Risks when you go past due...

[mercii]

Well, I'm apparently one of those people that goes late. Previous two babies I went 41+3 and 42+4(? we think, I lost count and would have to calculate it again). I'm currently 40+3 and don't have any reason to think it's going to be soon.

I'm wondering if anyone could link me to statistics about the risks of going overdue. My midwife can legally only take me up to 42 weeks - the only reason we went past that last time was because we decided to go with my ultrasound date, which gave me a few more days.

If I do face transferring to a hospital instead of a birth center, I want to be as armed as possible against the scary words I'll inevitably get. Stillbirth scares me terribly, and if I get "dead baby" threats I will have a tough time resisting induction.

Statistics, facts, etc -- I'm interested in it all!

[phathui5]

The reason that many doctors use as an excuse for induction when you go "past due" is that the risk of neonatal mortality rises after 40 weeks. Most doctors are using outdated statistics (and I'm not blaming them, it's what they were taught in school).

This is from Gail Hart's Research Updates

"This chart comes from a study published in 1963—yes, 1963—by McClure-Brown from data gathered in 1958. This is the study that originated the phrase “Stillbirth doubles at 42 weeks.”

 

Did you know that modern studies don’t show this at all? Modern studies contradict that famous graph.

 

The perinatal mortality rate in McClure-Brown shows:

 

(old stats)

20/1000 at 38 weeks

10/1000 at 40

12/1000 at 41

18/1000 at 42

25/1000 at 43

60/1000 at 44

 

A graph from 1987 statistics (Eden, Sefert) shows:

(new stats)

6/1000 at 38

2/1000 at 40

2.3/1000 at 41

3/1000 at 42

4/ 1000 at 43

7/1000 at 44"

What I see when I look at that chart is that at 42 weeks, you have a 997/1000 chance of delivering a healthy baby. At 43 weeks, the numbers are 996/1000. You are not going to implode at 43 weeks.

[skycheattraffic]

I thought the biggest risk was of the placenta not working optimally and baby's oxygen supply being compromised past 42 or so weeks. I don't have sources and hope someone can shed light on this. Of course fetal mortality is by far the most serious outcome but other serious complications could definitely come out of a placenta that isn't functioning properly. I'm not trying to scare anyone but hope to get more information.

[Jo Mama]

There's actually a lot more recent research about the risks of going post-dates.  A quick google search yielded this: http://www.sciencedaily.com/releases/2008/10/081007091459.htm

And this:  http://webcache.googleusercontent.com/search?q=cache:mUqjjd1s7pEJ:www.fammed.washington.edu/network/sfm/postdatepregnancy.ppt+&hl=en&gl=us The forth slide is the relevant one and is from a study from 2004.

I would never go past 41 weeks, personally.  Induction doesn't have to be scary.  A good friend of mine just had a wonderful induction at 37 weeks for severe pre-eclampsia.

Edited by Jo Mama - 12/3/12 at 5:27am

[phathui5]

"The national study found that women who delivered beyond their due date had an increased chance of cesarean section or operative delivery – such as one requiring forceps – versus those who delivered at 39 weeks."

I really feel like this could be because those moms were delivering in hospitals. When you are "post-dates" in a hospital setting, the staff assumes that something is going to go wrong. Their fear that something could happen increases the chance that something will happen. I think that in an out of hospital setting, being 41 or 42 weeks doesn't increase your risks of intervention.

[J and Js mommy]

I live your fear everyday for the rest of my life. If you are fullterm just get your child out. It's nonsense these doctors letting moms go so far beyond 40 weeks. My sister just was induced at 40 weeks and her placenta was already hardening/ shutting down which was something they only found postdelivery. I don't want to scare u plus u have already been thru this but if I were u I would jump at being induced

[buko]

Originally Posted by J and Js mommy 

I live your fear everyday for the rest of my life. If you are fullterm just get your child out. It's nonsense these doctors letting moms go so far beyond 40 weeks. My sister just was induced at 40 weeks and her placenta was already hardening/ shutting down which was something they only found postdelivery. I don't want to scare u plus u have already been thru this but if I were u I would jump at being induced

Yes, let's all let irrational, scientifically-unsupported fears rule our lives.  My grandmother had a stillbirth at 39 weeks.  Let's all induce at 38 weeks.  No, wait, a friend had a stillbirth at 38 weeks.  Let's induce at 37.  After all, there are no risks (including death) to induction. 

[skycheattraffic]

OP, do you have an update? I think you are around 42 weeks - if you haven't had the baby yet. I'd love to know what's new good luck, wishing you a healthy, uncomplicated birth.

[mumm]

Originally Posted by Jo Mama 

I would never go past 41 weeks, personally.  Induction doesn't have to be scary.  A good friend of mine just had a wonderful induction at 37 weeks for severe pre-eclampsia.

Originally Posted by J and Js mommy 

I live your fear everyday for the rest of my life. If you are fullterm just get your child out. It's nonsense these doctors letting moms go so far beyond 40 weeks. My sister just was induced at 40 weeks and her placenta was already hardening/ shutting down which was something they only found postdelivery. I don't want to scare u plus u have already been thru this but if I were u I would jump at being induced

Induction can be very awful.  I was induced at 41 weeks with my twins.  It was awful- miserable, painful, embarassing, expensive, exhausting.  Ohmy, the exhaustion of being watched and monitored.    And the result after 3 days?  Nothing.  I went home from the hospital still very pregnant.  They "let" me go to 41 weeks because I lied about my dates once I discovered it was twins because I knew they would push me to go early. 

The placentas were lovely and healthy and there were no health issues, although one twin seemed like a preemie.  Just under 7lb, very skinny, no body fat, etc.   Every situation is different but I was surprised by all the judgement I got for going so long with the twins.  As though I was intentionally trying to cause harm. 

At this point I hope the OP is busy with her new babe! 

[mercii]

Thanks all! Thankfully I didn't go so late this time - It was just 41 + 4 days when I gave birth to a beautiful little girl. The midwives commented on how healthy the placenta looked. :)

[courtney1986]

I know this is an older thread, but I'd like to chime in.  I've had 2 babies born at 42 weeks, both had wonderfully healthy placentas and great outcomes.  

I'm pregnant again and am ready to be pregnant until at least 42 weeks again.  Some babies/woman gestate longer.  

[myra1]

I just want to say that I did go 42 and a half weeks with all but 1, who was 41w1d. I did not have early ultrasounds and have slightly irregular cycles so always assumed my ovulation may have been a bit off anyway. I had a 20week anatomy scan w my first and they tried to use his perceived size (very subjective) to move my due date up..... wow I would have been induced for sure....so I opted out of all scans after that.

The babies were big but very healthy, healthy placentas, and I strongly attribute my natural births to not being induced and the healthy big babies to being truly ready to come out. My undstanding is that 41 is actually the average for white moms when we dont factor in induction. The 40 weeks was an estimate from a doc 100 years ago that it became "fact". I was concerned and did my research but my experience was good.