I need stats about 42+ week births

[kimberlylibby]

Someone told me if you go past 42+ weeks you have a 90% chance of fetal demise?

I know this is wrong, does anyone have a link to some sources (prefer not hb or uc sources since she doesn't trust those types of sites) that would prove her wrong?

It's driving me nuts. Totally not applicable to me and my baby since mine were at 38w5d and 37w2d but she's still driving me crazy!

Kimberly

[True Blue]

Don't have stats, but DH's cousin recently gave birth at home to a perfectly healthy, 12lb 2oz baby boy at 43 weeks. I believe there was some shoulder dystocia, but everyone knew how to handle the problem and the outcome was perfect....mom didn't even really tear!

Oh wait! I should also add that DH was 19 days late and a vaginal breech birth at a hospital.

[rfraser]

http://www.obgmanagement.com/content...0900_00064.xml

A similar retrospective study of 171,527 singleton births by Hilder et al showed that, when calculated per 1,000 ongoing pregnancies, the rate of stillbirth increased 6-fold, from 0.35 per 1,000 ongoing pregnancies at 37 weeks to 2.12 per 1,000 ongoing pregnancies at 43 weeks. 8 When infant mortality figures were included, the difference was even more striking, with an 8-fold increase in the risk of pregnancy loss (stillbirths plus infant mortality) from 0.7 per 1,000 ongoing pregnancies at 37 weeks to 5.8 per 1,000 pregnancies at 43 weeks ( Figure 1 ).

so while to might increase by 90% ( the chance of still birth ) that is 90% increase up from only .35%... not saying that 90% of 42+ weeks of labor will result in a stillbirth.

if that makes sense

http://www.aafp.org/afp/20010215/tips/10.html

The number of stillbirths and neonatal deaths, respectively, were 45 and six at 40 weeks, 22 and four at 41 weeks, and 17 and six at 42 weeks.

and perhaps the most telling reason why dr's like to induce:

http://www.phyins.com/pi/risk/minimize/postdates.html

Up to 30% of obstetric malpractice claims involve pregnancies progressing past 42 weeks estimated gestational age. Clearly, postdates pregnancies require closer management by physicians and obstetrical staff.

[Mamid]

yeah, and how many pregnancies have "accurate" due dates????

[momto l&a]

Not what you are looking for but my second dd was a 42 weeker, she is now a very active 2 year old.

yeah, and how many pregnancies have "accurate" due dates????

ITA

[Mamid]

well.. my midwife is going by my ultrasound (early) due date since that matches with my O date by a few days - like 2.

Which doesn't match my LMP date which doctors would only use. That puts me at the day after DS's second birthday - which is coming up next month!

I had a miscarriage on CD5 and didn't O till CD28 or test until cd 41/42. Hell, I didn't even know I was pregnant...

Though, technically, I have already passed my "due date" for my last "true LMP" which was in October.

I could just see a doctor having a fit over all this! "You're 41 weeks??? See?? My little swirly thing says so!"

[kimberlylibby]

Ah-ha! 90% INCREASE is huuuugely different from 90% demise.

I will have to call her on it next time she says that.

[Jennifer H]

Just curious if anyone knows. I read through the links and was wondering if they controlled for inductions with those numbers. My preggo brain is not concentrating like it should so maybe I missed it.

Since induction can really stress a baby I would think that fetal demise may be higher in post-term babies because of the higher induction rate.

Just wondering if anyone knows.

The whole post-dates/fear of induction thing is the most stressful part of all of my pregnancies. I've once again expired and so it is starting to weigh on me. I trust my body AND my baby to come out when the time is right, but I don't feel like anyone else does!

[doctorjen]

The other thing that needs to be controlled for in those studies is lethal congenital anomalies. We know, for instance, that babies with anencephaly are often postdates. The theory is that there is some fetal factor that is supposed to help trigger labor that isn't present in those babies, so the pregnancy goes longer. I don't know if there is a similar situation with other anomalies or not, but it could make a difference in statistics if there is.

[doctorjen]

Just wanted to add that I just came home from assisting a little 42 week baby girl into the world. Baby was born on her cousin's birthday. The cousin, an excited young man of 13 or so who waited outside in the hall during the delivery, predicted her date of delivery from the very beginning, and much to her mama's dismay, she waited for exactly 42 weeks to make her appearance. Baby was perfectly fine, and only 6 lbs 15 oz. An anecdote, I know, but just had to add since we've been talking about 42 weekers.

[Al Dente]

T doctorjen, I wish you were my sister instead of my (incredibly) mainstream sis who, as a new M.D., gleefully predicted I wouldn't have a natural birth (I didn't) and that ds wouldn't be okay if we didn't induce (he was perfect, born at 42 wks 6 days). I sooooo wanted to have a homebirth and prove her wrong! Next time, next time...

...back to your regularly scheduled thread...

[Mamid]

The problem with that study is when a death happens, the odds aren't 0.18%. They are 100% to the poor woman who has deal with a dead baby.

And that is something I wish that no woman ever has to go through.

[~lapetitesirene~]

Kimberly-I am so glad that you asked this question...and others gave great insight, info. It will be great to reference if I go post dates :0 It makes me crazy when people speak of statistics in an overblown exaggerated way-when it is all fear driven...and they are doing it to make themselves feel better or superior or whatever?!

[Leilalu]

My dd was 44 weeks! She was a c-section as she was footling breech. She didn't even really have too many signs of being"overdue'. She was great. Extremely healthy and very alert. 8 pounds, 14 ounces

Henci Goer has an exellent book called The Thinking Womans Guide To A Better Birth. That should answer any questions about stats.

[JesseMomme]

I second Henci Goer. Her stats are usually very well researched and she checks and rechecks everything; I recommend her books for anyone that doesn't want a homebirth/unassisted perspective.

[surromomtm]

My first and second sons were 42 weeks and a day or two overdue. I had to fight like you know what to keep the OBs off of me...they were really trying to force me into an induction both times. I went into labor on my own with both of them, and had uneventful labors/births. They each weighed just under 9 pounds, and everything went beautifully. I don't believe that due dates are rocket science, so I pretty much don't really listen to them.

My 3rd son came exactly on his due date, and my 4th son was 1 week early. It's all nothing but a guess.

[orangebird]

Originally Posted by kimberlylibby

Ah-ha! 90% INCREASE is huuuugely different from 90% demise.

I will have to call her on it next time she says that.

Oh my gosh! She was saying that 90% of babies past 42 weeks die? ROTFLMAO! Definitely, you HAVE to call her on that next time you see her. Sounds like she was trying to scare you or is just confused by what a 90% increase in risk means. Hard to believe she could be a nurse and not understand what that means, maybe she heard the info wrong from someone else.

The other thing that needs to be controlled for in those studies is lethal congenital anomalies. We know, for instance, that babies with anencephaly are often postdates. The theory is that there is some fetal factor that is supposed to help trigger labor that isn't present in those babies, so the pregnancy goes longer. I don't know if there is a similar situation with other anomalies or not, but it could make a difference in statistics if there is.

Great point. That is the problem with just looking at numbers sometimes. I wonder if they corrected for that in the study.

There was a mom here or at Amity's that said she delivered her baby at 49 weeks. Was that someone here?

[Village Mama]

I am all for natural birth and letting thing progress as nature intends.. that said my first son was 14 days 'overdue" , and the doctor was telling me that thay dont let moms go more than 10 days over without trying to get things started. I pushed for letting things happen in thier owntime, but settled at two weeks over with letting them break my waters. Everything turned out fine.. with a very large baby! There was a bit of shoulder discotia though... the main reason to add to this thread however , is to say that the placenta does begin to lose ists ability to function properly after this amount of time,which can cause decels in the babys heart rate between contractions, meaning that the baby may not be getting sufficient oxygen.. and the heart rate takes some time to recover stressing the baby out, and everyone in the room out. I luckily did not have to have a c- section, for often time is of the essence in this situation. Sometimes stats do not show the true concerns regarding this matter. No doctor or midwife wants to watch someone go through the death of thier child or have complications due to insufficient oxygen during the birth. I didnt have any long term problems due to this, but i wonder if I may have if I held out any longer? PS the non stress test that I had before going into labor didnt show any sign of the placentas decline in function.Just a thought . Whatever it takes to have a healthy baby. What is the lesser of two evils in your mind... being induced, or an emergency c- section?

[AmyB]

Originally Posted by Mamid

The problem with that study is when a death happens, the odds aren't 0.18%. They are 100% to the poor woman who has deal with a dead baby.

I think your view of the statistics is wrong. What .18% means is that if 500 women carry their pregnancy past 42 weeks about 1 baby will die (.9 is actually a little less than one).

So, the relevant statistical questions are, would you be willing to subject 499 women to c-section or induction in order to (maybe) save one baby? (the doctors are). Are you willing to be one of the 499 sacrificial women yourself, even if there is no evidence that your own baby is in distress?

--AmyB

[orangebird]

Originally Posted by AmyB

I think your view of the statistics is wrong. What .18% means is that if 500 women carry their pregnancy past 42 weeks about 1 baby will die (.9 is actually a little less than one).

So, the relevant statistical questions are, would you be willing to subject 499 women to c-section or induction in order to (maybe) save one baby? (the doctors are). Are you willing to be one of the 499 sacrificial women yourself, even if there is no evidence that your own baby is in distress?

--AmyB

I see what you are saying Amy, but I think what Mamid meant was that in any one case the odds for that mom are 100% or 0%. The baby dies or it doesn't. She wasn't saying the study is flawed or overall irrelevant, but that when you look at it from the point of just one mom, if her baby dies the statistics don't mean squat (to her, the mom with the dead baby, not overall).