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Discussion Starter · #1 ·
I am only allowed to remain in my MW's care until 41 weeks & then they need to turn me over to the OB's for a section. I am attempting a VBAC, but I don't think that really plays into the time limit. Is there any reason why I can't be allowed to go past 41 weeks other than it is their policy? I am 40 weeks today & have no intention of scheduling a c-section based on an arbitrary date. Should I find another provider if I hit 41 weeks? Am I putting my baby in danger by not having a c/s? What is the harm in going past 41 weeks other than the usual postdate problems that may occur? Does attepting a VBAC put me in a higher risk category? I shudder to think they would schedule all women for a c/s just based on dates. Is it just easier for them to send me for a c/s because I have already had one? I just don't see the logic. Whay shouldn't I be allowed to go into labor on my own. I had two previous VB's in which I went into labor on my own so my body certainly knows how to do it. My c/s was for a purely stupid reason because my OB was an idiot & I was uninformed & the situation is not something that will repeat itself. Anyone have any advice?
 

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first off, happy due date! I had my last baby on his due date
Maybe you will too

There is no reason to have a c/s just because you are 41 weeks. Heck, there's no reason for an induction. The real "risk" of going postdates doens't even start until 43 weeks. I think I'd find a bunch of info, print it, and sit it in front of the doc if I had to see them. Ask them for evidence-based support of an elective c/s based solely on dates. Tell them you want hard stats that prove the necessity. And remember that you don't have to have a c/s Or an induction. THey can't perform surgery on you if you aren't there! Youdon't have to schedule it, you don't have to show up if you do schedule it and until you sign that consent to the OR and are alrady numb on the table, you don't have to have a c/s. You are not putting yourself or baby at any greater risk by going past 41 weeks. Having a c/s just based on crappy policy is just that: crappy policy. Best wishes to you, lots of {{{labor vibes}}} comin' your way!

Namaste, Tara
 

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You may want to have a backup plan to transfer care if you have not given birth by 41 weeks.

An increased risk is at 42 weeks, not 43. However, it is very small increase in fetal death and is still normal for about 2/3 of woman to carry past this date. One would get a Biophysical profile to check fetal health and if it is good then in general one can feel pretty secure in carrying for 2-3 days more and then if not birthed, get another and so on....

The 41 weeks thing is probably a general practice rule for everyone.

I can;t write more now, have to run! Others will post... Good luck! Let us know... Paige
 

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If your midwife does dump you for going to 41 weeks, don't show up for a scheduled c section. Instead, labor at home as absolutely long as you can and show up at the hospital when you must. Be prepared to fight, but just because they have a no vbac policy doesn't mean they can force you into a c section if you're already close to giving birth.
You could try to contact other midwives in your area and see if they have a different policy.
Or, your other option might be to go unassisted at home, although with a vbac I'm sure you're probably not comfortable with that option. This would be my choice, honestly.
 

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I wonder if you called your midwife once your pretty far into your labor, she might turn up?

i agree with pp's you dont have to have a c/s.........you dont have to turn up, and you dont have to sign the consents, they can't do it without your consent (unless your passed out and the baby is in danger).
 

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Quote:
An increased risk is at 42 weeks, not 43.
Somebody here, more than once, has posted some good stuff about it being 43 weeks. I think pamamidwife posted at least one of them (I always read her stuff which is why i remember that) Now that search is back, maybe I can find it...

Namaste, Tara
 

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They may have this policy due to a published study (I think New England Journal of Medicine??) regarding out-of-hospital vbac. The one that has had all of the birthing centers freaking out about vbac. Basically, the research did conclude that there was an increased risk for adverse outcome for the vbac patient, with "continued gestation"- which means past 41 weeks according to them.

Many midwives, including myself, have begun creating protocols based on this finding. Risk exsists for the baby, and mom as the pregnancy continues past 42 weeks. My personal vbac protocol is making a plan for delivery/referring out for vbac clients at 41 weeks and 4 days if labor has not occured. I have found that physicians will schedule a c-section for the day of 42 weeks if I line this up, which gives the woman and extra 3 days to have her baby. This is also why I always insist upon really good dates for vbac, even if that requires an ultrasound, because uncertain dates will short change a woman if we "think" she is post-dates. I feel like increased risk probably exsists as far as uterine rupture, etc.. for vbac women that go postdates. I want women to have a vaginal birth and work within safe limits. In my state I also cannot do anything to stimulate labor for a vbac, which makes it even harder. I have had women try moxabustion "on their own accord", but no herbs, etc..

At my "time limit" I also try to arrange induction of labor for a vbac at a hospital nearby that is willing to do it. This is not available at most facilities without 24 hr anesthesia, etc..If baby is ready and mom is a good candidate, they will do it.
Again, the goal is vaginal birth, it may become not possible for homebirth, but still possible for a normal, vaginal birth that is safe for mom and baby.
 

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The irony of it is that an induced labor is a bigger risk to vbac mamas than going "post dates".

I agree with whomever talked about biophysical profiling.. if all is well then why have major abdominal surgery?
 

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I have to be honest, I do not know the risks of VBAC in this situation, but I did have a very healthy baby at 45 weeks gestation. The increased risks are minimal and are non existant if THIS baby and THIS mama are showing they are fine. Please don't base your choice on statistics, base it on your personal situation. Many hugs to you and honestly if you feel comfortabe, the safest place for you might be at home alone or with personal support.
 

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Discussion Starter · #10 ·
Thanks for all the responses. Just to clarify, I should have said I am seeing a group of medwives, buit I did not want to offend anyone. I will be giving birth in the hospital. The OB's are their backups & they would transfer me over to them if I hit 41 weeks for a c/s. I will refuse the c/s if I do hit 41 weeks & then just show up at the hospital when I am in labor. I just wanted to know that I was not crazy & it is much more harmful for my baby, myself & my future pregnancies to have another c/s just because of some arbitrary date rather than go to 42 weeks as long as the baby is doing well.
 

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I would do what the others said, IF you cant find an OB this late in the game who is willing to leave things alone. As someone else said, you will be in much greater risk inducing or having a cesarean then leaving the baby where he/she wants to be. I have to agree that going 43 weeks is where a baby is concidered really overdue. Even my old OB felt that way.
If you go over, your biggest worry is about meconium, but if the baby is not being stressed and you arnt being stressed, that probably wont happen. Even if it does, it really isnt a big deal. Then the other thing they worry about is the placenta getting too old and not working as well. As long as your baby seems to be doing fine, this really isnt a concern until after 43 weeks.
My mom went to 44 weeks and 1 day with me. My aunt did the same with my cousin (I think she was like 43 weeks 6 days). In both cases, our placentas started to seperate and we were born VERY quickly. I dont know the specifics of my aunt, but with me, my mom went into labor and had me 45 minutes later. I did have meconium, but like I said, it isnt the end of the world. The fact is, your body isnt stupid. I do agree that being monitored to some extent is a good idea, esp if you go that far over...but once the placenta started getting too old and seperating, we both popped out quickly and in perfect health. Mind you, I only weighed 8lbs 11oz. I am very glad that my moms OB wasnt section happy, you know not many docs would let you go that far over these days! Oh, and my first was 2.5 weeks late. He would have been fine had they not induced me for two days or insist that I push the way they wanted...GRRR!
 

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Hi Tara and Cari,

I would love to see the information about 43 weeks... I tried to find out info in a quick search on-line but didn't talk about anything but the 42 wk stats, and 41 weeks not being a reason to induce.

Thanks much, Paige
 

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i just had to add (i am not a midwife or doula or cbe) but, all of my children were born at 42 weeks, 2 inductions/ (for being "overdue") then csections
my last was a vbac at home with midwife, who did not pressure me and while i don't know any research to support this or whatever, but guess what? i needed no induction (of any kind-including herbal), labor did occur, and dd was the healthiest baby i had. (first was in nicu, second was in "level (#) nursery")
i think some women have long cycles, and this isn't shown/talked about/etc, in the medical arena. grr.
 

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Two months ago, I had the pleasure of attending a home VBA2C birth for a mom at 43w1. She was told by her previous midwife she needed to go to the hospital for a c-section as soon as she hit 42 weeks, due to that particular midwife's protocols. (In fact, this mom had fibbed to her previous midwife about her LMP.... so she was actually 43 weeks when she got asked to transfer to the OB).

Instead, she came to us and had a beautiful homebirth.

She had a BPP during her 42nd week that showed all was well. She also was attentive to baby's activity and reported no changes in kick counts, etc. So this mom said wasn't willing to "go lay down on that table" when everything was well. Although she had said to me if anything was truely concerning, she'd willingly go in and be the happiest c-section mama around.
 

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I'd like to see this research on the dangers of going 42 or even 43 weeks... I'm not sure that I buy that.

Mec alone is not a sign of distress. It should be accompanied by other distress signals before being treated this way.

If mamma is ok- BP is ok, etc. and baby is OK- not showing distress (FHR or kick count)-- why mess with nature?

Everyone cooks their baby's at different rates. I don't believe that it is a guarantee that the placenta stops working or degrades at 42 or 43 weeks as a general assumption.

Show me the research. Too many times, I hear these things and when I ask to see what info and research backs up that statement- no one is able to produce it. Make your caregiver's accountable.

I was born at 44 weeks. 6 lbs 8 oz. No one in 1967 told my mom she had an arbitrary deadline! EDD's are estimated....
 
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