This is personal for me. I birth my babies between 42 and 44 weeks (with the four I went into labor with). I knew the day of conception with my 4th child and she was born at 42 and 1/2 weeks. My children have weighed between six and nine pounds and have all been healthy because they were born when they were ready.
When you are 40 weeks pregnant your baby is only 38 weeks gestation. It is not until you are 42 weeks that you are truly ‘post dates’. This should be irrelevant though when we look at how the typical 40 week due date began.
From The Lie of the EDD: Why Your Due Date Isn’t When You Think:
“The 40 week due date is based upon Naegele’s Rule. This theory was originated by Harmanni Boerhaave, a botanist who in 1744 came up with a method of calculating the EDD based upon evidence in the Bible that human gestation lasts approximately 10 lunar months. The formula was publicized around 1812 by German obstetrician Franz Naegele and since has become the accepted norm for calculating the due date. There is one glaring flaw in Naegele’s rule. Strictly speaking, a lunar (or synodic – from new moon to new moon) month is actually 29.53 days, which makes 10 lunar months roughly 295 days, a full 15 days longer than the 280 days gestation we’ve been lead to believe is average. In fact, if left alone, 50-80% of mothers will gestate beyond 40 weeks.”
At this point, I think most of you know not all women have the same length cycles and ovulate on the same exact day in that uniform cycle. Also, not all women gestate the same, nor babies grow the exact same rate. Do all babies start walking at 11 months, 4 days, hour 23 of their life?
So, why the rush to get babies out between 38-40 weeks? That question can be answered in two words… fear and control. Doctors feel more in control with babies on the outside. Why, I have no idea. How can our world, environment, plastic, etc. grow a baby better than a mother’s perfect womb? When care providers tell women the risks of going post dates (which are not accurate, but probably what they have been taught), they hardly ever counter that with all the risks of inducing before baby is ready. A parent can not truly decide what is safe and best for their unborn child with out all the facts.
What can you do?
- Make sure the EDD given is based off of YOUR cycle. There are also different ways a due date can be calculated.
- Hire a care provider that is comfortable with post dates, meaning gestating even past 42 weeks.
- Do your own research.
- Follow your instincts and be patient! Only your baby knows when s(he) is ready to be earthside.
“French obstetrician and author Michel Odent, also a critic of the induction ‘epidemic’, as he calks it, argues that labor begins when the baby is ready to be born. Odent likens gestation to apples ripening on a tree: ‘You wouldn’t pick them all on the same day, would you?’ “- Jennifer Block, Author of Pushed
*Michel Odent is an MD practitioner who has specialized in birth, but is not an obstetrician. Small detail, but worth noting.
{ 101 comments… read them below or add one }
← Previous Comments
I just want to say that with my last pregnancy my doctor wanted to induce at 39 weeks due to “big baby”. I was induced for this reason for my first pregnancy and my DD was 7# 4 oz! All the research I did and the perinatologist said that ultrasound is not accurate for weight. My last pregnancy lasted 41 weeks and 5 days and I am so glad I let my DS pick his birthday! The labor was much easier and it was fun waking up knowing it was time. I made an informed decision and I wish more women did.
I looked it up recently, and the main factor is that statistically, after 42 weeks the risk of adverse outcomes for both baby and mom doubles. That is a large risk. Doctors want healthy babies too. Midwifes can’t take on liability. Induction is just as with any other intervention has it’s right time and place and like with any other intervention it is routinely used in cases it is not necessary.
Hi Ilka,
Can you please give your source for that info?
Thanks!
There’s a HUGE difference between inducing at 42 weeks and inducing at 39 or 40 weeks. Yes, the evidence shows that statistically speaking (in other words, it isn’t predictive for any individual pregnancy, but instead is predictive within a population) the rate of complications increase after 42 weeks. That’s why most midwives will transfer care at that point, because a gestation beyond 42 weeks goes outside the realm of normal, and midwives are experts in normal birth.
However, so many of my clients (I’m a doula and a student midwife) start receiving pressure to induce from 39 weeks on, it’s unbelievable. The average gestation for a nulliparous woman is 41 weeks and 3 days, so you’d think that doctors would wait until 42 weeks before they start discussing induction. 42 and 0/7 is the first day that is considered postdates, according to ACOG. That is the first day that induction should be considered, when mom and baby are both doing fine.
The issue is complicated further when you have a mother with previous healthy pregnancies that went postdates. In those cases, even midwives who would transfer a nullip at 42 weeks will usually continue care, because that tells them that this particular mother just gestates longer. I don’t know if there’s been an academically rigorous study that shows that the risks of going postdates are equal for a multip with a history of healthy postdates pregnancies, but anecdotally I’ve never met a midwife who considers that a high-risk situation.
I have read this about “undesirable outcomes” as well. However (and it’s a big however)… don’t forget that in order to accurately compare risk for births prior to 42 weeks and those after 42 weeks, you would have to adjust the numbers a lot. So FEW babies are born after 42 weeks in the US that the “risk” may be severely overinflated. Whereas the number of babies born prior to 40 weeks makes some risks look “statistically insignificant” the same numbers are obviously going to be artificially high when you look at a smaller population of individuals.
Regardless of mathematical issues with analysis of “risk” past 42 weeks, the truth is that most inductions are, as you said, not done out of medical necessity at all. And that’s the real problem.
The experience is different for every woman. I went 6 days past my due date with my third. He ended up being 10 lbs., 9 ozs. So, unfortunately, I experienced my first c-section with my 3rd baby.
A large baby doesn’t necessarily warrant a c-section however.
I went into labor at exactly 39 weeks with my first. I have a strange uterine condition that doesn’t allow me to deliver naturally, so I’ll be having another C-section. Knowing that my first came at 39 weeks and that my uterus is more likely to kick my babies out early than keep in them in extra long makes me more comfortable with the idea of scheduling a section at 39 weeks this time around.
I thought I’d add a few links on the current recommendations on inductions. Some ladies may find it useful in their research, I know I have.
http://whqlibdoc.who.int/publications/2011/9789241501156_eng.pdf
(World Health Organisation)
http://publications.nice.org.uk/induction-of-labour-cg70/guidance#induction-of-labour-in-specific-circumstances
(National Institute for Health and Clinical Excellence)
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004945.pub3/pdf/standard
(The Cochrane Library)
Great blog post and I could not agree more! You are right on. I love the book “Gentle Birth Gentle Mothering” by Sarah Buckley (a physician who delivered all 4 of her babies at home). In her book she lists research against inducing and also states that 42 weeks is normal gestation AND the “risks” we have been led to believe that exist for going over 40 weeks are founded on flawed science…if any and are practically non-existent! In fact, the risks are far greater with induction at 42 weeks. She also discusses ultrasounds and their lack of accuracy (and risks), “big babies,” and why it’s best to let your baby bake until its ready. A great read for ANYONE wanting to do research in this area.
I had a really good idea of my conception date- and they kept telling me I was wrong. I watched her due date bounce from early November, to late October, to mid November (which is what it should have been).
She was a big baby, yes, but also had a fluid enlarged kidney that made her abdomen huge (which threw a lot of the results off the chart). I went with my conception date, and fought hard to keep it that way. She was born at 40 weeks and a few days – made me very happy.
This hits so close to home!!! I had a doctor give me a vaginal exam at “40 weeks” by her count, 39 weeks 2 days by mine. I wasn’t dilated or effaced. Without another word she opened the door and yelled down the hall asking a receptionist if she had a c-section slot open for me for the following Tues, (it was Thursday so just a few days away!) I asked her what was wrong. What changed? Why was I all the sudden being given the eviction notice for my baby who was otherwise fine. I’m not even due yet! The c/s was scheduled for the day I considered 40 weeks, based on knowing EXACTLY when she was conceived and knowing I have long cycles. I told her all of this and her response: You are 40 wks by our standards. It doesn’t matter how long your cycles are or when you ovulated. We use 28 days to keep everything uniform among our clients and to make things easier (FOR WHO?!?!) Without dilating or effacing you are showing us your body isn’t going to go into labor. Some women just can’t. You need a cesarean because your body will just hold onto the baby and it isn’t safe for either of you….. I informed her politely that I wouldn’t be consenting to a cesarean based on pre-labor dilation at 39 weeks. She gave me pamphlets on therapists and told me I should contact someone to discuss my issues with a cesarean birth as well as anesthesia dept at the hospital to ease my concerns (what?!). Needless to say I stormed out. Didn’t bother rescheduling my follow up. I received a call that night from a very nervous secretary who said she wanted me to come see another dr next week. I agreed. She then went on to tell me it had to be by Tuesday. I asked why it needed to be by Tuesday and she awkwardly went on to tell me, “well the obstetricians have a meeting on Wednesday mornings and that’s when they discuss the problem patients so we need to see what’s going on with you before then” LOL. I’m now labeled a problem patient for not having a c-section for no reason. I agreed and came to the appointment Tuesday- MY DUE DATE! I was 80 percent effaced and 1 cm dilated. My water broke that evening and I VAGINALLY delivered my daughter 36 hours later. I can’t tell you how many times I’ve reflected on this story, thinking of how close I came to undergoing a c/s for NO reason. I was in labor the evening after I would have had my c-section. I thank God I had enough knowledge and trust in myself and God that I went against my doctors orders.
Great story! Good for you for standing up for yourself and being a “problem” patient.
Good for you Tara for being assertive! That sounded like such a disempowering experience. It makes it seem like women’s bodies are not to be trusted! I guess to be fair though, it may be that some obstetricians had a bad outcome with post dates and perhaps they never want that to be repeated, especially when they know that a baby will be quite okay if delivered at 38-40 weeks. That’s where it’s important that mothers can make their own informed decisions
At my 39.5 wk appt, I was not effaced or dilated, and the baby hadn’t dropped into the birth canal. My OB told me though I was full-term, I had a 85% chance of a c-section if she induced me within the next week. She knew I was terrified of having a c-section. I went into labor naturally 3 days later and stalled at 8 cm, and ended up having an emergency c-section (not the horrible experience I was expecting, thank goodness.)
My baby’s head was measured at 15.75″ (8.5 lbs) and would never have fit through my pelvis. My OB said she’d never seen such a big head. I didn’t have a duola or a midwife and I’m glad I didn’t try to go through labor at home or in a birth center. If I had lived a few hundred years ago before safe c-sections were available, we likely would have both died in labor.
Sometimes modern medicine isn’t so bad. But doctors are not all interchangable. Make sure you have an OB that is on the same page as you next time.
I had a 10lb 4oz baby at home, (accidental unassisted birth) with an unmolded 15 inch head. No tearing. People have big babies! Don’t let someone tell you you cannot pass a baby through your birth canal with out even being given a chance! She cannot know you could not vaginally birth your baby if you were 8cm and not pushing.
A baby’s physiology makes it possible to have a big headed baby…. I am small statured, and had my 9 pounds son at home….. His head was 16 inches.
My 4th could have been a nightmare if I were working with a regular OB, but I was planning a homebirth with a CNM. According to Naegele, my due date was Dec. 10, but by date of conception it was Jan 2! He was born on Jan. 6, 10 lbs. 2 oz., and so fast that she wasn’t there for it. I birthed his huge shoulders by myself!
I find all this really interesting, but I had a slightly different situation. I’m a first time mom and my son is now 7 months old. Anyways, I really wanted to go into labor naturally and have a vaginal unmediated birth. Everything looked good until 36 weeks. I was suddenly measuring small and they were concerned that the placenta wasn’t working right. I was sent to an ultrasound specialist who diagnosed my baby as being gestationally small and It was scheduled for me to be induced at 39 weeks. I ended up having to get a C-section due to failure to progress (I got stuck at 4 cm dilation). I’m still really disappointed that I wasn’t able to have my natural birth
I know my body just wasn’t ready and I still wonder if the induction was really necessary.
Hi there does anyone have a calculator for a EDD based off your personal cycle etc. that could be used I would like to as for my pregnancy issues I feel like this could answer a long ignored question of mine…
My last birth was at 42w5d. I didn’t see a huge issue, because my midwi4 was making sure I had biophysical profiles done often. He was perfectly fine, as was the placenta. And he was a large baby, to boot. 11lb. 7oz. Easiest birth out of the three I have had. Trust your instincts.
The interesting part, for me, in reading articles like this, is that my personal experience with due dates is so different than what is postulated here. My 4 babies all came naturally from 3 weeks to 1 1/2 weeks early. So, my average time being pregnant was 38 weeks, which would then mean my babies were technically born at 36 weeks gestation … then, if 42 week pregnancies should be considered the norm, then my babies were technically all preemies, being 5 to 4 1/2 weeks early under that premise ! However, as some say and I agree, babies come when they are ready but also when mom’s body is ready, too. I think my body handled pregnancy as long as it could and then said, baby is big enough and ready enough. My first child, a boy, was the earliest and smallest at 5 1/2 lbs, but all three of the others were 6 lbs 10 oz (the last baby, a girl, was one oz more). So, my personal logic is that my babies could have been big babies had they been more ‘full term’, but they were born when my body considered them full-term, I guess. I agree that doctors do not need to get so antsy and should be more patient with supposedly overdue babies and I agree that due dates are not exact. It seems mine were not, at least according to traditional logic, but going in the direction of early rather than late. However, I did have regular cycles … not 28 day ones, but 26-27 day ones then, and I generally knew the moment/time of conception, too, and didn’t think my due dates were too far off. Anyway, I never had to deal with post-term/post-due date babies, but it is sure not the same for everyone.
I had my daughter at 41.6, and I’m thankful I wasn’t induced or anything because she was only 6.6 lbs.. and I enjoyed my extra week and 6 days of pregnancy:)
I hate unnecessary inductions.
I so agree with this. I was not induced but had a cesarean at two weeks before my due date because my baby was suppose to be ready to come. She ended up having difficulty breathing because she was early. My next baby I knew when I ovulated and knew that it was later than was supposed by the EDD so decided I would at least fight for “my” date if I had to have another cesarean. When I was able to have a VBAC, sure enough, he was right with my due date.
What do you personally do if a pregnant mama is past 44 weeks gestation? What if she is over 44 weeks and still feeling movements as usual?
← Previous Comments
{ 3 trackbacks }