty and prenatal monitoring not yet developed. The McClure-Brown report shows a rise in stillbirth from 10/1000 at 40 weeks to about 18/1000 at 42 weeks. Yes, that is nearly double. But think about those numbers. Even the beginning point is nearly ten times the modern mortality rate. Either modern delivery methods are vastly different or something is wrong with the data collection. This study should be updated by research conducted at least in this century! Modern statistics show an almost flat rate of stillbirth from 40 weeks to 42, with a slight rise at 43 weeks (all numbers being close to 1/1000).(2)
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