I’M OVERDUE: NOW WHAT?

Bayo Ajibola

i am pregnant now what

Is it normal to go beyond my expected due date?

Yes, this is very common. Only about four per cent of babies are born on their exact due date.

The due date is an estimate of the day that you will give birth, and is calculated as 40 weeks after the first day of your last period. Your midwife may update your due date following your dating scan, which gives a much more accurate picture of how far along in your pregnancy you are.

A lot of babies arrive between 37 weeks and 41 weeks of pregnancy, usually within a week either side of their expected due date. Twins and triplets tend to arrive before this timeframe.

A prolonged pregnancy is defined as  the one that lasts longer than 42 weeks (294 days). It’s estimated that between five per cent and 10 per cent of women have a pregnancy that lasts this long.

Many hospitals have a policy of inducing labour before 42 weeks, so it’s difficult to give an exact figure for pregnancies which go beyond this time. In the UK, only about four per cent of babies are born after 42 weeks.

 

Does it matter if I go past my due date?

Provided you’re only a few days past your due date, most doctors won’t offer to induce your labour for a while. Though by this stage it’s likely that you’re feeling a bit fed up with being pregnant.

Obstetricians do worry about babies that are born several weeks past their due date (postmature). That’s because a very small number of babies die unexpectedly while they are still inside the uterus (womb) after 42 weeks of pregnancy.

The number of babies that  are stillborn or who die shortly after birth gradually increases between 39 weeks and 42 weeks and again after 43 weeks. Even so, having a baby that is stillborn at between 39 weeks and 42 weeks is very rare.

Obstetricians aren’t sure why the chance of loss increases as the weeks go by. They don’t know whether it’s to do with the length of pregnancy or the health of the mum or baby. It may be that after 42 weeks, your placenta may not work as well as it did. As a result, the supply of oxygen and nutrients to your baby may be reduced.

There are no tests that can tell you whether it would be better for your baby to have your labour induced. But most hospitals suggest inductions at about 42 weeks.

There is some debate about the timing of induction, however. Some studies show that babies are healthier at birth and more likely to be born safe and well when hospitals induce labour at or before 42 weeks.

Other studies disagree and say that routinely inducing labour at this time makes little difference to babies’ well being if their mums are healthy.

 

How common is induction?

The induction rate is about 20 per cent. So you have a one in five chance of having your labour induced.

If your pregnancy has been straightforward, you should be offered an induction after 41 weeks. The timing will vary according to your hospital’s policy. In some areas you may be offered an induction at between seven days and 10 days after your due date, in others it may be two weeks. This variation happens because it’s still not known when the ideal time is to induce labour in overdue mums.

You may prefer to have your labour induced by 41 weeks, by which time you may have had enough of being pregnant. Or you may rather wait to see what happens.

If your obstetrician suggests an induction, ask if your hospital routinely offers inductions at a certain date, or if it’s due to your individual circumstances. Your wishes should be taken into consideration when an induction date is suggested.

If you decide not to have your labour induced, it’s likely that you’ll go into labour on your own before 42 completed weeks. That’s if your due date is based on a dating scan. Your baby is still very likely to be born safe and well at this stage.

 

If I’m overdue,Then What happens?

If you haven’t had your baby by the time you’re 41 weeks pregnant, you’ll see an obstetrician for an antenatal appointment.

Your obstetrician will:

  •          Check that your due date is correct, by confirming when you had your last period.
  •          Ask if your menstrual cycle normally lasts 28 days, referring to your dating scan, if you had one.
  •          Measure your blood pressure and test your urine for protein.
  •          Examine your bump to check the position and size of your baby.
  •          With your permission, carry out a vaginal examination to see if your cervix feels soft and stretchy and ready for labour.

Your obstetrician should ask you if you’d like to try a membrane sweep to see if this will trigger labour.

Your obstetrician or midwife will carry out a membrane sweep during a vaginal examination. She’ll insert her finger into the entrance to your cervix and gently but firmly move it around. This action stimulates your cervix to produce hormones which may cause your labour to start.

Membrane sweeping will  increase  the chances of labour starting naturally within 48 hours. You don’t have to have a membrane sweep if you’d rather not. Ask your midwife or doctor if you’d like more information.

But If a membrane sweep doesn’t do the trick, your obstetrician will discuss with you the pros and cons of having your labour induced with hormones. She should outline the alternative of letting nature take its course. If you decide to go for an induction, you’ll be given a date to go into hospital.

 

What are your choices?

If you’ve had a word with your obstetrician and you are not sure about having an induction, you could ask for a day or two to consider it. See what your midwife thinks and talk to friends who have had an induction. But do keep in mind that every pregnancy is different.

Another alternative to induction is to have your pregnancy monitored every two to three days, to check that your baby’s well. This should be offered to you if your pregnancy continues beyond 42 weeks and if you decide not to be induced.

You may be asked to go into hospital so your midwife can get a record of your baby’s heartbeat on a cardiotocography (CTG) machine. An ultrasound scan will check your baby’s movements and look at the levels of amniotic fluid in your uterus.

You could even try a few natural remedies to get labour going, though there isn’t much in the way of research to show that any of these work.

Above all the decision whether or not to have an induction is yours. Make it on the basis of the information you have been given and talk to your midwife if you need more advice.

 

What can I do while I’m waiting to have my baby?

  •          Have something planned for every day. Don’t stay at home wondering whether you can feel anything happening. Get out of the house, but don’t go too far!
  •          Now’s a good time to stock up your freezer. After your baby is born you’ll be really glad to have lots of food in the house.
  •          Tell friends and relatives not to ring every day to find out what’s happening. Reassure them that you’ll call them when the big event has taken place.
  •          Go out for lots of last-minute treats with your partner. It won’t be as easy to do after your baby’s born.
  •          Rest. If you’re finding it difficult to sleep at night, take a nap during the day. Put your feet up. Play some music. Don’t fret if you can’t sleep, just dozing is fine and will help to build up your energy stores for labour.
  •          If you think your labour has started, but you’re not sure, phone your midwife and ask for advice. Don’t hesitate to give her a call if you’re worried.

 


Bayo Ajibola

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