Due Dates are often wrong - Mothering Forums

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Old 06-02-2008, 06:08 PM - Thread Starter
 
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In my thread about what to do about discrepancy between LMP and ovulation dates, the fallacy of due dates came up and I thought I'd share this information. It's more relevant when we get closer to our due dates, but it's important information to have from the start.

Most doctors start out stressing that our due dates are ESTIMATES, but as we hit the 38 week mark, they undergo this radical change and suddenly, it's set in stone and really, more of an expiration date. Which is as far from the truth as possible, of course. My daughter wasn't ready until 42 weeks (my best friend, not until 44 1/2 weeks). Average gestation is actually 38-44 weeks, with more births happening on the later side of things (between 41-43 weeks) when left alone.

Even midwives often succumb to the 40 week freak out--in some states, they are pressed by OBs who are 'in charge' of them (such as in Missouri) to not 'allow' pregnancies to continue beyond 40 weeks--which is why this information is so important to have in the beginning--so you can decide how much information you want to give them.

This was written for specifically VBAC mamas, but I think it applies to all pregnant moms, especially first-timers:

http://www.truebirth.com/2008/04/27/...piration-date/

Quote:
About your Due Date

The first piece to understanding your estimated due date (EDD) is the origins. No doubt when the due date calculators online, plus your doctor’s office and any wheel chart all calculated your due date, you assumed some scientific equation that averages out all births? You’d be wrong.

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Old 06-02-2008, 08:09 PM
 
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wow, very interesting, thanks for sharing.
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Old 06-02-2008, 09:12 PM
 
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I've been trying to explain this to everyone. the 'expiration date' thing you mention irks me beyond ....
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Old 06-05-2008, 04:26 PM
 
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Thank you so much for this! I wish I'd known this info at the start of my last pregnancy. I have a family history of women who go into labor at 42 weeks at the minimum. Unfortunately, when I went that long, my homebirth MW freaked out and refused to deliver me past that point. We still got the home birth, barely, and my daughter was ok, but it was full of intervention and general ungoodness.

If I'd known about this then, I'd have taken steps to ensure a different outcome. This time I'm doing things differently.

T , mom to S and C
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Old 06-05-2008, 04:37 PM
 
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My daughter was born full term three weeks before her due date.

I'm considering "January" my due date. Mind, again, my last kid was due in "September" and was actually born in August.
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Old 06-05-2008, 04:47 PM
 
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I so agree! I can't understand why it turns into an expiration date either... everyone knows babies come when they want to. I don't get the new push to get them out ASAP at that EDD in the past couple years.

I'm happy that my midwife said when it goes past 40, they will just have me keep coming in once a week to be monitored to make sure the baby isn't stressed or anything, and as long as everything checks out... we wait.

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Old 06-05-2008, 05:43 PM
 
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I think the OB's are justified at not letting you go past 42 weeks. There are studies out there that point to an increase in fetal demise after 42 weeks. In this day and age, we don't accept any fetal deaths. Hence the OB gets blamed, I mean sued.

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Old 06-05-2008, 07:08 PM
 
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That's a good point. If I may assume that you're talking about placental deterioration then I thought that was pretty easy to check with a routine ultrasound and fetal monitoring and it doesn't happen crazy quickly.

Correct me if I'm wrong though.
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Old 06-05-2008, 08:26 PM
 
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Originally Posted by mclisa View Post
I think the OB's are justified at not letting you go past 42 weeks. There are studies out there that point to an increase in fetal demise after 42 weeks. In this day and age, we don't accept any fetal deaths. Hence the OB gets blamed, I mean sued.
I do think OBs are justified in discussing their recommendations with their patients, but I do not think it is their place (or the place of any health care provider) to decide what to "allow" or "let" their patients do or not do. Ultimately, it is the patient's responsibility, and what the patient needs from their provider is information about the risks and benefits of any proposed course of action, not bullying. Further, I don't think an OB's worry about their liability is justification for automatically taking a baby out if there is question about whether that baby is ready to survive outside the womb, with no good reason (other than a date that is likely wrong) - remember, "First, do no harm." I also think that the legal system is on the wrong track when doctors are encouraged to take a riskier, more often harmful approach in order to decrease their own liability, but that's another topic.

You have a good point about fetal demise increasing after 42 weeks. This often happens due to congenital abnormalities, which would be a problem regardless of the length of the pregnancy. The rest of the time, due to risks inherent in induction and inaccuracies in EDD to the point where iatrogenic (i.e. doctor-caused) prematurity is rampant, whether to induce on an arbitrary day is not a one-size-fits-all issue. Automatic induction is not the only choice. By watching the fetus closely (kick counts, non-stress tests, etc) after 42 weeks, intervention can successfully be done on an as-needed basis if the fetus begins to show signs of distress. I think it is wrong that many women are not even informed of this option, or worse yet, refused when they request it. Further, the risks of a 42-week pregnancy on a fetus are very different than the risks of a 44-, 46- or 48-week pregnancy. It should be up to the fully informed woman to decide at what point the risks of induction would be acceptable when compared with the risks of continuing the pregnancy.

Interestingly, there is a study that suggests that perinatal mortality is lower post-term (42+ weeks) than at 37 - 39 weeks, but that doesn't mean doctors would be justified inducing everyone at 36w6d over the patients' objections! (Bergsjø P; "Post-term pregnancy"; Progress in Obstets & Gynecol; Vol. 5; 1985; 121-126., for anyone who is interested)

Edited to add: Sorry to hijack the thread - although it's still about the same general issue of often-wrong EDDs and how they are used to limit women's choices, in re-reading I feel I got a bit too specific here.

Ok, off my ten-month-mama soapbox and back to your regularly scheduled thread topic!

T , mom to S and C
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Old 06-05-2008, 08:38 PM
 
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My midwife would fudge in an extra two weeks on all her "due dates". She didn't like the docs to pressure her to induce anyone.

Put that aside... all my babies came "early". They were fully cooked but one came a month early , the other two weeks early. They had good weights I thought, one 6 lbs 10 ounces the other 6 lbs, 14 ounces.

I truly dislike the "expiration date" thing that some women seem to face nowdays.
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Old 06-05-2008, 08:57 PM
 
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Excellent, thank you!!!!

wife to DH 2/03, mama to DS 3/03 & DD 1/09
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Old 06-06-2008, 12:00 AM
 
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I too think of being due in a birth month. Last time I assumed I would be due Sometime in November and I was. That is what I aim for, hopefuly not earlier then 38ish weeks and hopefully not later then 42ish weeks.

Nancy, Mom to Kyra (2005), Zoe (2006), Callie (2007) (2008), and Xavier (2009)
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Old 06-06-2008, 01:11 AM - Thread Starter
 
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Quote:
Originally Posted by mustangtbn View Post
I do think OBs are justified in discussing their recommendations with their patients, but I do not think it is their place (or the place of any health care provider) to decide what to "allow" or "let" their patients do or not do. Ultimately, it is the patient's responsibility, and what the patient needs from their provider is information about the risks and benefits of any proposed course of action, not bullying. Further, I don't think an OB's worry about their liability is justification for automatically taking a baby out if there is question about whether that baby is ready to survive outside the womb, with no good reason (other than a date that is likely wrong) - remember, "First, do no harm." I also think that the legal system is on the wrong track when doctors are encouraged to take a riskier, more often harmful approach in order to decrease their own liability, but that's another topic.`
Exactly.

A group of midwives in my area is actually doing a study on plcental deterioration and has (tentatively) found that it only seems to occur in mothers who don't eat enough protein. The placenta is an organ and has its needs like any other. They're working on a theory that taking care of the placenta can totally destroy this 'condition.'

My best friend was born at nearly 45 weeks and her tear ducts weren't even formed yet. She was only just ready to come out. No deterioration at all.

Not to mention the fact that the risk of deterioration is exaggerated and it's a very rare thing (not that it's not a horrible thing, but monitoring of the placenta by u/s after 41 weeks or the baby by NST can show if any concern is warranted. In most cases, a baby won't stay in there unless he/she has a need to.

I can still understand the frightened mamas that don't feel the minimal risk is worth it--or those who have had unexplained 40+ week losses. But exaggerating the risk and further frightening moms who are experiencing perfectly healthy pregnancies is NOT okay.

There are waivers for everything. If an OB doesn't want to be sued, he can draft a waiver that says patient has been informed of the risks and wants to continue and agrees not to sue if said risks present. It's bullspit saying that women are incapable of making an informed decision against doctor's advice (doctors are not gods, they are just fallible humans rife with as much misinformation as the next person and should have no right to bully, intimidate or attempt to control another person because of risks THEY have deemed to be unacceptable).

Talkative, AP SAHMama to my bright and spirited girls Lilly 10-15-06, Naomi 1-1-09 vbac.gif and Katarina 11-16-11 vbac.gif

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Old 06-06-2008, 04:22 AM
 
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On Tuesday, I was at a birthday party at a park with a lot of young mamas. They invited me into their conversation and one of them said her babies went 44 weeks except for her first one (she was induced with that one). The babies were little when they were born, but definitely full term. When I said she just cooked her babies longer than most, she and the other mamas laughed. I don't think they had ever heard that term before.
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Old 06-06-2008, 10:31 AM
 
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Originally Posted by quietserena View Post
That's a good point. If I may assume that you're talking about placental deterioration then I thought that was pretty easy to check with a routine ultrasound and fetal monitoring and it doesn't happen crazy quickly.

Correct me if I'm wrong though.
I beleive you are right in what I know and what my midwife has told me... hence the monitoring she plans to do if I go past, to make sure baby is still getting what it needs and all is okay.

I don't think induction on a happenstance is a good cause.

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Old 06-07-2008, 07:24 PM
 
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That's why when people ask my due date, I tell them sometime between December and February. I mean, honestly, I can't even think of a month as being acurate. I'm due January 19th (and that's the true 40 week mark, as I know when I ovulated). However, Christmas would be full term (and I want to also say that my DS came at 35 weeks and was perfectly healthy, so I may even go BEFORE Christmas), late January is 40 weeks, which means even the 42 week span would put me into the beginning of February. So really, there's a 1/4 of the year when my baby could decide to show up. Which is a huge difference from a single date.

Momma to DS1 4/5/06 nursed with IGT to self-weaning at 27 months, DS2 1/20/09 still nursing, DS3 due late November - planning to tandem with IGT and SNS
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