Increased risk after 42 wks?

[SpiralWoman]

Hi all~
My midwife says the most recent studies & statistics show an increased risk after 42 wks gestation~ does anyone have any responses or rebuttals for this? I wonder how much of the adverse outcomes after 42 weeks stem from the increased numbers of inductions, not the actual time of gestation!
I am doing some other searches on line, but thought I would ask for any additional input. Sources & links are much appreciated!
(I'm also posting the same question on Midwives & Doulas)
blessings, Maria

[Spark]

I know that my midwife beautifully delivered many post-term babies. She's been practicing for 23 years. Sorry, I don't have any more info for you.

Best wishes. May your little one come when the time is just right! Blessings to your family.

[greenluv]

Um, I'm wondering what risks she's referring to? Just in general, or something specific?

[JesseMomme]

*

[dotcommama]

According to the American College of Obstetricians and Gynecologists, 10% of all pregnancies go past forty-two weeks (if that makes you feel any better)

Check out the link below for some details of what issues may occur in post date babies: http://www.gentlebirth.org/archives/...l#IMPLICATIONS

It's kind of technical, but in the end it says,

"It would appear that almost routine induction around 42 weeks is widely practiced in Australia, and is documented as the most usual management in the UK and U.S.A., most authors and studies do not agree with such policies. It is possible that the decision to induce is due to social and legal pressure as there does not appear to be much scientific research to approve of such management."

which I thought was pretty interesting.

[miriam]

After forty-two weeks there is an increased risk of - what?

I DO know that the placenta tends to be somewaht less efficient as the pregnancy progresses and this is believed to be the precise mechanism that triggers labor. There are hormonal deficiencies that may be at fault or the uterus may be tired and ineffectual after a prolonged pregnancy for labor to begin.

However due dates during the first half of a pregnancy gleaned from U/S scans tend to be based on bone density (the first 20 weeks of prgnancy).

The second half of pregnancy (the last 20 weeks of pregnancy) genetics tends to take over as the main determining factor of the fetal size and gestational age of the pregnancy.

There are plenty of tests done on fetuses to determine gestational age and maturity as the L/S test, surfactant test, stress test, oxytocic challenge test, and so on.

I have known of plenty of living people who were born a month to six weeks late....one was I feel because her father left her mother, and I am sure the stress of the situation affected her mother's pregnancy to the point where perhaps the pregnancy was in "suspension". I know of another woman who miscarried a twin and continued the pregnancy with the other fetus; she was three weeks late. The baby decided the day she would be born.

Talk to your midwife and ask her what risks she is afraid of. Remember, your body is healthy and is designed to work.

[frogertgrl]

Many, many pregnant women think they are X number of weeks but they do not know for sure. Neither does midwife or doc. These due date estimations are just that. Estimates.

I challenge any care provider to prove I'm in week #whatever, and be absolutely certain.

We all know that babies gestate differently. With DS, I didn't pay much attention and mw did a gestational age assessment (another estimate) after birth and determined he was 40 weeks.

Better to assess # of weeks after the baby is born, imo. There is a risk for too early babies but not for 'late'.

[annakiss]

I was 42 weeks & a day late and had my baby at home. From what my mom (midwife) told me then, the main "risk" that becomes a concern for post-due babes is the placenta becomes old and thus less effective. Which is why after 40 weeks, they usually recommend that you keep track of your baby's movements. We had a chart that said:

"Choose a time of day when he baby is active and you can relax. You should try to do this about the same time every day. (The best time is after a meal). You should be sitting or lying down.

Note the time and then count every movement you feel (kick, flutter, turn, flip, roll, swish, or hiccup). When you get 10 movements, note the time.

Call midwife if:
- It takes more than 2 hrs. to get 10 movements.
- It seems to take longer each day to feel 10 movements.
- If you have not felt the baby move in 8 hours."

From what my mom also told me, they usually like to do births in the hospital after 43 weeks (or most homebirth midwives prefer, though not all). I think that the other thing you run a greater risk of having is meconium, which isn't necessarily a terrible thing, but they don't necessarily like it either. I wouldn't worry until 43 weeks. Your baby will come any moment, I'm sure (though I know from experience that the waiting can be agony).

[Greaseball]

There has been no real evidence of the placenta or the fetus doing poorly at 42, 43, 44 or more weeks - UNLESS the pregnancies were messed with in some way, with amnio or stress tests or any of those other things they make you do.

I believe some babies just need more - or less - time than medical personnel would like to permit them. Mine was born at 38 weeks, but sometimes babies die after being induced at 38 weeks because they needed to stay in there longer.

If the placenta were deteriorating, it would create a hostile uterine environment and the contractions would start. In other words, if the baby needed to be born before 42 weeks, it would come out on its own.

Moms can go for 10 months if they are not interfered with and be just fine. I think the risk of induction - with any agent, not just pitocin - far outweighs the chance that nature doesn't know what it's doing.

[starfairy]

Well, my first was 5 weeks "overdue" & just fine! I know for a fact she was that overdue, it wasn't a mistake with dates. I do think that many "overdue" births are simply a mistake of dates,though!

My Mom was induced when she went over 42 weeks, and gave birth to a tiny baby just over 5 pds. Drs had insisted he was over 8!

Personally I think there is far more risk in induction than there is in going over dates.

It makes me crazy that I can go to the zoo & be told that a certain animal has a gestation of 8-10 months, but humans? If we dont give birth by 40 weeks or very soon after there must be something wrong! Crazy!

[candiland]

A woman that my MIL works with - a fellow teacher - was told last week that because she was 41 weeks, she was considered "overdue" and needed to be induced.
The induction failed miserably, the baby's heartrate crashed, and they did an immediate c/s. The babe's vocal cords were paralyzed and the lungs weren't mature enough yet. The baby has spent the last week in the NICU because the lung collapsed and the trachea isn't functioning properly. Probably due to not being patient and letting the baby finish cooking And from vigorous suctioning after the birth
I wish TO GOD these women would sue the living sh*t out of these idiot obstetricians and force them to change their protocols. All of these mothers and babies at risk in their hands... errrr, it makes me so angry.

[Katana]

My first, my ds, was born at exactly 42 weeks. I had a homebirth, my midwife wasn't concerned. My blood pressure was fine, he was moving, I felt okay.

He was perfectly fine. 10.8 lbs, but fine.

She said babies are like batches of cookies. No one ever 'cooks' the same lenghth of time.

I agree with the other ladies. Who can really know how far along you are, for sure.

This is just my own personal opinion, not based on any facts, but I think, especially in the US, babies are expected to be 6 or 7 pounds, so really to go even to 40 weeks is almost unheard of. And the longer babies stay in, the greater chance there is that the baby will be 8, 9 or 10 pounds.

I can't even tell you how many women I know who have gotten induced at what they thought was 38-40 weeks, because the doctor said, oh, the baby will be too big. And the poor babies were only 5 or 6 pounds and had problems that required hospital stays.

[MamaMonica]

There is a risk- at 42 weeks, I had an ultrasound to check how things were doing and we scored an "8" (the top score), so my midwife let me go past 42 weeks and I went into labor the next day and had dd at home.

[LukesMum]

* is the top score?? My baby got a "10" they said at 41.2 weeks. I deliverd a 10 lb 4 oz baby girl at 42 weeks--she evaulated at 39.6 weeks and still had vernix. I let myself believe that 43 weeks was "scary" and listened to the OB office where I was gettting my prenatal care (not telling them I was having a homebirth--well, they sort of new) I used the cohoshes to get my labor going...just 4 doses. I thought it was a gentle "nudge" for her but now realize she would have come when she was ready

[crazy_eights]

I believe that 8 is the top score for a BPP if just an u/s is done and 10 is top if there is a reactive non-stress test. I might be wrong however!