Do you know someone who is almost always late for a meeting or an event? They always get there eventually, but only after much frustration on your part. You may feel irritated with this person. The waiting may make you anxious. Well, this is how you might feel if you haven’t given birth and you’ve passed your due date by two weeks. This is especially difficult if you’ve had a complicated pregnancy. Through much effort on your part, you’ve made it to the “finish line” only to find the event isn’t over.
Very early in the pregnancy you were told your due date. This is computed by adding 280 days, or 40 weeks, to the first day of your last menstrual period. This date may have been changed by a few days or even a few weeks if an ultrasound led your doctor or midwife to believe your baby was earlier or farther along than indicated by the first due date. When your due date is firmly established, your OB provider expects you will have your baby sometime between the thirty-eighth and forty-second week of your pregnancy. If your baby is not born within the two weeks after your due date, it is considered postdate.
After 42 weeks gestation, your doctor or midwife will closely monitor your pregnancy to be sure that the placenta is still functioning effectively to supply nutrition and oxygen to your baby. Other complications that can occur as a result of your baby’s overstay in the womb are that your baby may grow too large for a vaginal delivery, or the amount of meconium (the greenish bowel movement of the baby) may increase in the bag of water. The baby would be in danger of inhaling this meconium at the time of delivery. Electronic fetal monitoring, ultrasound, and noting how much your baby kicks will give your OB provider valuable information about how and when to induce labor or plan for a cesarean section delivery.
Induction
If you are postdates, your OB provider may try to artificially induce or start your labor. This is referred to as an induction. One method of induction, stripping the amniotic membranes, is thought to be effective in getting labor to start or resume and can be done in the OB provider’s office. With this procedure, your OB provider sweeps a finger inside the lip of the cervix to pull the membrane away from the wall of the uterus. This action can cause some spotting and cramping. If stripping the amniotic membranes does not help, your doctor will admit you to the hospital and may use the following methods:
- Cervical ripening is used to get labor started by dilating and softening your cervix. Medical cervical ripening uses medications that are either swallowed or put into your cervix. Mechanical cervical ripening is the insertion of a sterile tube and balloon appa-ratus into the cervix to stretch the opening.
- A very common method of induction used along with cervical ripening is administering Pitocin intravenously. This medication works very effectively to make contractions get stronger to start labor. Some women need this medication throughout the labor and some only once to jump-start the labor.
- Your doctor or midwife may also decide to rupture your membranes , using a sterile plastic hook to puncture the amniotic sac. There is no pain, just pressure, but it is thought that the baby’s head can move closer to the cervix to help the labor progress.
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