What Next When You’re Past Your Due Date?

Once you enter your last month of pregnancy, you’re bombarded with questions about your due date and if your baby is ready to pop out. The anxiety builds up quick. But what you need to remember is your due date is only an estimate. Only 5% of the babies are born on the given due date. Your friends and family will start asking you what the doctor says, especially when you’re past the 40th week.

“No woman should feel nervous or anxious if she’s still pregnant after her due date,” says Alex C. Vidaeff, M.D., M.P.H., a maternal-fetal medicine researcher and practitioner at the University of Texas Medical School at Houston. “Due dates can be off by a week in either direction.” Sometimes, you may be delayed by even two or more weeks, but this is no reason to worry. Many women get worried and distress when it’s past their due date.

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Your doctor calculates or estimates your due date in the first trimester by adding 40 weeks to the first day of your last menstrual period. Then, this timeline is synced with an ultrasound image of the embryo or fetus to get a clear picture. But the fact is, this is all just a guess. “You might really be 39 weeks when you think you’re at 40,” adds Vidaeff. She also goes on to say that the delivery date is genetically determined in many cases.

When you go post-term that is when your pregnancy is well beyond 42 weeks, is when your pregnancy is going overtime. Research shows that delivery after 40 weeks has its own complications and certain risks. “We now change our clinical practices at 40 weeks to prevent potential complications in both mom and baby,” says Carri R. Warshak, M.D., an assistant professor in the department of maternal-fetal medicine at the University of Cincinnati.

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Once you hit your 40-week mark, your doctors or midwives will become more careful and will monitor your baby more. Studies show post-term infants are at a higher risk of problems with glucose metabolism, which may lead to excessive birth weight. Another problem is inhaling meconium (fecal waste) which can result in breathing problems or infection at birth. Once you are in your 42nd week, the efficiency of your placenta decreases and your amniotic fluid levels too drop down. “If the fetus weighs more than 8 pounds, 13 ounces, you may have difficulty pushing during labor, and using a forceps or vacuum may be necessary for delivery,” says Warshak.

It is best to deliver your baby when you’re 39 or 40 weeks pregnant. Most studies point out that admissions to the neonatal intensive care unit (NICU) increase when your pregnancy lasts beyond 40 weeks. The chances of stillbirth too though less come into play. It is estimated at 40 weeks, the risk of stillbirth is 2 to 3 per 1,000 babies, and at 42 weeks the risk is 4 to 7 per 1,000 babies. Your doctor may induce labor if you still haven’t entered labor even after your 41st week. “If your cervix has started to dilate, odds are in your favor for a successful induction,” Warshak adds.

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Inducing labor depends on a lot of factors like your own health, the status of your cervix and your baby’s well-being too which is determined by a non-invasive procedure known as fetal non-stress testing. Warshak says, “Even if your cervix is at 8 centimeters and labor is progressing, we’ll do a C-section if the baby is not tolerating labor well.” Moreover, since your uterus is not as efficient as before, your baby may be stressed during labor.

Midwives though wait a little longer than OB-GYNs. “In our practice, we wait until 42 weeks for women to go into labor naturally,” says Joanne Hasman, C.N.M., a certified nurse-midwife at Special Beginnings Birth and Women’s Center in Arnold, Md. “If they don’t by then, we schedule an induction at our hospital. We also try natural methods and refer women for acupuncture, reflexology or reiki.”

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Your cervix is dilated at least 2 centimeters when you are 40 to 41 weeks pregnant. Midwives use a finger to separate the cervix from the amniotic sac, a practice known as ‘cervical sweep’. “If the woman is really ready [to go into labor], I’ll see her back here in 24 to 36 hours,” Hasman says.

A major concern among doctors and healthcare experts is whether labor induction, as opposed to natural labor, can lead to an emergency c-section. A new Danish study conducted with more than 230,00 women found that inducing labor after week 39 to week 41 is not connected with emergency c-section rates.

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In all seriousness though, once you hit your 39th week, you are tired and just want this to end as soon as possible. But sometimes, it may take longer than you anticipated. And these few extra weeks can be really exhausting with the incessant backaches, heartburns, and hemorrhoids. So here are a few things you could do while you wait for your baby to finally make his/her entry into the world:

  • Catch up on your sleep and finish that nursery. Use this time to finish your thank-you notes and birth announcement cards.
  • This is the time when you’re constantly getting calls about your delivery. Record voicemail messages or create a blog to answer the common questions regarding your delivery.
  • However, do not try the DIY labor starters you see online. “There are no home remedies that reliably and safely initiate labor,” says Warshak. “If there were, we’d use them in the hospital. Castor oil can make you sick and dehydrated. Spicy foods can give you heartburn. And, no good studies back the claims that sex or exercise can trigger labor,” she says.

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