Would you fudge your lmp?

[FoxintheSnow]

I always go late. Last time I went a couple days past 42 weeks. My babies just take longer to cook. Legally at the birth center I risk out at 42 weeks. Should I fudge my lmp by a couple days just give myself a couple days wiggle room? My midwife says they do nst starting at 41 weeks every 3 days, so they will be on top of things. Ive only had a consult and havent given her my lmp yet.

[laylasmomplus1]

I would.

I know my cycle is 35 days instead of the 'usual' 28 so I ovulate later and therefore need a few extra days. I started my first pregnancy at a Birth Center and they took it into consideration and adjusted it for me. When I had to transfer to an OB because of my BP I told them the adjusted LMP that my midwife had given me. Thankfully I did because they had to induce me at 35 weeks and if I hadn't adjusted it my daughter would have been born when she was only 34 weeks along. 

[WifeofAnt]

I fudge mine to match day 14 with my ovulation date (ovulated on day 21 for this LO).  I don't know if I'd fudge it any further than that though.

[jeminijad]

I would adjust the info on LMP to reflect an accurate date of ovulation, and avoid the dread Wheel Of 28 Days For All.

I wouldn't do it for long gestation, however... not going over 42 weeks is one of the few things I will happily comply with an MD on.

[Cheshire]

If it were me I wouldn't fudge it - it's not fair to them to not have accurate information to base your and your baby's care on. 

[MegBoz]

Quote:

Originally Posted by FoxintheSnow 

I always go late. Last time I went a couple days past 42 weeks. My babies just take longer to cook. Legally at the birth center I risk out at 42 weeks.

Given those 2 issues, absolutely, definitely I would fudge!

I'm personally planning an HB with a CPM (CPMs are illegal here in Maryland, although my MW is both legal & licensed in neighboring Virginia. So stupid!) So there are no specific "restrictions" on her practice. No hard-and-fast "Rules." So I was honest with her. She didn't question me when I told her my LMP, but told her I KNEW conception occurred on day 22 of that cycle.

But if I was birthing at the birth center (and the only FSBC in our area also risks you out at 42 weeks) and I had any doubt about my HCPs trusting me that there is absolutely no possible way the baby was conceived a day earlier than cycle day 22, I would lie if necessary.

I view it just like how many of us advocate lying about when your water broke. :( Sad but true. If you KNOW your hospital or FSBC (or even HB MW, but that's rate) has a "policy" that you must deliver within XX hours of ROM, and you personally don't agree (i.e. don't have a problem going longer than the hospital's XX hours), then what choice are you left with but to lie?! It's a heck of a lot easier than fighting.

[MegBoz]

Originally Posted by Cheshire 

If it were me I wouldn't fudge it - it's not fair to them to not have accurate information to base your and your baby's care on. 

Well, yeah, that would be true if that "care" were:

1. Always 100% evidence based

2. Always 100% informed- choice (consent) based

3. You had nearly complete freedom of choice

Unfortunately, way too often in America that's not the case. :( Such as with the "must deliver in 24 hours of ROM" policy many hospitals have & why it can be good to lie if your water breaks before you go to the hospital in labor.

Since the OP personally feels comfortable going beyond 42 weeks, but legally can't birth at the BC, then it kinda forces her into the lie! If it were like my relationship with my HB MW, where she doesn't have "hard and fast rules" and empowers her clients to make choices for themselves, then yeah, be honest, sure, but that's not the reality of American maternity care.

IOW, while it may be "not fair" to lie to your HCPs, it's also "not fair" of the HCPs to place restrictions like that on us.

I went to 41W 4D with my son - I was certain of my dates. He weighed only 7# 4 oz & had not a single sign of post-maturity. I would absolutely be comfortable going beyond 42W. Yes, the risk of stillbirth DOES go up, that's true, but it's still low. I might have some second thoughts about passing the 43W mark, and I'd certainly want NSTs at the 42W mark, but I would HATE to have a "hard and fast" EXPIRATION DATE by which I'd be FORCED into a hospital birth since I'd be risked out of my FSBC birth. That's a lot of pressure & if I could take some of that pressure off myself - even if by lying by 4 days or so, I would make the choice to lie.

(Oh, sorry OP if you're not in America.)

[dakotablue]

Do you know your O date? I would fudge it to match that (rather than LPM)  or at most give yourself a day or two.

On one hand I'm all for fudging for more accurate dating (such as Oing on day 21 verses day 14 which puts you at actual 41 weeks when 'they' say 42 weeks)

On the other, I wouldn't be comfortable pushing much past 42 weeks of actual gestation, but then again I haven't done much research on it past the general recommendations I've read on here.

[AutumnAir]

Yup - I would.  I did in fact, and I'm really glad I did.

DD1 was born at 43+1 weeks and I held out against all pressure to go into spontaneous labour, but it was incredibly stressful for me.  She was perfectly healthy - long gestations run in my family.

With DD2 I knew date of conception but moved it forward a week, thinking second babies usually come a bit earlier, so by their count I'd probably only be 41 weeks or so.  Turns out DD2 took even longer to cook and was born at 43+6!  I avoided having to deal with 'mandatory' induction policy at 43 weeks maximum by just a day!!  She was perfectly healthy too :)

[kawa kamuri]

Yes and without hesitation. I gestate for a good, long time - even my 5th baby wasn't born until well into my 41st week. 

[Christine4kiddos]

Being a mom who goes to 42 weeks, I understand the frustration here. But as a midwife, I abhor the thought of a client lying to me about this, or anything! I am in a licensed state, have a scope of practice... yet within that scope, there is leeway. I would rather TALK about scenarios honestly and deal with situations as they arise. I wouldn't lie to a client... . and certainly expect the same in return.

[Christine4kiddos]

Being a mom who goes to 42 weeks, I understand the frustration here. But as a midwife, I abhor the thought of a client lying to me about this, or anything! I am in a licensed state, have a scope of practice... yet within that scope, there is leeway. I would rather TALK about scenarios honestly and deal with situations as they arise. I wouldn't lie to a client... . and certainly expect the same in return.

[GoBecGo]

When i had DD1 (NHS HB with community midwives) i was told "after you hit 42 weeks you HAVE to come into hospital to deliver and we will be inducing" and sure enough, i got to 41+4, by which time they'd already prepared to drop me and scheduled my (VERY unwanted) induction.  If i had to go through that care again i would lie.

With DD2 (independent MW) i signed a contract with her which stated she would care for me "for 42 weeks or until the baby is born" and there was zero pressure to induce, augment or investigate ANYthing based on dates.  If the baby had shown signs of needing help at ANY gestation she would have gotten us some, but she wasn't as obsessed with dates as other models of care are.  I told her the truth.  I do get that the NHS is so over subscribed they HAVE to use formulas and rules to care for people because they don't have time to watch people carefully or develop a close relationship.  As it happened i only went to 40+4 that time, but she was totally unperturbed by the idea that i might go to 42+ weeks.

[SilverFish]

honestly, i would just lie by omission, rather than making something up. say you don't know when your LMP is, refuse an early dating ultrasound, and resist attempts to give you a specific "due date." i thought i was being so clever by fudging my O date to the latest possible date it could be... ended up biting me in the butt when baby ended up arriving at 35+4. 4 more days, and i would have had a homebirth and avoided some of the unpleasantness of her early hospital stay. she was definitely on the earlier side and might have needed help post delivery anyway, but a preterm birth gets just as much, if not more, hassling than a postdates birth. if i'd just gone with my actual LMP, she wouldn't have been considered any less than 37ish weeks.

anyway, just one reason why fudging the dates can be a bad idea. i do understand your concern though... i was 100% sure i'd be going well over my due date, since my mom did with all 4 of us, and my sister did too.

[mmaramba]

Well, yeah, that would be true if that "care" were:

1. Always 100% evidence based

2. Always 100% informed- choice (consent) based

3. You had nearly complete freedom of choice

Unfortunately, way too often in America that's not the case. :( Such as with the "must deliver in 24 hours of ROM" policy many hospitals have & why it can be good to lie if your water breaks before you go to the hospital in labor.

Agreed.

I am really loathe to lie or "fudge," but under the same circumstances, I very well might.

[MegBoz]

Originally Posted by Christine4kiddos 

Being a mom who goes to 42 weeks, I understand the frustration here. But as a midwife, I abhor the thought of a client lying to me about this, or anything! I am in a licensed state, have a scope of practice... yet within that scope, there is leeway. I would rather TALK about scenarios honestly and deal with situations as they arise. I wouldn't lie to a client... . and certainly expect the same in return.

I totally understand where you are coming from with this & if I were to be a MW, I too would hate to think of a client lying to me.

However, there ARE situations where there is no leeway whatsoever. For example, we have only one free-standing BC in the greater Baltimore area & you absolutely cannot birth there past 42W. I also imagine some states or countries have rules where you can't HB at 42W either.

While I personally wouldn't HB a premie baby, I absolutely would HB a 42W+ baby (maybe not a 43W, but 42+2 or so, absolutely!)

So what choices are we left with? Submit to rules we totally disagree with/ we don't feel are evidence-based and which force us into birthing situations we are distinctly trying to avoid --or-- lie so we can get the care we want?

It really is a quintessential example of choosing the lesser of 2 evils.

Thankfully, I'm not personally in this situation. I'm planning an HB with a CPM & she's actually illegal in Maryland (although legal & licensed in Virginia, so stupid!) She has no particular problems going beyond 42W. I'm fairly certain she also attends HB twins, breech & VBAC. In a way, being illegal is beneficial because she doesn't have those sort of rigid restrictions on her practice. And because I know she doesn't have rigid restrictions, I AM being 100% honest with her.

Although excellent point on if you have a near-premie who becomes mistaken for a premie! I honestly hadn't thought of that & should have. When you wait what feels like forever for your baby to arrive, it's hard to imagine being on the other side of the issue.

[plantnerd]

I will next time but only because I have very long cycles (45 days or so) and that automatically puts me at "late" at full term gestation.  If I had regular cycles I would not, simply because some babies can go post dates for one reason or another, and I fully agree with extra monitoring in that situation, and induction for extreme post dates in some cases.  I went 41w5d with my son (induced labor w/ castor oil), and even with the long cycles he was born with dry skin and no vernix, so I know he was getting a little "overdone"

[Quinalla]

I would give them the information so they would have a correct due date. If they calculate based on the stupid "everyone has 28 day cycles" wheel and everyone ovulated on day 14 when you know when you ovulated and how long your cycles are, I would give them the information necessary to make my due date correct. My OB pissed me off because they wanted to do the due date based on the 28 day cycles wheel, but I have 27 day cycles and had my charts and all that, I get it for people who don't chart, but jeez. And she was only off by a day for mine, but then moved it to the correct day by me once she did the early U/S for dating (hah!). I didn't fight it since it was only one day and would have actually let me go one day later, but it is ridiculous that some practitioners won't listen as far as that stuff goes. I mean, I could be wrong as the patient, but I have a much better chance of being right then the 28day/14day nonsense.

I would be tempted to lie (I don't consider the above lying), but I personally wouldn't do it.

[RoseRedHoofbeats]

I don't consider using your actual day of ovulation to be "fudging". After all, if you got a dating ultrasound like "they" want you to, THAT should correct any discrepancies, but no, let's go with an outdated pregnancy calendar from the 1800s... *rolls eyes*

I'd fudge by a week max, especially if I was getting regular NSTs.

~Rose

[AtYourCervices]

Keep in mind that if you have the quad screen, fudging your dates could result in a false "positive", which would result in further interventions.