danger of going past 42 weeks

Jessynlove · June 2011

I have been trying to find the post with the answer to this and I cant.

My doctor says he wont let me go past 42 weeks because of the dangers that can cause...but 41 weeks and 6 days is ok???

I want to argue with him tuesday at my appt, that I want an induction date No time past 41 weeks.... I dont want to get anywhere near that "danger" zone.

what are your thoughts?

MissEmilee · June 2011

Hi, I'm 40weeks 3 days and scheduled to be induced Tuesday.

My doc said he doesn't want me to go past 41 weeks because less blood travels through the placenta to baby and the placenta becomes calcified.

desmerelda317 · June 2011

There is a statistical increase in stillbirths after 42 weeks gestation. This is the main reason your doctor does not want you going past 42 weeks. If you want to continue beyond 42 weeks, you need to do your research, learn the risk factors, and ask your doctor about other options. Is he willing to do NST tests and ultrasounds to make sure your placenta is fine and the baby is fine? My opinion is this: Yes, there is a statistical increase in stillbirths after 42 weeks. However, it is important to not induce a woman simply because she is 42 weeks but instead see how those statistics apply to her pregnancy. Is she low on amniotic fluid? Is the placenta showing signs of aging? Is the baby showing signs of distress? What is the woman's overall history throughout the pregnancy? Are kick counts still showing good numbers? This is just my personal opinion. Only you can decide what you want to do.

MustanGTbaby13 · June 2011

desmerelda317:
There is a statistical increase in stillbirths after 42 weeks gestation. This is the main reason your doctor does not want you going past 42 weeks. If you want to continue beyond 42 weeks, you need to do your research, learn the risk factors, and ask your doctor about other options. Is he willing to do NST tests and ultrasounds to make sure your placenta is fine and the baby is fine? My opinion is this: Yes, there is a statistical increase in stillbirths after 42 weeks. However, it is important to not induce a woman simply because she is 42 weeks but instead see how those statistics apply to her pregnancy. Is she low on amniotic fluid? Is the placenta showing signs of aging? Is the baby showing signs of distress? What is the woman's overall history throughout the pregnancy? Are kick counts still showing good numbers? This is just my personal opinion. Only you can decide what you want to do.

Well put. I had a pretty thorough discussion with my midwife about this the other day. She was saying that the data is quite old, based on women from accross the world, including women who may/may not be at high risk. So theoretically, that data may not be transferable to women in countries like the US and Canada who are healthy, low-risk patients. I know once I am past 41 weeks I will be having 2 ultrasounds a week, and at 42 weeks will have a consult with an OB (As per the canadian midwifery guidelines) but as long as baby and I are healthy, I could presumably decline induction and continue to wait it out.

For me personally, I have had higher borderline BP that has me having bi-weekly appointments, and weekly BPPs...which clearly show that baby is doing awesome, my BP is just hovering a bit higher than normal...so we continue to wait it out as there is no clear medical indication to induce. That being said, I may not be comfortable going beyond 42 weeks, but it is a decision I will have to make if I get there. I feel pretty stronly in the idea that most first time moms will naturally go into labor about ~9 days post due date. So, aside from the hassle of being monitored and people continually asking me if the baby is here yet, I will continue to wait it out

SarahPLiz · June 2011

I think you need to do research before you believe everything your doctor says and make decisions based solely on hi fear tactics. Someone posted a chart the other day saying that still birth risk increased by less than 2% after 42 weeks, I think. To me, that is minimal. If I am being monitored closely and neither I nor the baby is having any medical issues, I don't see any reason to pre-empt nature's processes.

Also, just so you know, average natural gestation (without augmented labor) is 41w1day. That's just the average. 40 weeks is an old benchmark that has been disproved many times.

kg_08 · June 2011

I'm sure you can ask for an induction before 42 weeks, that's just usually the LONGEST they'll let you go for the baby's safety. My hospital does it between 41-42 weeks.

As you get further along, your fluid levels can decrease and the placenta could start to deteriorate. They will give ultrasounds to check this every few days after you go past due. DD's ultrasound looked just great at4 0w 4d and she came on her own at 40w 6d.

google123 · June 2011

I think you should do what makes you feel comfortable. If you don't want to go until 42w, so be adamant about it. They'll listen...don't be intimidated by doctors, sometimes you have to tell them 'this is what I want because I don't feel comfortable'...I'm sure your baby will be fine.

but hey, maybe you'll deliver before then and all will work out!

mooninlv · June 2011

my doc will induce at 41 weeks, and i'm am on board with that. 42 weeks seems like awhile to wait for me. i don't know what the medical term is for it, but my mom said i was two weeks late and my skin literally started to dry up and shrivel a bit because i was overcooked. ha.

emmyloustu · June 2011

Personally, I think it is wonderful that your OB lets patients go to 42w. IMO, too many OBs are induction happy at 41w. As long as the baby is being monitored with bio physical profiles and non-stress tests and looks great, there is no reason to induce sooner. BUT, if you are uncomfortable waiting until 42w, have the conversation with your OB - your body, your body = you get a say in your care.

My MW will let me go 42w with BPP and nonstress stress tests every other day.

teenybean · June 2011

I have to wonder however how long anyone is willing to wait? This may get me flamed but at what point if you don't go into labor are you going to get the ball rolling? Also baby is getting bigger and bigger, there is a statistical increase in risk for C/S as well beyond 41 weeks as babies are bigger, placental deterioration and poor perfusion, increased risk for meconium aspiration etc. Also consider the time and cost of increased testing, are you going in 3X a week for nst/bpp is that worth it to you? Not saying we should all be induced at 39 and 3 days but be realistic,and I talked my doc last time out of a scheduled cesarean section last time (although he was right and I ended up getting one after many hours of stressful labor anyway for very good reasons I agree with), docs aren't just out there to save their butts, they also want you to have a good birth experience and a healthy baby and mommy. Just my opinion. No I am not a doc either. But not very many would have viable businesses if they made all their clients mad and they never returned to have routine ob/gyn care post delivery, and or they had constant major catastrophes because they wanted to please their clients rather than practice safe experienced medicine.

teenybean · June 2011

And I realize the OP is wanting to be induce prior to 42, just continuing the rest of the discussion

maddiemoon43 · June 2011

SarahPLiz:

I think you need to do research before you believe everything your doctor says and make decisions based solely on hi fear tactics. Someone posted a chart the other day saying that still birth risk increased by less than 2% after 42 weeks, I think. To me, that is minimal. If I am being monitored closely and neither I nor the baby is having any medical issues, I don't see any reason to pre-empt nature's processes.

Also, just so you know, average natural gestation (without augmented labor) is 41w1day. That's just the average. 40 weeks is an old benchmark that has been disproved many times.

If we're both thinking of the "Dr. Amy" Wink chart, I think it said something along the lines of 0.2 in 1000 babies...?

Another point to consider, and I know OP is looking for one earlier than 42, not trying to convince OB to hold out for 42, bur for others is the accuracy of a due date.

Depending on who you ask, I am over 41 weeks...and that's the date we've gone with for the sake of work mat. leave starting, etc., but really, I am 99% positive that I am actually just over 40 weeks. My orig. EDD was June 23rd, based on m/c / LMP on Sept. 14, and charting and O date of CD 16, or Sept. 30. At 11w6d we had "dating" u/s for the sake of reassuring us after 2 losses. Random u/s tech who has no idea that we charted, etc. just typed on the report that we were measuring about 12w6d, "accurate within a week." And voila, date got moved to June 16th...but I've always been skeptical, and I am now regretting not opposing the earlier date.

ETA - Apparently there is an entire post about dates below too...glad I am not the only one questioning.

genekelly · June 2011

From what I've read, the avg gestation is 37-42 weeks. There is a higher risk after 42 wks to the placenta breaking down and baby not getting enough. I imagine your OB is having you do NST to make sure baby is doing ok. I think some OB's don't like to go past 41 wks and others are ok up to 42 wks. I would just ask for some extra monitoring to ensure baby is doing fine. I'd also find out if your cervix is favorable for induction(using Bishop score might be helpful). Good luck and hope baby decides to come on his/her own so you don't have to decide!

emma_stegall19 · June 2011

I honestly IMO would not wait until 42 weeks, to be induced. I'm 40 weeks today, and my doctor will induce me friday July 1st at 40 weeks and 6 days. And I'm ok with that. If you dont feel comfortable don't be afraid to tell your doctor. If you do plan on waiting til 41-42 weeks, I'd make sure your doctor is checking the baby as often as possible. With ultrasounds and NST, to make sure your little one is still healthy.

megd06 · June 2011

I would much prefer to avoid pitocin, but that being said--if you go much past 40/41 wks, I'd want them to be doing NSTs or u/s's to check on the baby and the placenta, since the placenta DOES start to deteriorate (sp?) and that is obviously a huge risk to the baby.

futuremrsmcnichols · June 2011

teenybean:

I have to wonder however how long anyone is willing to wait? This may get me flamed but at what point if you don't go into labor are you going to get the ball rolling? Also baby is getting bigger and bigger, there is a statistical increase in risk for C/S as well beyond 41 weeks as babies are bigger, placental deterioration and poor perfusion, increased risk for meconium aspiration etc. Also consider the time and cost of increased testing, are you going in 3X a week for nst/bpp is that worth it to you? Not saying we should all be induced at 39 and 3 days but be realistic,and I talked my doc last time out of a scheduled cesarean section last time (although he was right and I ended up getting one after many hours of stressful labor anyway for very good reasons I agree with), docs aren't just out there to save their butts, they also want you to have a good birth experience and a healthy baby and mommy. Just my opinion. No I am not a doc either. But not very many would have viable businesses if they made all their clients mad and they never returned to have routine ob/gyn care post delivery, and or they had constant major catastrophes because they wanted to please their clients rather than practice safe experienced medicine.

I have to agree with this, again don't flame me for it, but there comes a point where you would think that needing to go into the doctor every other day, having all these extra tests would take a toll on some people. At what point do you say ok enough of this. A co-worker of mine had a similar situation happen to her. Her doctor let her go to 41w3d, she delivered on her own but had a rough labor with 4th degree tears and DD had meconium aspiration to which she had to be in the NICU. Co-worker was also pretty sick after delievery due to this. Baby weighed 9lbs and she and her husband are tiny people. I do believe that not all doctors are out there to save their butts and do what is convenient for them and their schedules. I do know that my co-worker was pretty adamant on going into labor on her own and having a naural vaginal delivery, and refused an induction that was offered by her doctor. She is pregnant again and has already said that she is planning a c-section with this baby due to the horrible experience she had with her last delivery. Everyone is different and should not be shunned for what they want for themselves and their children, whether they want a c-section, vaginal delivery- with or without induction.

WellMyKel · June 2011

I'd probably let my doctor induce somewhere between 41 and 42 weeks.

I think it's a sign of improvement in our maternity care that we're having this discussion about weeks in the 40s instead of say, weeks 37 or 38.

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