Overdue- how long would you be willing to wait?

[hapi2bhealthy]

So apart from the placenta not working, what are the other risks? What was the story with bubba passing his meconium?? I am in no way overdue, in fact I'm not even 24 weeks yet, but I really don't want to be induced or use pain meds at all, and my fear is induction = more pain = birth plan out the window...my hospital is very very good with pretty much leaving mum and bubs to grow and labour peacefully, so not sure of induction techniques favoured but is there one that is know to NOT be as painful? My baby's health and life is far more important than my birth plan...

 

[fifi-folle]

I was a classic case of cascade of interventions. I was induced at 42wks, had the gel, then ARM, then syntocinon drip, then had diamorphine, then an epidural, ended up with an EMCS after being allowed 30 mins pushing due to meconium and increase in fetal heart rate. This was a far cry from my desired natural water birth using hypnobirthing.
I feel there is a case for induction in some cases (pre-eclampsia etc) but not for not coming out in the medical profs timescales!
This FB group has lots of links: https://www.facebook.com/TenMonthMamas

 

[hapi2bhealthy]

I was a classic case of cascade of interventions. I was induced at 42wks, had the gel, then ARM, then syntocinon drip, then had diamorphine, then an epidural, ended up with an EMCS after being allowed 30 mins pushing due to meconium and increase in fetal heart rate. This was a far cry from my desired natural water birth using hypnobirthing.
I feel there is a case for induction in some cases (pre-eclampsia etc) but not for not coming out in the medical profs timescales!
This FB group has lots of links: https://www.facebook.com/TenMonthMamas

Urgh this is my fear, as I too want a water hypnobirth I know I wont be pressured due to docs timelines, but I fear pressure about other factors and wonder what the serious risks are...? Can baby die if gone over a certain time? I know women "used to do it all the time" but there also used to be a much higher infant/maternal death rate...soooo that argument doesn't work much for me.

 

[fifi-folle]

The risk is placenta stopping working and low levels of amniotic fluid. These can both be monitored by ultrasound, although measuring of fluid levels can be somewhat erratic. My friend had a scan at 42+wks and it was fine, mistakenly she was scanned again 30 mins later and was told the levels were low! She went on to have a home water birth at 42+3 but she had to be very strong not to give in to induction (she had had a horrible 3 day induction with her first son).
The statistics indicate that the risks are low though. However doctors err on the side of caution (and imo like to control birth) so prefer to have baby out rather than take a wait and see approach. This is why I am going to avoid going in to hospital to have this baby, I feel a HBAC is safer for me due to medical professionals obsession with monitoring and controlling everything! (Obviously if there are any concerns I will go in though!)

 

[hapi2bhealthy]

Here's a link to a review of the literature out there so far on induction, for those that want to read what science and studies have actually proven so far and hear more than just anecdotes:

https://www.kentmidwiferypractice.co.uk/induction-review/

It states that for LOW RISK, there is no evidence thus far of the placenta having a 'shelf life'; thus, if you have had a normal, uncomplicated pregnancy your placenta will continue to function as it should until baby is ready to be born.
If you are HIGH RISK, this is not necessarily true, although fetal death and distress is often due to OTHER factors, rather than placental 'die off'.

There has been reported reductions in overall fetal death and complications WITH inductions in SOME studies, however these studies have been criticised on their internal validity: poor sampling, poor data taking etc. So cannot be taken as true evidence, considering the validity of the experiment.

There IS clear evidence that inductions often cause a cascade of interventions, DO cause more painful birth, and each method has various risk factors of their own:some more than others.

Overall, there is NO conclusive evidence EITHER WAY. Basically, ya damned if ya do, damned if ya don't....

My hospital allows us to go to a full 15 days overdue before an induction. I think that by then, I would be ready to be induced and have formed an alternative birth plan, because there is no evidence to tell me that my baby WILL be safe if I don't induce.

OK, now to be sure that from week 40 onwards I eat curries every meal, drink rasperry leaf tea, have accupuncture, sex, and dance around to make sure I don't NEED to be!!

 

[fides]

in my state, home births are legal 37-42 weeks. if you go past 42 weeks, you have to see an OB who monitors the pregnancy and decides whether you can continue at that point.

sooooo hoping this one doesn't come late like my first so that i don't have to cross that point - our son came a few hours shy of the 42 week mark, and i'm pretty sure the OB would have said i needed an induction the next day.

 

[amjon]

So apart from the placenta not working, what are the other risks? What was the story with bubba passing his meconium?? I am in no way overdue, in fact I'm not even 24 weeks yet, but I really don't want to be induced or use pain meds at all, and my fear is induction = more pain = birth plan out the window...my hospital is very very good with pretty much leaving mum and bubs to grow and labour peacefully, so not sure of induction techniques favoured but is there one that is know to NOT be as painful? My baby's health and life is far more important than my birth plan...

I was induced with just about everything they can apply down there. I had Cervadil first (did nothing), then Cytotec (got to a fingertip), and then the sea weed rods (L (something)). I had NO idea I was in active labor. I thought I was just having the "cramps" they told me the Cytotec could cause. I told the nurse it was a 5 for pain (delivered about 20 minutes after that). I had an OB tell me that Cytotec labor is supposed to be more painful than Pitocin (which I didn't get until after delivery).

 

[ace28]

Just wanted to come back here with updates.

I've done a lot of literature reading and review (thanks Hapi for that link as well) and it seems from what I have read that the risk increases SLIGHTLY at 42 weeks and SIGNIFICANTLY at 43 weeks.

Armed with this information, I talked to my midwife about it and we decided that at 42 weeks, I will have a biophysical profile done. As long as baby is fine, we can wait until 43 weeks, at which point I WILL insist on induction. If baby isn't fine, then obviously that's a different story and I'll head straight to the hospital for induction.

A coworker of mine is due TODAY and she just went in for her dr appt and her dr scheduled her for induction in one week. And I'm like... why? Her cervix is effacing and dilating, so even though she's not in labor yet her body is clearly working up to it. Her baby isn't in any distress. This is her first child, so there's not even an established timeline of when the baby might come from previous births. She told me the doctor just said he would "prefer not to wait' and, because she's just done being pregnant, she agreed.

Not gonna lie, this kind of attitude pisses me off. You can get pregnant and wait the 40 weeks, but you can't go so much as one week and one day over so that your baby can come when SHE is ready, because you and the doc are both impatient? Really? I get being tired and sore but baby's health is more important.

I know these are fighting words to some and I'm okay with that. It would be different if it were for a medical reason but since you're not even over term technically until 42 weeks and statistics show no increase whatsoever in risk of waiting from 40-42 weeks- WHY put yourself and your baby at risk with unnecessary interventions?

/end rant.

 

[fifi-folle]

rant away, it annoys me how all the discussion is about the risks of going past 42 weeks but no discussion of the risks of interventions! Such as the risks posed by a c-section, grr.

 

[ace28]

rant away, it annoys me how all the discussion is about the risks of going past 42 weeks but no discussion of the risks of interventions! Such as the risks posed by a c-section, grr.

agreed. csection is presented as such a routine choice to women instead of as the major surgery that it is. Also, women are ridiculously underinformed about exactly what interventions they'll be undergoing when it comes to induction and the risks of each- just overheard my coworker talking about "something they can stick up there that does something to yoru cervix- I think." Pretty sure she's talking about cervidril and 100% sure she has no idea of any of the risks involved- and her doctor isn't going to tell her, he'll just tell her it's "necessary." Gah.

 

[BunnyN]

I get how you feel, I'm not even pregnant, but I saw my mum go through this with my little sister, some people seemed to think she was TRYING to endanger the baby by waiting as long as possible, she wasn't being overly paranoid about risks or a silly female who didn't understand she just wished to wait until there was a reason not to, thankfully labour came the night before her induction (a long walk did it for her ) She was almost 2 weeks over by then but they would have induced at a week over if she'd given them the chance.

 

[fifi-folle]

That's so sad. There are implications for both mother and baby but they don't bother to find out In my case I knew the risks of induction and delayed as long as I could but the combination of tiredness from 5 weeks of contractions and a DH who was starting to get concerned made me take the risk. However now DH has even been telling his colleague the risks of induction

 

[LolaAnn]

This conversation is so refreshing! I'd be willing to wait for 43 weeks with monitoring, possibly even longer. I doubt it will come to that as my son came a day before his due date so I'm hoping the same for this baby although it would mean a Christmas baby!

 

[BunnyN]

Don't get me wrong, I'm totally for induction and C sections WHEN there is a good reason, they save lives after all, it's just that they seem to be given without much thought sometimes. In my mum's case I think they were mildly concerned because she was 38 and had slightly high blood pressure or something like that but there wasn't any serious concern, if there was I'm sure she would have been happy to do whatever. Personally I think I would be getting concerned by 43 weeks but I'd be happy to go over 42 if everything was fine.

 

[ace28]

Don't get me wrong, I'm totally for induction and C sections WHEN there is a good reason, they save lives after all, it's just that they seem to be given without much thought sometimes. In my mum's case I think they were mildly concerned because she was 38 and had slightly high blood pressure or something like that but there wasn't any serious concern, if there was I'm sure she would have been happy to do whatever. Personally I think I would be getting concerned by 43 weeks but I'd be happy to go over 42 if everything was fine.

this is exactly how i feel.

 

[hapi2bhealthy]

so glad I found this thread and thanks to the PP who posted what their literature results were!!

Thankfully I am allowed to go 15 days overdue before there is a very serious induction discussion but I will agree to it by then. Not that it's going to happen! (Trying to think positively here hehe)

 

[Vicyi]

With my DS i had written in my birth plan that i would ONLY go to 41weeks and then i wanted to switch to a hospital birth. Although i would still want to wait as long as possible without induction i just didnt feel i could go that far at home. My MWs never actually gave me a set out but seems ok with my choice.

 

[ZoeZo]

Well it was hard, as everyone scared me that baby would be in serious danger after I hit that magic 42 weeks (which was nearly 43 weeks by ultra sound!)

She came spontaneously at 17 days over my LMP (42+3) and 23 days over USS EDD (43+2!) I wasn't silly, researched and had us checked over when we hit 42 weeks MY date - I'm sorry but I think my bodies cycle date is more accurate than a measurement on a screen on a particular day which is 'average'...

I had a ctg, fluid level scan and cord doppler done, then another ctg, movement was all good and normal and my instinct just knew she was ok (I didn't know she was a girl at the time!) I know there is no clear evidence that the placenta starts to degrade at 42 weeks, and that studies are based on a report from 1958! (Sure I put this in my previous post, sorry!) lol
Babies pass meconium in the womb when their digestive systems mature as they reach full term, once you are in labour they stop practicing breathing (or something) so it is very rare to inhale or ingest it on birth, it does happen, but rare.

I was so worried by the scare mongering and pressure from MIL I agreed I'd have at least a sweep, then be booked in for induction if didn't work - I hardly slept the night before it, then I was woken up early hours by uncomfortable braxton hicks, they'd never woken me up before - so I was going to stay at home, but still went in for the scheduled ctg monitoring I WAS contracting normally! They were getting stronger and I agreed to be checked - 2-3cm effacing and head so low she couldn't do a sweep!

The rest was a cascade of intervention as she was 'late' but bascially in short, one shot of pethadine, iv fluids (I was nutritionally drained) full story here :https://babyandbump.momtastic.com/p...1142599-over-week-ago-yellow-turned-pink.html ARM, synto, forced pushing on my back, constant monitoring, time limit when the Doc decided I needed kiwi vantose to help (although she was 'just' there but I was exhausted by then) which then resulted in 4th degree tear, immediate cord cutting (she injected anaesthetic to give me an episiotomy which I declined) blood transfusion.

But she came out vaginally and chose her own birthday, latched on fine (once I got to hold her 3 hours after her birth ) and I swear if I'd be let to labour naturally and no forced/rushed pushing I wouldn't have torn (but this is their policy for 'overdue' babies) oh and she was perfect, no signs of overdue and placenta healthy, she was just a 42 weeker..
x

Helpful articles:
https://midwifethinking.com/2010/10/09/the-curse-of-meconium-stained-liquor/
https://midwifethinking.com/2010/08/20/in-defence-of-the-amniotic-sac/
https://midwifethinking.com/2011/07/17/induction-a-step-by-step-guide/

 

[ace28]

Well it was hard, as everyone scared me that baby would be in serious danger after I hit that magic 42 weeks (which was nearly 43 weeks by ultra sound!)

She came spontaneously at 17 days over my LMP (42+3) and 23 days over USS EDD (43+2!) I wasn't silly, researched and had us checked over when we hit 42 weeks MY date - I'm sorry but I think my bodies cycle date is more accurate than a measurement on a screen on a particular day which is 'average'...

I had a ctg, fluid level scan and cord doppler done, then another ctg, movement was all good and normal and my instinct just knew she was ok (I didn't know she was a girl at the time!) I know there is no clear evidence that the placenta starts to degrade at 42 weeks, and that studies are based on a report from 1958! (Sure I put this in my previous post, sorry!) lol
Babies pass meconium in the womb when their digestive systems mature as they reach full term, once you are in labour they stop practicing breathing (or something) so it is very rare to inhale or ingest it on birth, it does happen, but rare.

I was so worried by the scare mongering and pressure from MIL I agreed I'd have at least a sweep, then be booked in for induction if didn't work - I hardly slept the night before it, then I was woken up early hours by uncomfortable braxton hicks, they'd never woken me up before - so I was going to stay at home, but still went in for the scheduled ctg monitoring I WAS contracting normally! They were getting stronger and I agreed to be checked - 2-3cm effacing and head so low she couldn't do a sweep!

The rest was a cascade of intervention as she was 'late' but bascially in short, one shot of pethadine, iv fluids (I was nutritionally drained) full story here :https://babyandbump.momtastic.com/p...1142599-over-week-ago-yellow-turned-pink.html ARM, synto, forced pushing on my back, constant monitoring, time limit when the Doc decided I needed kiwi vantose to help (although she was 'just' there but I was exhausted by then) which then resulted in 4th degree tear, immediate cord cutting (she injected anaesthetic to give me an episiotomy which I declined) blood transfusion.

But she came out vaginally and chose her own birthday, latched on fine (once I got to hold her 3 hours after her birth ) and I swear if I'd be let to labour naturally and no forced/rushed pushing I wouldn't have torn (but this is their policy for 'overdue' babies) oh and she was perfect, no signs of overdue and placenta healthy, she was just a 42 weeker..
x

Helpful articles:
https://midwifethinking.com/2010/10/09/the-curse-of-meconium-stained-liquor/
https://midwifethinking.com/2010/08/20/in-defence-of-the-amniotic-sac/
https://midwifethinking.com/2011/07/17/induction-a-step-by-step-guide/

congratulations on your healthy baby! good for you for sticking your guns with the dates and the monitoring and the going "overdue". Even though you had some interventions in the end you did everything you could for that baby girl and she's happy and healthy and here. congrats again!

 

[flubdub]

I would definitely wait until 43 weeks, no problem. Yes I'd be fed up by that time lol but the baby knows when he/she is ready. Scans only give you a rough estimate of when the baby is due. I totally expect the dates to be out by a few weeks either side and so 43 weeks to me would be fine. Under no circumstances do I ever want to be induced UNLESS there is something wrong with the baby. Anything other than that - no chance.
If you DO get to 42 weeks, ask for a scan. They will tell you if the baby is fine in there and you can decide then what you want to do. Good luck.