You Need To Read This If Your Baby is "Past Due"

When I was pregnant with my first son, Titus, I felt so anxious when my EDD came and passed. If you do a quick google search asking when most babies are born, it’ll tell you between 38-40 weeks. What isn’t clear is that those statistics are skewed by inductions and cesareans. If we wait until our bodies and babies are actually ready, the statistics would likely be a lot different. I didn’t know this at the time, so when 40 weeks came and passed, I started getting worried. I planned on a homebirth with a midwife, and I started to worry that she would transfer me to the hospital for an induction if my baby didn’t arrive “on time.”

I knew I didn’t want to birth in the hospital. I knew I wanted to avoid the cascade of interventions that can be triggered by an induction. Instinctually, I knew what my body and my baby needed… but the closer to 42 weeks I got, the more anxious I was that I would meet resistance from my care providers if I wanted to stick to my original plan (wait for labor to begin spontaneously and birth from home). That’s when I started to look for truly unbiased information about the REAL risks (and benefits) of waiting on my labor to begin on its own (even if that meant going into labor well into my 42nd week of pregnancy).

If you are nearing your “due date” (or, more accurately, your EDD), I highly recommend reading the two articles I have linked below:

Evidence Based Birth: Evidence on Due Dates

This reference was actually released right AFTER Titus was born. It features a photo of an online friend of mine (stretch_birthwork on instagram) who I met in my due date group during my pregnancy with him. She was also pregnant for closer to 43 weeks! We bonded over that experience. It wasn’t her first baby, or her first time to go past her EDD, so she was so confident in herself that I gained confidence just from talking to her.

Although I did not have access to this resource during my experience going past 42 weeks, I LOVE to recommend it because it is SO thorough. It defines the terms “full term” and “post term.” It discusses the ways we calculate our Estimated Day of Delivery (mistakenly referred to as our “due date”) and how they are flawed and inaccurate by at least a week, and probably more than that. The most accurate way to calculate your EDD is to have an ultrasound between 11-14 weeks of pregnancy. “Due Dates” should never be changed based upon a third trimester ultrasound. Once you pass 20 weeks, ultrasounds become significantly less accurate in predicting the age/size of your baby.

This article is also wonderfully enlightening because it discusses the relative risk versus the absolute risk of going past 42 weeks. Providers tend to pose the statistic as “the risk of stillbirth doubles after 42 weeks of pregnancy,” when this is the relative risk. The absolute risk is the actual risk. So, at 41 weeks the absolute risk of stillbirth is .17% (or 1.7 per 1000 births) and at 42 weeks the absolute risk of stillbirth is .32% (3.2 per 1000 births). While the relative risk sounds frightening (“the risk of stillbirth is 94% higher at 42 weeks than 41 weeks”), the absolute risk is very low at .32%. I understand that when we are talking about our babies, we want to be extremely careful. But there are ways to check in on your baby to reduce risks that I will list at the end of this article.

“About half of all pregnant people will go into labor on their own by 40 weeks and 5 days (for first-time mothers) or 40 weeks and 3 days (for mothers who have given birth before). The other half will not.” If you’ve gone past 40 weeks, you are NOT alone. It is actually quite common. Nature has variations of normal. Babies are not all the same size. Embryos do not all implant at the same rate. Pregnancies do not all last the exact same amount of time.

A Timely Birth, by Midwife Gail Hart

This resource is the one that influenced my beliefs and decisions regarding the length of my gestation. I am so thankful that I stumbled upon this article after I had passed my “due date” with Titus. It gave me the confidence I needed to trust my body, trust the process, and advocate for myself when speaking to my care providers about my choices.

Hart makes the point that postdates, by themselves, are not associated with poor outcomes. Extreme postdates, and postdates in conjunction with fetal abnormalities do show an increased risk. Hart states that if growth restriction and fetal abnormalities are removed, there are no significant increases in risk until past 43 weeks. She asserts that the medical community overreacts to postdates, and that care providers should simply monitor postdate pregnancies carefully and induce only if problems arise, to avoid the risks of induction unless they are absolutely necessary. She posits this is the best way to reduce the astronomical induction rates in the US (more than a third of women were induced in 1999, and another third had labors augmented with pitocin; in 2013, 41% of mothers reported that their care providers induced labor, and the majority of them were induced for going past their EDD).