Pregnancy over 42 weeks - what are the risks? - Page 2 - Mothering Forums

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Old 01-23-2009, 03:44 PM
 
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Originally Posted by liliaceae View Post
I keep thinking about this issue. I don't really know anything about it, but I'm wondering....what are the risks of being induced at 42 weeks, compared to the risks of not being induced? I mean if you're induced at 42 weeks, you know the baby isn't going to be premature right? Aren't you pretty likely to have a healthy baby? Sure you might not get a natural childbirth, but if the choice is between pit and an epi, or even a c-section.....or waiting too long and having a stillbirth....is there really any choice? I'm sorry if this sounds completely ignorant, I'm genuinely curious as to how the risks and benefits compare.
The rise in stillbirth starts at 38 weeks so technically one can argue that the chances of having a c/s is better than the chances of having a stillbirth starting then. That study that just came out about waiting for c/s till 40 weeks was better for the baby and of course some dr had to mention still birth. That waiting till 40 weeks (not over due mind you, just the week of the due date) is not worth the risk of stillbirth. Everyone has to make their own decisions given the information they have and do what they feel comfortable with. Would we fault someone for having an induction or c/s at 38 weeks to avoid a stillbirth? Its not a black and white decision.

To the OP: So glad to hear the bpp looked so good. So sad though your mom has to leave! Thats a bummer! Maybe you will have the baby tonight?!

Expecting #9.  Always busy hsing.
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Old 01-24-2009, 05:22 PM
 
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Originally Posted by DreamsInDigital View Post
The rate of stillbirth goes up dramatically at 42 weeks. I would not personally feel comfortable continuing a pregnancy beyond 42 weeks and 1 day, which is when my 3rd son was born. He was fine, but I sure as heck couldn't live with myself if one of my babies was not fine. I was actually planning on going to the hospital for an induction that night, but he was born early that morning.
This isn't really true. I'm trying to dig up a study, but what I have on my PC is


Postdates, by itself, is not associated with poor pregnancy outcome. Extreme postdates or postdates in conjunction with poor fetal growth or developmental abnormalities does show an increased risk of stillbirth. But if growth restriction and birth defects are removed, there is no statistical increase in risk until a pregnancy reaches 42 weeks and no significant risk until past 43 weeks. The primary "evidence" of a sharp rise in stillbirth after 40 weeks—often misquoted as "double at 42 weeks and triple at 43 weeks"—seems to come from one study based on data collected in 1958.(1)

The first question one should ask is whether neonatal mortality statistics from the 1950s should be compared to modern statistics, since labor anesthetics and forceps rates were very different. Early labor monitoring was scanty and prenatal monitoring not yet developed. The McClure-Brown report shows a rise in stillbirth from 10/1000 at 40 weeks to about 18/1000 at 42 weeks. Yes, that is nearly double. But think about those numbers. Even the beginning point is nearly ten times the modern mortality rate. Either modern delivery methods are vastly different or something is wrong with the data collection. This study should be updated by research conducted at least in this century! Modern statistics show an almost flat rate of stillbirth from 40 weeks to 42, with a slight rise at 43 weeks (all numbers being close to 1/1000).(2)

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