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The "dangers" of a postdue baby

post #1 of 44
Thread Starter 
Can someone point me to some real evidence that going "overdue" is actually going to lead to the following:
- Longer labor
- Traumatic birth for mom and baby
- Doubling of stillbirth by week 43
- Failure of the placenta
etc etc...

All the "mainstream" sites I visit tell this horrible tale of NEEDING to be induced by week 42, and my own doc wants to "talk about induction" by July 5th, a mere 5 days past my EDD. I want to go see her armed with some solid evidence/statistics.

TIA!
post #2 of 44
subbing!

Had my first visit with the new OB today, and since I don't know the date of my LMP and don't want a u/s, they're confused as to my dates.. Even though I know the date of conception, none of the geniuses can figure my due date out? Ummm... ok? So he proceeded to tell me that the placenta will fail by 41.5 weeks, and not knowing my dates could put the baby at risk, blah blah blah.
post #3 of 44
I really love pamamidwife's Postdates Informed Choice Agreement (it's a link to a PDF on that page).
post #4 of 44
Quote:
Originally Posted by Halfasianmomma View Post
Can someone point me to some real evidence that going "overdue" is actually going to lead to the following:
- Longer labor
- Traumatic birth for mom and baby
- Doubling of stillbirth by week 43
- Failure of the placenta
etc etc...

All the "mainstream" sites I visit tell this horrible tale of NEEDING to be induced by week 42, and my own doc wants to "talk about induction" by July 5th, a mere 5 days past my EDD. I want to go see her armed with some solid evidence/statistics.

TIA!
psh...5 days past your EDD? post dates starts after 42 weeks, not at the beginning of week 42, so all this BY week 42 stuff is a whole bunch of bologna. i dunno, i would say "i will not consider an induction before the end of 42 weeks. after 42 weeks i will only consider an induction if my baby is proved to be showing measurable signs of distress." doctor will complain, you repeat ad nauseum. not to mention the fact that 42 weeks pregnant is probably only around 40 weeks gestational age...

longer and/or traumatic labour (as long as the trauma isn't escalating to the point of serious injury or death to mom or baby, obviously) is IMO not a valid medical reason to induce. what constitutes long or hard is up to the person giving birth, and that varies greatly.

increased risk of stillbirth and placental failure is another story. i've never been pregnant myself, i've done a lot of research, but i might be wrong but wouldn't reassuring weekly (or daily? every two days?) NSTs put that concern to rest? as long as baby is moving at the regular rate, has a good HR, and as your fluid is good it's kind of a moot point, isn't it? i did a quick search but came up empty, hopefully one of the experienced moms will chime in. i would cross-post this in the UC forum, those women know a lot about stuff like this.

personally, i would have greater concerns about fetal distress during an induction than the risk of going post dates, assuming that both mom and baby are healthy. would you consider natural induction methods or AROM to get you going after you've past 42 weeks? maybe that's the way to go for you... since you're a first time mom, and i assume delivering in the hospital if you have an OB, i would be really worried about induction since you don't have a "proven pelvis". induced labours are often long, and they might try to get you for unproven pelvis and failure to progress. also, i've read that the risk of uterine rupture in first time mothers who are induced is actually higher than the risk of uterine rupture to those going for a VBAC. not that many VBAC moms rupture, but if they can throw stats in your face to scare you, they probably will, and you don't want to walk out of there with an incision unless you absolutely have to.

and the obvious and probably annoying question: are you absolutely sure on your dates?

good luck mama!

oh, i might have just found something. try this link, i didn't read it all, but it looks promising.
post #5 of 44
Quote:
i dunno, i would say "i will not consider an induction before the end of 42 weeks. after 42 weeks i will only consider an induction if my baby is proved to be showing measurable signs of distress."
I agree with this.

I know personal experience is not fact, but clearly the "dangers" of going past 42 weeks (or past 41 weeks, depending on who you ask) are not across the board.

My last two babies were each a few days past 42 weeks. There was *no* placental deterioration, they were covered in hair and vernix, no meconium evacuation before birth, and both of those labors were 4 hours long, almost to the minute. The only "complication" from post-dates was that they were big (9 lb 15 oz and 10 lb 8 oz).
post #6 of 44
I would read Henci Goer's books. She goes over the "evidence" about postdates in detail, and also explains why she does not believe the research supports such a practice.
post #7 of 44
There is no reason a healthy woman's placenta is going to start to deteriorate because of a date. Placentas don't watch calendars. I don't know why on earth a long pregnancy would have anything to do with a long labor or a traumatic labor. That makes no sense at all. Mine were 11 and 6 days late. My 1st labor was maybe 12 hours of active labor (15 or so of early labor). My 2nd labor was less than 4 hours from start to finish. Both were painful & hard (hello, it's labor) but not traumatic.

I don't know the still birth stats-I remember in my old Bradley materials that the risk at 43 weeks is equal to the risk at 37 weeks. Yet they're happy to induce at 37-go figure. However, the risk of stillbirth at full term is REALLY low. Even if it's doubled at 43 weeks, it's still tiny. It's like the "you're 5 times more likely to die from cesarean than vaginal birth" stat. Yeah, it's true-but the risk of death from either is very low. The difference, though, is that a cesarean is a manmade intervention, while a long pregnancy is just nature doing its thing. I would not personally induce without some reason, beyond dates.
post #8 of 44
I’m impressed at your resolve to do this. A lot of PPs have provided some great resources. You can also do a search on the Cochrane Library database, which is the storehouse for obstetrical research.

That being said, the burden of proof is your doctor’s to justify the intervention, not yours to decline it. Have no qualms about asking, “Can you point me to any studies indicating that an induction in my case is medically necessary?” If she comes back at you with anecdotes, (“A lot of my patients . . . ,” “I’ve seen a lot of cases of . . . “), politely insist on actual research.

If you do say no, you do not owe any explanations.

Good luck!
post #9 of 44
I would probably delay the visit for a while, but that's just me. I also said that if I got pressured into scheduling an induction, I would not show up for it.
post #10 of 44

"Overdue" Babies

I butted heads with an OB over this. DS was nine days overdue. The OB wanted to induce me based on statistics, policy, procedure blah, blah, blah. I flat out refused, knowing that she'd do an ultrasound to check the placenta if she had no other choice... and they checked, and the placenta was great. I went into labour on my own that day.

If the placenta had shown signs of aging I'd have been willing to talk induction, but I wasn't about to be induced based on population statistics, not when she could easily check what she claimed to be worried about.

I do think that there is merit to some of this research, but the research only points to things that a provider and mother may wish to consider. You still need to consider the specifics of individual patients, and what is applicable to their particular situation.
post #11 of 44
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post #12 of 44
dd1 born 37w 7#1 - still don't understand why she was born "early"
dd2 born 42w5d 8#13 - I was climbing the walls, but I wasn't terribly worried

I think it's all a mythical guessing game anyway, regarding the "dates"! How on earth can it be an exact science? My period Usually comes 24-26 days, and I Usually ovulate about day 6-9. But, even that isn't EXACT. So, my dates have been predicted as anywhere between Dec 14-27. How do you know when it will be 2 weeks overdue?
post #13 of 44
Some definite "dangers" of an overdue baby, as determined from numerous anecdotes:
Being told that something will go wrong.
Having to refuse inductions.
Getting treated like you're putting your baby's life at risk.
Calls from relatives asking where the baby is.
Having to defend your decision not to induce.

These risks begin at 40 weeks 1 day and increase in severity every day after that with sharp increases at 41 and 42 weeks.
post #14 of 44
Quote:
Originally Posted by SublimeBirthGirl View Post
There is no reason a healthy woman's placenta is going to start to deteriorate because of a date. Placentas don't watch calendars.
It's like the old "your breastmilk turns to water after X time" argument for weaning at X time.

Quote:
Originally Posted by SublimeBirthGirl View Post
I don't know why on earth a long pregnancy would have anything to do with a long labor or a traumatic labor.
Cause they're induced.

Hey, there's a thought, Halfasianmomma, "OB, how many of those longer labors you saw started spontaneously with no augmentation?"
post #15 of 44
I am not sure about that but I do know I was 7 days "overdue" with my 1st, and 9 days "overdue" with my 2nd....and everything was fine. It sounds like a scare tactic to me.....I have a friend who went 43 weeks and everything was fine fine fine.

Quote:
Originally Posted by akaisha View Post
i've read that the risk of uterine rupture in first time mothers who are induced is actually higher than the risk of uterine rupture to those going for a VBAC. not that many VBAC moms rupture, but if they can throw stats in your face to scare you, they probably will, and you don't want to walk out of there with an incision unless you absolutely have to.
.

Where did you read that about the risk of ur in 1st time mothers as compared to vbac mothers? I am just curious as I am going for my 2nd vbac and would love to read the article....give me some courage:
post #16 of 44
Wow, only 5 days past the due date? I was 10 days past with my first and 12 with my third. Out of my three children, the longest was 12 hours, but that was an induction 2 weeks early (and wasn't my first baby, either).
post #17 of 44
The PP was right that being overdue doesn't START until 42 weeks, and I thought was right on the money that at 42 weeks from LMP, baby is only 40 weeks developed, which is right around when most are born.

All of my pregnancies have been "overdue", probably because I normally have long menstrual cycles. The longest one was 17 days past the EDD (baby #3). All of my labors have been from 3 hours (shortest, natural homebirth) to 9 (longest, induced, figures, huh?).

Good for you for standing up for you & your baby!!
post #18 of 44
Yeah, the Doctors seem to forget that the due date is ESTIMATED.

I always go by my dates anyway because I know the day I ovulate and I refuse to have some bloody idiot claim that some machine knows better than I do as to when it happened.

Also, as others have said, a normal pregnancy ranges from 37-42 weeks so it seems adness to want to induce between 10 and 14 days.
post #19 of 44
I am really curious about where the idea that longer pregnancies result in more difficult labours comes from. As someone else said, induction must play a role. I was also wondering if babies who were not positioned properly might have something to do with it. If the baby is not in optimal position, there is less pressure on the cervix so it may take longer for labour to begin and those labours are usually longer and more painful. I have not even found any source to back up the initial assumption that post date pregnancies lead to longer labours, but I would be very wary of their conclusions of I did find them. From my purely anecdotal experience with what I have heard from people I know, it seems that babies who come between 41 and 42 weeks are usually easy labours. I do not see why that would suddenly change after that. Maybe it also has to do with OB's fear of bigger babies and their 'OMG! This baby will be almost 9 pounds, we have to do a c-section!' attitude.


OP, you should feel free to refuse any NST and such until at least 42 weeks if you feel everything is fine or just skip your appointment altogether. At this point, especially after refusing induction, you should absolutely refuse any internal exam to avoid the 'accidental' sweeping or breaking of membranes.
post #20 of 44
Ds1 was born at exactly 42 weeks, based on a calculation from my LMP, which I knew was off, as I always have long cycles. I usually ovulate on day 20+. A due date based on my LMP would automatically be a week or two early, since I NEVER ovulate on day 14. But, with my first I didn't realize it was a big deal, so just accepted the date I was given. When my doc started talking induction, I brought in my calendar, and said that based on my mean and median cycle lengths from the last year (I didn't know how to chart at that time), I most likely ovulated between certain dates... which would push my due date back a couple of weeks. So, at the time they were talking induction, I really was not even at a properly calculated EDD. Ds1 was born spontaneously, without any augmentation, with maybe 4 hours of active labor, right about when I estimated his due date to be. He had a bit of wrinkling on his wrists and ankles, but certainly was not a "postdates" baby.

Ds2's due date was calculated from ovulation, based on charting, not LMP. He still didn't arrive until 41 w, 5 days. He was covered in vernix and the newborn exam showed him to be term, not late. So, even with KNOWING my dates and the exact day I conceived, it still took a bit longer for him to cook. Oh, and that birth was 2 hours long from start to finish.
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