Increased risk after 42 wks? - Mothering Forums

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Old 06-01-2003, 09:30 PM - Thread Starter
 
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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 Homebirth)
blessings, Maria
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Old 06-01-2003, 09:37 PM
 
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Maria~
I am in no way an expert, nor a midwife...But, here's my theory..
I know you are sure of your dates, because we were both in TTC together. The baby comes out when he/she is ready...when that hormone is released..I know some people recommend doing a non-stress test after 42 wks, my friend really didn't want to, went home, had sex, was in labour 1/2 hr later...sometimes the babe just needs that extra push..so to speak. Are you now at 42 wks? I am sending you many labour vibes.

Peace,

Mamasoleil
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Old 06-01-2003, 09:44 PM
 
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There's some great information on post dates at the Birthlove website.

Here are some links:

http://www.birthlove.com/free/ten_month_mama.html

http://www.birthlove.com/free/ten_month_mama.html#refs



I've had a few mamas go at least two weeks over, one was about three weeks and one was four weeks and two days over her due date.

The risks increase, though not much in a healthy mom, after 43-44 weeks. 42 weeks is not the correct cut-off time, but it is the time in which many midwives are legally bound to transfer care.

Why would your body maintain a pregnancy longer than it could naturally sustain? If you are healthy and ate well, there's no reason why your placenta isn't still strong and adapting to your baby's needs. No reason at all.

Fetal movement counts and in-home non-stress tests are a great reassurance.
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Old 06-03-2003, 02:20 AM
 
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Another thing to consider is that post dates babies have more meconium than term babies.

By the way, I'm new here. My name is Megan. I'm a homebirth midwife (CPM pending) in Madison, WI
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Old 06-03-2003, 06:30 PM
 
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Ah, but meconium in the absence of fetal distress is not an issue.

In fact, in those links I gave, there is a great article from a wise midwife on how the meconium=past dates link is actually related *more* to induction, rather than just postdates itself - or issues with distress.
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Old 06-03-2003, 10:26 PM
 
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I agree with you that mec not being an issue unless the baby is in distress, as long as you stay home.
And if for any reason you had to transport, the mec would be a big deal at the hospital. As you probably know, they really over react to it. Mec even in the absence of fetal distress, even with a vigorous baby, can cause a lot of un-necessary mother/baby seperation in the hospital.
I also have found in my own practice that 42+ week babies are not quite as resilient and not as able to tolerate long labors. Our transport rate is higher with postdates babie because of non-reassuring FHTs, particularly in long labors.
That does NOT mean that I pressure anyone into induction. In fact, I never induce at all.
My own mother had all of her children at 43-44 weeks!
As long as there there is plenty of water and the baby is nice and reactive, I am content to wait until the baby is ready to come.
I just take the slightly increased risk into consideration and share that information with parents.
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Old 06-07-2003, 08:42 PM
 
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it also has to do with what "induction" will be. my son was well into the 10 lb range at 40 weeks, and i had pronounced polyhydramnios. i was measuring 47cm, and i am 5'2". i took the risks of homebirth with poly into consideration and decided to meet my trusted friend and family doc at the hospital the next morning as recommended. i had had 2 children medication free, spontaneously, one at home, and deeply feared the stories i had heard about "pit" and the like. still, i was miserable and worried about a bleed, worried about the baby and SICK of pregnancy. at the hosp the next am i was braced for the worst. my doc broke my water with a tiny sterile thing, and just kept his hand there to sort of stem the waves of fluid and prevent cord prolapse. that was it. i felt soooo much better with that water out, and went into full labor that evening. 21/2 hours passed and i pushed my 10lb 2oz son into my hands. it was a good experience and the gentlest sort of "induction" i had ever heard of. and i did bleed heavily a couple hours later, requiring massage by a team of nurses to release clots and help my uterus clamp down (my son was a sleepy nurser yet ). i was treated well and greatful for the help i felt i needed. so induction is not always a horror story.
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Old 06-10-2003, 11:40 PM
 
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There was a great article in Midwifery Today a while back on this topic (I think it was last fall?). I wish I remebered more details, but I know at the time I was very impressed with the information presented regarding the true risks of post dates pregnancies. Essentially (if I am remembering correctly) the data showing a sharp increase in problems after 42 weeks is from a very old study, and other more recent data does not back this up. The article included two graphs, one detailing the numbers from the old study (with a sharp increase in problems after 42 weeks) and the other showing more recent data that shows a very gradual curve, with a true rise only after the 43 week mark (again this is from memory - feel free to correct me if I'm wrong).
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Old 06-11-2003, 08:02 PM - Thread Starter
 
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hi guys~
NAK
I've been lurking since having Griffin 11 days after my "due date" so I never really got to advocate for going over 42 weeks! I haven't got a chance to put my whole birth story down yet. I really need to, but here I just want to address the mec issue that came up.

We just keep doing supportive things for the pregnancy & we finally had sex. That seems to be what did it! My waters broke about quarter to 4 that morning. I caught the forewaters in the baby tub & saw they were very thick with mec, not just "stained" ~ I wasn't too worried about distress, Griffin was super active after we had sex, so I figured that's when his passed the mec. We were in active labor by 5am & doing really well about 8am, but as more waters passed MW could see they were still very thick. The baby was handling labor really well, no problems there, but we were concerned with the mec & risk of aspiration. My MW said it was the thickest heaviset mec she'd ever seen & she has never transported for mec before. It was always part of my birth plan to be in the safest place for the baby based on our specific situation. It took us about 30 minutes to discuss our options & decide that we wanted to birth @ our hospital of choice so that if Griffin needed anything more than we could do @ home for the possibility of mec aspiration after he was born we would have it.

It wasn't really a hard decision, but we knew it would be a trade off. We worked really hard @ the hospital to stay focused & my labor never stalled as I had always feared a hospital transfer would. I progressed ahead of their time schedule (praise god) & pushed Griffin out @ 3:41pm. I did miss having him placed on my belly & the cord was cut immediately, but I got him back very quicky, he never left the room & was crying so loud they didn't have to do the deep suctioning they were prepared for. HIs apgars were 8 & 8. BTW as far as being "over due" he was only 7lbs 6 oz, 20 in long, pretty skinny, & still had vernix! He definitely wasn't postmature!

well, I guess this gets me a good start on my birth story! It is pretty easy @ 8 days postpartum to 2nd guess myself, but I know we made the right decision for us after praying for guidance & being within a circle of protection. Still, it is disappointing to not have birthed @ home. However, even if we'd been @ home, it wouldn't have been what I had visualized bcz it went so fast! Now I'm even more motivated to have baby #2 ~ is wanting a home birth a good reason??

blessings, Maria
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