The problem with EDDs

[Amy_K]

Okay, so I went over my EDD on Saturday. No big deal, I'm relaxed about it and prepared to be patient while waiting for my baby to arrive.

However, I do feel that the medical establishment and lay people in my life will be pressuring me more and more as each day passes.

My MW came to the house today to do a sweep and made an appointment for me to see the consultant on Monday (T+9) as my LHB guidance says women should be induced after 12 days, and I said I want to wait until +14 (actually +17 but I'll fight that fight when we get to it)

The sweep told her that I'm 1cm, (but due to Mutips Os) uneffaced, cervix is central, and station was -2cm above spines. So all in all not promising for an immediate kick off


Anyways, I decided to do some reading about due dates just to arm myself for the meeting next Monday and for own own continued peace of mind.

According to my ultrasound my EDD should be 5th Feb however, using my LMP alone it would be the 6th Feb.

Adjusted for 'true' lunar month, gives the 12th Feb.

Using both "Woods Method" and "Mittendorf's Method", gives 14th Feb.

As far as I can see, and certainly judging by my own experience both this time and last time, EDD are a flippin' nuisance and act more as something for other people to get hung up on and worst case, use against you and your baby.

 

[indigo_fairy]

Definately, my edd going by my charting of when I know I ovulated would be the 9th July, but the scans I've had put it to the 1st July. In my own mind I'm going to think to myself that I'm not due intil the 9th. I'll have to cross the bridge when it comes to arguing my case re due dates etc...! I'm also planning on waiting at least until +14 and refuse induction offer on the policy day +12, which luckily I didn't need last time, but they were telling me I'd HAVE to have it, I'll be telling them different this time round.

Good luck on things starting for you soon!

 

[KandyKinz]

Yay! Lets rant about the evil's of due dates! I HATE them!!!! First off, the concept of a single due date is very misleading and it absolutely drives me crazy and people poke and prod to get an exact date out of me. Babies are term between 37 and 42 weeks. They can come anytime during that time. Babies who come at 37 weeks did not come early they came on time. Babies who came at 41+6 did not come late... They came on time! Then there's the accuracy issues........ Then there's the management issues.... I've seen NICU staff refuse to attend a birth of a baby born at 23+2 days because it was not yet viable..... It had absolutely nothing to do with the baby's condition at the time of the birth. The decision to withhold care was entirely based on that babies due date. A due date that could have very easily been wrong! And I've seen a perfectly healthy 35+5 week old baby spend it's first 48 hours in the NICU purely because it was born at a gestation less then 36 weeks old which was extremely extremely hard on the mother and had a real detrimental effect on the initiation of breastfeeding.... I could go on and on.... Each situation should be assessed on an individual basis. IMO management SHOULD NOT be based on EDD alone!!!!

Then there's my current due date issues. This was a planned pregnancy. I charted my BMT, cervical mucus, position, saliva ferning and used ovulation predictor tests while we were ttc as well as for many months prior to that. I KNOW my cycle. My periods have been irregular and wonky for years and my luteal phase was more often then not on the shorter side of normal.

Anyways, based on my BMT and ovulation tests and everything else I ovulated on June 30th which according to Naegele's rule puts me due on March 23rd.... But if you're lazy about it and rely soley on a pregnancy dating wheels the due dates vary from March 24th to March 26th. Turns out not only are those wheels inaccurate in calculating a 40 week pregnancy but they are extremely inconsistent as well. I have three of them which I have obtained over the years and each one yields a different due date and none of them correlate with Naegele's rule (which in the obstetrical worlds is considered the gold standard....)

So at my first appointment, my midwife initially wanted to use my LMP which puts me due on March 18th but I was insistant that my last period was of no revelance to when I ovulated and after some persuasion she agreed to use the date of conception. Unfortunately, she's one of those lazy midwives who rely on the wheel and stated that my due date is March 25th.... Ugh no! The majority of the questions in the first exam in the Intro to Midwifery courses consists primarily of due date calculating questions. My midwife would fail it for sure! How reassuring is that?!?!

Anyways, I had alot of bleeding in the first tri and ended up having an early ultrasound and the due date according to that ultrasound was March 18th. Just lovely! It corresponded perfectly with my LMP conflicting with my BMT, my cervical mucus, my saliva, and don't you actually have to have sex to conceive????? Cause hubby didn't put out at all until the wee hours of the morning on the 31st cause he was too tired from work (and probably the preceding months of ttc) to abide by the sperm meets egg rules. I remember it well as I was quite grrrrrrrrrrrrrrrrr at him over it. So if I were truly due on March 18th hubby's sperm must have access to some sort of teleportation system cause there's no other explanation for how they would have gotten in there at that point in time.

EXCEPT for the fact that first trimester ultrasounds (the most accurate dating ultrasounds) are only accurate to +/- 5 days (and some studies have suggested that the window of accuracy is even larger then that. So according to my conception date I'm due March 23rd and according the the U/S I'm due March 18th which is a 5 day difference. SOGC guidelines (the guidelines Canadian OB's and midwives are suppose to abide to) state that if the there is greater then a 5 day difference between the u/s and dates then the ultrasound dating should be used. So in my case 5 is not greater then 5 so you'd think that it would all be good.

BUT my midwife has flat out refused now to use my conception date due date because the OB's in our community ALWAYS just use the ultrasound due date if a first trimester U/S dating is available :/ Hmmmmmm so really what's the point of even having guidelines when they're not even followed??? She then went on to say that the u/s corresponded with my LMP and she'd look foolish to argue with that as there's "two indicators for the 18th against one for the 25th" (Ugh again do the math my due date is technically the 23rd and that's when I hit the point where I wanted to start banging my head against the wall). She then goes on to say that it's no big deal anyways because due dates are just a guideline.

Which would be lovely if it were true but I have a history of going postdates (and god only knows the accuracy of the due dates they were using back then... I never charted and was really relatively clueless about such things back then) and sadly alot of prenatal management is purely based on dates. I REFUSE to undergo another unnecessary induction and doctors here are very very induction friendly.

There's ALOT of social inductions done between 37 and 39 weeks and the ob's refuse to let women go beyond 41 weeks. (Again, these guys really have to start reading their own guidelines! According to their postdates management protocol all women are to be "offered" and induction at 41 weeks and if they decline the recommended management is for them to undergo regular fetal surveillance (with either NST's or BPP's every two days) until 42 weeks at which point induction is recommended. IMO being offered an induction is not the same as being told you are 40+4, all is well with you, all is well with baby, but if you don't get induced tonight I will refuse to be your care provider and you will have to travel 2 1/2 hours to the next nearest hospital for maternity care when you go into labour (which is what they did to me last time....)

Ugh!!!! Technically according to midwifery guidelines when a woman reaches 42 weeks they have to do an OB consult (essentially the woman just has to go in and chat with the doctor who will then tell them the recommendation is induction). I have already told the midwives that I will not agree to that consult until I am 42 weeks at which point they told me that other women have "tried" that but the doctors have refused to see them because they were beyond 41 weeks (and keep in mind my 42 weeks is 42+5 in their eyes.....). If I get to that point it IS NOT gonna go over well and my midwife is well aware of that and last time she even started talking about starting stretch and sweeps at 38 weeks (which is my 37+2)... I DON'T THINK SO!

I was hoping that now that there were midwives in my area there would be less prenatal bullying but it appears that the OB's continue to rue the day and have bullied the midwives into practicing like them if they are to be accepted into this medical community. As a background it took them 4 years to gain hospital privileges (they were the only ones in the province to have that problem for such a long period of time) and frankly they are scared sh*tl*ss of losing the ground they have obtained thus far... The power dynamics and politics involved in this is just awful and the pregnant clients are the ones suffering as a result.

Grrrrrrrrrrrrrrrr at due dates!

So there's my due date rant. Wish I had a solution for both of us.

 

[Jenniflower]

From the day we found out when I was due neither me or hubby have told people our "due date". Well that is to say we try not to but people won't let it go. Hubby's even gotten in a few rows with the women at his work who ask him "When's your wife due?" "Sometime in Feb" "You don't know the date? That's horrible" "There isn't a date, the baby can come in any time" "There's always a date, I can't believe you don't even know your own wife's due date" To which he then finally has to say Feb 12th, but that doesn't mean the baby will come then. "Oh yea we know know that, we just wanted to know that date." Seriously, what's with the obsession.

Anyways, I've never let it bother me much. My midwife has said on more than one occasion that 40+12 is the standard for a homebirth but I've already told her I don't except that and will be going as long as needed without feeling pressured. She seemed fine with that. (Truthfully after the debacle with the whole 37 week thing she doesn't fight with me much anymore, hahaha) So if I go over I go over. I won't feel pressured, even if they try to. They're just doing their job and I don't fault them for that. I just know my body well enough to know it's ok to wait.

What I didn't realize KK was that you could go through such an ordeal in Canada over it!! No wonder you were fighting so hard for a better date. Here in the UK it's simply our right to say no but we still have to be cared for. I can't imagine an OB saying "no I won't care for you anymore" That's just insane!!

 

[PeanutBean]

Kandy I didn't know half that stuff!

 

[Bournefree]

Full heartly agree! Might as well call it a GUESS date!
.. and it can do so much damage as well to a persons mindset. Not only the mother, but the health professionals too. There is far to much focus on it, and I also found the pressure with first pregnancy unbearable! Not really from my MW but from the consultant, friends, relatives etc.. This time I'm sticking to "sometime in July"

Still Only 153days to go for me!! LOL I'm aware that I'm guilty of it too!!! ;-)
xXx

 

[pinkmonki]

I always tell people I'm due in April, and whilst my due date is the 16th I don't expect any movement until at least 41 weeks.

I think we all focus in on the date to some degree, simply because we want to know the end is in sight. I am blessed to be having a healthy child, but I absolutely HATE being pregnant. I'm thoroughly miserable and completely fed up, and having that time (albeit a week after my supposed due date) to focus in on makes me feel like it'll be over soon. If that makes any sense?

Having said all of that, there is no way on earth I'll submit to being induced unless not doing so could prove fatal for either of us. This baby will come when it's good and ready, whether that's 41 weeks or 43.

Conversely my midwife is convinced I'll go earlier than my due date simply because baby is so big and I'm so small. With my son, I had a few consultant appointments and she was certain he was coming early, even celebrating my 37 week appointment with me because that meant I'd get my home birth.. 4 weeks later he appeared haha.

Urgh, I suspect I'm merely rambling rather than making a point here (I'm having one of those days) I think my point is, due dates are a lovely thing to focus on when you're feeling fat and miserable but only the baby will decide when it's birthday is going to be, and no one (including medical staff) have the right to change that.

 

[KandyKinz]

What I didn't realize KK was that you could go through such an ordeal in Canada over it!! No wonder you were fighting so hard for a better date. Here in the UK it's simply our right to say no but we still have to be cared for. I can't imagine an OB saying "no I won't care for you anymore" That's just insane!!

Fortunately for the rest of Canada or atleast Ontario, the difficulties I am having with the maternity care here is isolated to this community. I have done midwifery placements throughout the province and while there does seem to be quite alot of variation amongst how care providers calculate due dates (despite having guidelines.....) having doctors refuse to provide care is certainly a rarity (except in my community ). There's definitly a noticable difference between maternity care offered in urban centers vs that which is provided in small rural isolated communities. In the larger places, especially the teaching hospitals, guidelines are always adhered to and if a client chooses to decline standard practice the potential consequences are discussed but they are still cared for.... Then there's the little places that seem to live in their own little world and maintain very outdated views and practices.

In my situation, the midwifery care I am receiving is really not a problem aside from the fact that the midwife is not adhering to guidelines in regards to calculating my dates (because she wants to be on the same page as the consultants ) and that she's not willing to firmly advocate for my choices and a change in the structure of the maternity care in the community. She's not going to "fire" me. She simply can't as she has absolutely no grounds to eliminate me as a client and I don't at all think she wants to. So should I go beyond the 41 weeks and have my homebirth (here homebirths are allowed until 43 weeks) I will have a care provider. However, if something goes wrong in the pregnancy following that 41 week mark then I will not have a consultant who is willing to care for me. So should something occur in which I'd see an induction as being a suitable option (eg baby scores poorly on a BPP or my membranes rupture for longer then ~36 hours or something like that...) or baby turns transverse at 42 weeks or my BP goes crazy then I'd be left having to travel 2-3 hours to the next OB as here in my community midwives have been denied the right to carryout inductions and cesareans are well out of their scope of practice.

I've been doing as much research as I can in regards to the legality of a physician refusing care and thus far I have discovered that should I go beyond 40+2 (41 according to them) and the consultants declare that they refuse to accept me as a potential patient if I decline an induction, that IF I end up being transferred in due to a "emergency" the consultant on call at that time CANNOT refuse to care for me. So that's reassuring. Though I imagine if it came to that I'd be pretty much gauranteed to be treated like sh*t.....

The information I've been able to collect regarding such matters has been extremely murky. It just doesn't seem acceptable at all that they can deny care, especially in a situation as minor as refusing an elective induction at 41 weeks in the presence of reassuring maternal and fetal wellbeing.......




Strangely enough Peanutbean my community is one of the few communities in the province in which the OB's have agree to allow GBS prophylaxis at home..... You win some you lose some....

 

[southerngal2]

I keep telling people I'm due at the beginning of June and they won't take that answer!
They always want a specific date!
I think it's because a lot of women around here get induced right after their due dates pass.
I keep telling them that I won't be induced and they mostly answer with, "Yeah we'll see when you are past due."

Hmmm, this is my third child, I think I know what I'm going to do!
I'm waiting till she's ready! That's her due date!

 

[Jenniflower]

I keep telling people I'm due at the beginning of June and they won't take that answer!
They always want a specific date!
I think it's because a lot of women around here get induced right after their due dates pass.
I keep telling them that I won't be induced and they mostly answer with, "Yeah we'll see when you are past due."

Hmmm, this is my third child, I think I know what I'm going to do!
I'm waiting till she's ready! That's her due date!

Oh yea I got that a lot! Same with the no drugs "Yea, good luck with that on the day" grrrr. I don't mind people asking questions especially when they're just curious or don't know better. But to down right patronize you?

 

[KandyKinz]

I keep telling people I'm due at the beginning of June and they won't take that answer!
They always want a specific date!
I think it's because a lot of women around here get induced right after their due dates pass.
I keep telling them that I won't be induced and they mostly answer with, "Yeah we'll see when you are past due."

Hmmm, this is my third child, I think I know what I'm going to do!
I'm waiting till she's ready! That's her due date!

I couldn't agree more. I've been telling everyone I'm due between March 2nd and April 6th and they get so with me. Especially my MIL, she's been the worst! They have absolutely no understanding of how this whole pregnancy thing works........

 

[Mervs Mum]

@KK

I havent really got anything to add other than to say I personally wouldnt even get into justifying dates etc. IF (and it's still a big IF as that cervix could change in just a few hours!) you get to a point they are putting pressure on then you can just say rather than get fixed on the dates as they are all so keen to do from the offset, lets go on what is happening from day to day. Monitoring, how YOU feel etc. That should preceed any talk of intervention.