To Induce or Not? How Long Should You Wait Past Your Due Date?

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It took a while for me to understand, why Yorubas would say to someone, “O se n se bi omo pe’nu bayi” meaning, “Why are you behaving like an overdue baby?”. Often times, it was a derogatory term and I had my fair share of it while growing up, whenever it seemed I was slow in running errands for the dozens of family members I grew up knowing.

However, they had always ended it with the fact that I was, after all, an overdue baby, so according to them, if I seemed slow, I was acting true to type. I guess by now you can deduce that traditional Yoruba belief is that an overdue baby took his or her sweet time to come out. They are slow and calculated.  

My mom had been expecting a late November baby, according to her last ultrasound scan, but I came out exactly ten days after her expected delivery day, making everyone pity her and wonder when she was going to “offload” her precious cargo. She however said her doctor back then at Island maternity never mentioned anything about an inducement, rather, they felt another two weeks wouldn’t be an issue and I was doing fine in utero, swimming and all.

That was over 30 years ago. Nowadays, I often hear women complaining about how doctors do not even bother to wait for a week after 40 weeks, before moving not to induction, but straight to C-section. Sometimes, when I’m at my favourite hideout,  (yes, I got one), which is close to a maternity centre, I hear women lamenting the glee and seeming haste with which doctors go ahead to open up a woman, without giving her body time to do what it can.

A pregnant lady at this maternity center was hospitalised for one whole week, two weeks after her due date, before she was eventually delivered of her baby, via a C-section, and that was because, she and her husband stood their ground against the emergency C-section the doctor had advised.  They made it plain, they were willing to wait and also try other options before C-section. The baby’s heartbeat was monitored regularly and after two days of being induced, with next to little dilation, they both knew it was time to have the C-section, and that was how their baby girl came.’

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Another mom, Ella, who was overdue was induced a day after she reached 40 weeks. Why? She was just tired and couldn’t bear an extra day of being pregnant. Before that time, she had been suggesting induction but her doctor noted that, even though it looked like her body needed only a small push to birth the baby, she should still wait for nature to take its course.

Nature refused to show up, so on day one after 40 weeks, Ella showed up at her clinic and demanded an induction. You know it is hard to refuse a heavily pregnant woman anything, so she got her way.  That day, she was induced and less than 12 hours later, she had her baby.

Usually, a pregnancy is considered “full term” at about 40 weeks gestation, measuring from the date of your last menstrual period. A pregnancy that continues for longer than 42 weeks is called a post-term, prolonged, or overdue pregnancy.

However, there is the indecipherable factor of knowing when conception actually took place, because the sperm can be in the body but not meet madam eggy until days later, which might lead to false calculation of the length of a pregnancy.

Unless you do IVF, you might never get the age of your baby right, at least in the early stages, before an ultrasound scan determines it.

Usually, when a  pregnant mom is one week overdue, doctors are still willing to wait, in fact, they are willing to wait for two more weeks after the EDD, but it becomes a case of close monitoring in the second week, because the risks for both mother and child increase during the second week.

From my research, medical practitioners say an overdue pregnancy presents risks in the form of a larger baby, which might likely lead to a complicated vaginal birth or even end up in a caesarean section birth.

Another risk is, the aging placenta may no longer suitably provide nourishment for the baby. Also, babies who are overdue are at risk of passing their first stool inside the womb. When this happens, the baby may inhale their fecal waste, known as meconium, during childbirth, which can cause breathing problems or a lung infection after birth.

When and if an induction will be considered depends on many factors, including your health, your baby’s health, and your doctor’s discretion. Anyways, most doctors would allow nature take its course in moms and babies who are healthy and have no medical conditions to worry about, at least till the 42nd week of pregnancy.

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However, induction will definitely be suggested, if not a C-section, when any of the factors below come up, according to an online medical resource, Mayo clinic:

  • You’re approaching two weeks beyond your due date, and labour hasn’t started naturally
  • Your water has broken, but you’re not having contractions
  • There’s an infection in your uterus
  • Your baby has stopped growing at the expected pace
  • There’s not enough amniotic fluid surrounding the baby (oligohydramnios)
  • The placenta peels away from the inner wall of the uterus before delivery — either partially or completely (placental abruption)
  • You have a medical condition that might put you or your baby at risk, such as high blood pressure or diabetes
  • A previous delivery. Inductions are more successful in women who have had a vaginal delivery already.
  • A favorable cervical exam. A softened and dilating cervix may respond better to induction.
  • A reasonable date. Gestational age and your doctor’s availability will be considered when scheduling an induction.

In the end, your doctor and yourself are in the best position to determine if you need to be inducted or not.

Just know that the how isn’t as important as the outcome; whether you are induced, whether you end up with a C-section, just know that a healthy baby is all that’s important.

Stay strong mamas.

 

 

 

Join the conversation with any of our TTC and Pregnancy Groups here

Photo credits:

  1. http://pregnancyanddiabetes.com.au/
  2. http://pad2.whstatic.com/
  3. http://www.obstetricexcellence.com.au/

 

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