[Averys_mom]

I'm nearing 40 weeks and it just occured to me that, after doing some reading, I'm not as comfortable going postdate as I was during the rest of my pregnancy.

This realization blew me away because I've always been a "the apple will drop when it's ripe" type person. Heck, my mom had me at almost 44 weeks (and she was positive about her dates)!

Though I know the risk of perinatal morbidity and other complications are very slim in postdate pregnancies (and there are a lot of factors that play into these), it does concern me that there is a significant jump in these adverse outcomes starting at about 42 weeks. I know many, many women deliver at 42+ weeks with no problems. I'm just wondering if I'm willing to take that slim risk because the outcomes can be so terrible.

Don't get me wrong -- I'm totally into risk-benefits analysis and willing to take calculated risks. I'm extrememly comfortable with the so-called "risk" I've taken by not vaccinating my daughter (I felt it was too much of a risk to vaccinate her). I'm also willing to "risk" a UR by attempting a VBAC because the odds are very much in my favour.

I feel like I'm stuck between a rock and a hard place. I know that my chances of a successful VBAC drop if I'm artificially induced. I'm totally willing to wait and do some conservative management with kick counts, NST, and biophysical profiles, and my OB is willing to go along with that. But he did say that he doesn't think he has as much faith in them as I do. I also have an RN friend who has worked extensively in labour and delivery units in different countries. She didn't seem bothered by all my natural birth, no intervention plan. All she said was, "just be careful with the postdates thing."

Has anyone else really read the studies about postdates and was also concerned?

 

[Storm Bride]

I haven't read the studies about this, as it's never really seemed like a concern to me. But, I will mention that if I were you, my mom would be a comfort. If she had you at 44 weeks, then maybe there's a genetic tendency to go postdate?

A friend of my mom's went 44 weeks, or close to it, with all four of her children...they were all perfectly okay. That's just the way her body worked. (She also had a 49 day menstrual cycle...I don't think that's a coincidence.)

How far along were you when your first one was born?

 

[Artisan]

Well, here's the thing... the alternatives to going postdates are just as potentially life-threatening for the baby and for you.

Induction is not a good thing in general. It should only be saved for true medical emergencies. With an induction, you are much more likely to have forceps, vacuum, or a C-section, all of which significantly increase your chances and your baby's chances of serious life-threatening complications. YOU are twice as likely to die during a C-section. You are much more likely to develop a uterine infection, which can also be life threatening for both you and baby. And that's not even factoring in your prior C-section and the increased chance of rupture with an artificial induction.

Your only other option other than to let nature take its course is to schedule a C-section. Which, as I mentioned, is far more dangerous for both you and baby. Your baby is nine times more likely to be in the NICU. Your baby is more likely to have asthma and allergies after being delivered via C-section. The list goes on.

I'm not trying to scare you, just trying to help you see the big picture here. No one wants to be overdue, it sucks in every way. But the alternatives are worse, in my opinion.

Stay strong, mama!

 

[loved]

I am sorry there's just so much fear out there about normality. It's very very hard to trust our own bodies in this culture.

I would recomend reading Henci Goer's Obstetric Myths vs Research Realities and The Thinking Woman's Guide to a Better Birth - both of which will debunk the 'research' about post-dates risk.

You know, if it's not that it's another thing. In obstetrics birth is only normal in retrospect.

 

[Averys_mom]

Apparently, there is no genetic (mother to daughter) link to gestation length. In fact, I read one study that said it is believed the father's genes have the most affect on gestation.

Yes, my mom did have me at almost 44 weeks, but she believes there was a reason for that. She was incredibly sick her entire pregnancy and didn't gain much more than 15 pounds. She thinks I just need that extra few weeks to gain weight.

As for my gestation length last time:
I went into labour after a membrane sweep with my daughter at 40w5d, she was born by section at 41 weeks after a 31-hour labour due to malpositioning (31 hrs, stalled a 6 cm, cervical edema, swelled back to 4cm blah, blah, blah).

I was positive of my dates with my first, and the ultrsound came within 2 days of my day. She appeared very well "cooked" when she was born, was 8.5 pound and had the most hair my doctor had ever seen in his career.

 

[Got_Cloth]

My thoughts are this. I have dont alot of research in this matter while working my my doula certification. Babies come when they are ready. If you are progresing normally in pregnancy baby is doing well, and all is calm, there is no reason to rush for induction which would likely lead to c-section. My mom went 42 weeks with all her babies and we were all fine. I have gone over with most of mine nad they were fine. THe only regrets i Have about going over iwth dd2 was lettgin them induce me at 40 weeks 3 days. My last was born at her own will at 41 weeks. Affter 15 weeks of bedrest

I do beleive in natural ways to help things along. BUT Nothing will work unless your baby is ready. I know of a mom who had 3- that 3- failed inductions before she went on her babys own will at 41 1/2 weeks.
I myslef had membrane sweep with my first.( first live bith had preterm twins so my body was not knew at this) I was 3 cm dilated, 2 days before my due date. was having contractions, I was 90% effaced. Full Moon, walked 7 miles that night. Doing the curb hopping thing( can you imagine?? LOL)even drank castor oil( I know alot of ppl think this is wrong but thats another thread)
NO BABY. she came a few days later, with chemical induction as my drs thought she was too big(what did i know??) I tired it all. my baby was not ready and I beleive I would have had a c section had I been chemically induced before i was.

I also dont think wt gain has much to do with when the baby is born, I only gianed 12 lbs ith my first, 7 with my second and 4 with my third and they were all of healthy wts 6 lbs 5 z- 7 lbs 9 oz
Also the amount of hair is coincidence. My last is 17 months and STILL BALD!!!

Remember all due dates are give or take 2 weeks. Even if you think you know for sure. Every baby is differnt and every pregnnacy is different. In the old days they would say the baby is due sometime in june or july. now they give you a date which is False hope!! only like 5 % of babies are born on that date..

Sorry that was so long. guess I am long winded.. thats whati Get for being a birth junkie

Good luck and try not to worry you will know what to do when the time comes

 

[Storm Bride]

Quote:

Originally Posted by Averys_mom Yes, my mom did have me at almost 44 weeks, but she believes there was a reason for that. She was incredibly sick her entire pregnancy and didn't gain much more than 15 pounds. She thinks I just need that extra few weeks to gain weight.

That's possible, but it really doesn't seem likely. I don't think maternal weight gain has that much to do with birth weight. I gained the same amount (within 2 pounds) with my kids, and there was over 2 pounds difference in their birth weights...I gained the extra 2 pounds with the smaller one.

Quote:

As for my gestation length last time: I went into labour after a membrane sweep with my daughter at 40w5d, she was born by section at 41 weeks after a 31-hour labour due to malpositioning (31 hrs, stalled a 6 cm, cervical edema, swelled back to 4cm blah, blah, blah).

That sounds as though you may tend to go a little bit post-date. Do you have any idea how long your MIL carried your partner and his siblings, if any? This just sounds like it may be the way you're built.

 

[bri276]

I know the feeling. In my mind, I tell myself this is a natural process, I picture living back in time when no one counted the weeks of pregnancy, I tell the baby to come when it is healthy and ready, but in a small corner of my heart I feel a tiny bit of panic at the thought of going *really* postdates. I'm positive about dates due to early betas and ultrasounds, so it won't be a case of "maybe I'm 44 but maybe I'm 42".
I think when we really break down this train of thought it comes to a single disturbing thought: which would be more "my fault"; if I didn't induce and something bad happens, or if I did choose to induce and something bad happens? and really the answer is neither, but if something bad did happen, we would probably blame ourselves either way. at least, that's what's going on in my mind, I certainly don't want to project my feelings on to you.
For me I think the answer is this; I want a natural birth. Induction will rob that from me. So I'm choosing to view it as a last resource to use if something is clearly going wrong. Otherwise, the baby will tell me when to have it, and I"m not going to interfere.

 

[Averys_mom]

That sounds as though you may tend to go a little bit post-date. Do you have any idea how long your MIL carried your partner and his siblings, if any? This just sounds like it may be the way you're built.[/QUOTE]

Yes. I think she had my husband at about 37 weeks and his brother at about 38 or 39 (she had a placental abruption with that one, so I think it may have been induced or augmented).

Then again, she smoked all through her pregnancies and I know that can affect things.

FWIW, I'm also a little concerned about postdates because my due date (June 21) is what I decided on based on when I think conception was. The ultrasound dated me for the 11th.

 

[Pepper]

Hi Avery'sMom,

Your thread caught my eye because I'm approaching my due date, too--in fact, we have the same due date, Summer Solstice

I'm also very strongly against any type of interference with encouraging birth but as this date comes closer it does mess with your head. I'm finding my biggest challenge right now to be everyone around me, mom, mil, siblings, ob's/mw's, even dh

They are all getting freaked out that my due date is fast approaching and no signs of baby yet.

I love the idea of letting my baby decide his birth date--I believe it is the first thing that I can do to truly show my respect for him--letting him know that I trust that when he is ready to be born, he will be. I've had a really strong connection with this little one since before conception and I feel I have much to learn from him so I actually see this as a gift.

I figure if I am still pregnant at 41-1/2 weeks I can deal with that at that time.

Good luck to you and I hope your baby's birth is beautiful and gentle

 

[pamamidwife]

yeah, it's the reason why most doctors love to induce before the due date. not evidence, but fear in general.

the rise in stillbirth is actually after 43 completed weeks - and it's such a small rise it is virtually insignificant.

however, everyone has to weigh risks for themselves. if the risk of induction is better to you than the risk of waiting, then that's your business, right?

I'm very comfortable with postdates - and have had women go four and five weeks over their due dates. Due dates are man-made anyway, right?

 

[danav]

"Apparently, there is no genetic (mother to daughter) link to gestation length. In fact, I read one study that said it is believed the father's genes have the most affect on gestation."

I don't have anything to add about post-dates, but I wanted to put my 2 cents in about this...whether research supports it or not, there definitely does seem to be a genetic disposition to gestational length in my family. Between my mom, her sister, my sister and me, there are 18 births. Not a single one of the pregnancies went to 40 weeks. So it would seem that we do have some kind of genetic disposition to shorter pregnancies!

 

[nichole]

this is what i did with my first. he actually was not overdue but i just wanted to decide what to do just in case

i read the statistics on still births in post date babies. like someone said it didn't seem to be an issue until 43 weeks. nst seemed to help, but i've read they are no guarantee.

then i read the statistics on what could happen with inductions/c-sections and so on.

then i knew whatever i decided, i chose the least risky scenario. if something happened ( which is very unlikely) i knew i made an informed choice and i could remove the blame from myself.

maybe that is too simplistic of a way to look at it. you are a complex human beings and beyond statistics, there is your intuition.

you might not go overdue. even if you give yourself 2 extra days before inducing, that would give the baby a chance to choose his bday.

jmo

 

[ctdoula]

To the OP - it's not very mothering.com of me, but I personally am uncomfortable with pregnancies as they near 42 weeks. I ran an infant/fetal mortality program for 4 years before having my dd, and that has changed the way I view certain things.

Another thing to think about, my midwife mentioned when I was pregnant this time that people were let to go a lot longer in the past because we didn't have early u/s technology & the ability to accurately date pregnancies. She also mentioned that the mortality/complication rate starts rising at 41w4d. I have been out of the field for 3 years, but I trust that she's more current on these things & is reading research as it's published.

 

[pamamidwife]

Amy, I'd definitely be interested in seeing actual evidence that backs up your opinions, rather than anecdotal evidence.

The sad fact is that ultrasound does NOT accurately date pregnancies. It could be off by as much as three weeks!

I'd definitely like to see some stats that show that the mortality/complication rate rising at 41 1/2 weeks. That is something that is way different than any solid research ever done.

Also, not to get snarky, but the phrase "let go" really irks me. It implies that our bodies and our babies are not the most intelligent - that somehow the linear, very narrow based view of pregnancy and birth that modern medicine espouses, is.

Why on earth would our bodies be such a danger to our babies at such a high rate? I beg to think that more harm is done by random inductions based on ultrasound due dates than going true (over 42 weeks) postdates.

 

[crazy_eights]

I thought the 41 week research was not related to infant mortality, but inductions before that point vs. after that point and resulting c/sec's. Everything I have read agrees with what Pam stated before - slight increase in risk at 43 completed weeks.

Even ACOG doesn't call it 'postdates' until 42 weeks and they don't recommend induction before that point (officially at least!).

 

[mamaverdi]

just be sure to follow your gut, not your fears.... There is a difference, and it can be subtle.

If you are worried because of something in your gut telling you to be worried, follow up on that to the point where you feel reassured. If you are worried because this culture teaches worry, then tell that worry to GET LOST.

Factually, everything I have read also coincides with what Pam and Mom2six are saying. But only YOU and YOUR BABY know when the right time is for that baby to be born....

Intuitively and experientially what I have lived is that YOU know if your baby is ready to come. With my second baby, I went through 3 midwives. Ultimately, I believe I chose the one who would be most flexible with whatever may happen. When my water started leaking at 34 weeks, we went to the hospital. No one could confirm a leak. We went home. For a whole month, I'm sure my water was leaking, but now one could confirm, but I kept asking that baby just to wait. I knew he wasn't ready. It turned out that my baby was born with an obstruction in his urinary tract (undetected). It turns out that it is common for these babies to leak their fluid, and it is common for the leaking to be "not confirmable." My baby waited long enough to get his lungs developed so he could face the other terrible things that were coming his way. I believe my intuition and my choice of midwives is what helped this happen for this baby.

He's only 14 months now, so it's still very emotional. Hopefully what I am saying makes sense.

MamaVerdi
who needs to go pump...

(Edited for spelling)

 

[loved]

Wow, mamaverdi.

WOW!

Much love to you and that little one (and the other one too!)

 

[Averys_mom]

Whether or not my concern about going postdate is generated by fear or intuition is hard for me to discern.

I don't think there is anything wrong with fearing something, so long as it is well substantiated. The question is how well substantiated is my worry about going postterm?

I was expressing my concern to my doula, who was well aware of my strict no-intervention plan, and she said to me, "maybe your intuition is telling you something."

Though I believe my intutition is better described as a possible answer to prayer (that's a whole other issue altogether), I admitted that thought never occured to me. It hadn't occured to me until that moment that maybe I was being warned to be cautious. I never even considered this in my first pregnancy (mind you, first pregnancies tend to make us wiser second time around), and wasn't even considering it this time until a couple of weeks ago.

That said, I am still torn and greatly appreciate the wise advice and feelings expressed in this thread.

Here's a very recent article from the "other side" of conventional medicine that is worth a read. I'm not saying that is comprehensive or addresses some of the things mentioned here. It's just interesting to see where they are coming from:

http://www.contemporaryobgyn.net/obg....jsp?id=163780

 

[mamaverdi]

...between fear and intuition. AND ITA that there is nothing wrong with fearing something that is a real threat.

I think the biggest clue here is that you are asking here @ MDC, you are asking your doula, you are asking yourself. To me that would be a clue.

I too was VERY non-interventionist about my first birth. Planned birth center birth turned planned homebirth when I realized the birth center was risking people out for slight blood pressure changes. I ended up having increased blood pressure at the end of my pregnancy, and had I still been with the BC, I would have had a hospital birth. My homebirth was quick and uneventful.

Call it intuition; call it an answer to prayer. Both are very important. I personally believe intuition is when you hear G-d's voice telling you something. And it needs to be paid attention to.

If you feel you are being warned to cautious, BE CAUTIOUS. Perhaps you could have a non-stress test?

As an aside, and slightly a cautionary tale, the subject of intuition came up recently on a list I am on for babies with urinary tract obstructions. Almost every mother KNEW something was different about this baby. They had testing done that they NEVER considered having done for other babies. I had an ultrasound at 14 1/2 weeks which I wouldn't even have considered with my first baby. It found nothing abnormal, but they also didn't check the kidneys. I wanted another ultrasound---I believed I was having twins and they were not able to see it....

I now believe that our not finding the defect led us for this particular baby to have a safer birth. There would have been advantages to knowing ahead of time, namely injury to the baby and the avoidance of a lengthy malpractice suit, but I really believe that he or I or both would have died during birth had we been in the hospital. My labor was VERY irregular. He was very very tangled in his cord: 3x around his neck and 2x around his left leg. There was meconium in his water, and my water had been leaking for a month. I was GBS+ (again something I didn't test for with my other baby). The midwives waited, let the cord stretch, gave me antibiotic injections, and listened carefully and often. When he came he actually hit the floor. He didn't breathe right away, but just as she had the bag ready, he breathed. I had a small hemmorhage and a piece of my placenta was retained. His apgars were 7 and 10, and I was done with all my bleeding by the 3rd day. All these things could have turned into disasters in the hospital.

Everyone pays lip service to the each pregnancy, each birth is different, but it's really true. There are so many things I never would have considered for my first child. I do them all for my second. And I would do them again.

That is the long way to say, it sounds like intuition to me. Listen to it.

MamaVerdi
green mama to ds#1 (5.5 yrs) and ds#2 (14 months)