Not going past 40 weeks if AMA

Rubygirl · September 2013

My OB has told me she doesn't like for her AMA patients to go past 40 weeks because the risk of baby not surviving gets higher at that point. I don't have any other high-risk symptoms - normal pre-pg weight, 25 lb weight gain, no swelling, no GD, no bp or heart issues, all very normal. I asked my OB and she said they typically ask the two MFMs they consult with but she "already knows what they would say." At 39 weeks today I really have no desire to go past 40, but I'm just curious if this is typical in other OB practices? What have you all been told?

SkiHorse · September 2013

In my first pregnancy, my OB told me she wanted to induce on my due date because of AMA, even though I had not had any pregnancy complications and the baby showed no signs of distress. I really pushed back on this policy. I had read that having an induction increased the chances I'd need a C-section, among other possible downsides, so I called MFM and basically got the perinatologist to override my OB.

To make a long story short: I still was not dilated at all at 41 weeks, so I had to have an induction anyway. It went smoothly, and I didn't need a C-section after all. So, this time around, I'll probably be much less opposed to an induction at 40 weeks. But it still irks me that, in my first pregnancy, the 40-week policy was based purely on textbook concerns about AMA, not my actual pregnancy.

Guennie · September 2013

My dr actually doesn't even want me to go past 39 weeks. I have a very healthy pregnancy also, no issues. It's just precautionary because of AMA. I think it depends on the dr but it looks like this is not an entirely rare train of thought.

Carnation77 · September 2013

I'm 36 and just had my first. He was 10 days overdue. So I don't consider myself super old to have had a baby - maybe I'm delusional? But I had no other health problems and my provider had no problem letting things continue. I just got scheduled for nonstress tests twice a week after week 40. I had a quick vaginal delivery and have a healthy baby now.

Tigger & pooh · September 2013

For me it would depend on the actual AMA age. My OB laughs at me being AMA at 37. She says she has delivered much older moms and has no concerns about my age. Of course we will still do Nst weekly starting at 36 wks just to be safe.

happywifemomofone · September 2013

I spoke to my OB today. They will start NSTs at 32 weeks (I am over 40) and will consider an induction if I ave not delivered by my DD. Also starting appts every 2 weeks at 25w, instead of 28w. I have an aunt that delivered a stillborn d/t placental failure, and that is so heartbreaking.

funchicken · September 2013

My midwife's office will let me go to 41 weeks as long as everything looks okay with the NSTs.

jb2rn · September 2013

I would fight that very hard. I was 35 when my son was born, and he came at 40w6d. I went into labor on my own.

If you are having NST's, or an u/s, that shows all is well w you and baby, there is NO reason to deliver you early.

kelley72 · September 2013

Is this your first pregnancy/delivery? I guess I'm biased bc of my history. I delivered all four of my healthy children, NO NICU time, between 36 and 37 wks... I cannot Imagine going one minute over 40 weeks...

I am petrified of a c-section, but bc of my history and age (I'm 41 will be closer to 42 at delivery) I would in no way want to go past 40 wks.

ugh no easy answers I hope you spontaneously go into labor on your own and wish you a happy and healthy labor and delivery!

wendylouwhoknew · September 2013

My both my daughters were late - and I mean when THEY were pregnant. My youngest was told at 40 that they would induce her. We made the appointment and even confirmed by calling prior to getting there. We get there, they start the check in procedures and start getting ready to admit her. Then a nurse comes in and tells us the doctor WILL NOT induce her. We couldn't understand what was going on because EVERYTHING had been confirmed. After many complaints and 900 year old crotchety, sarcastic old man enters and tells my daughter that he will not induce her because he has REAL patients to attend to.

Some of the nurses were so mortified at the way she was treated, they contacted the doctor who was going to be on staff the next morning, and got permission to have us go through everything all over again. She was 41 by that time and my grandson weighed just under 9 lbs.

My oldest was due June 29 and didn't deliver until July 10. She was told to come in and get everything ready so they could induce her. Started her on pitocin and around 7 hours later, the department head comes in and tells us they are taking her off the pitocin and would not restart it until the morning. I have never seen anyone so upset and I was livid.

In that case, I can now see why they did that. Bedside manner was abysmal and it shouldn't have been started to begin with. She was obese and the doctor was afraid of complications and if she were to deliver in the wee hours, they would not have the necessary staff to accommodate - and they did need it, eventually. My grandson went into fetal distress several times and they used the suction thing to assist in delivery. Had the concerns been discussed beforehand, I'm sure it would have gone over much better.

Lennie.Keba@gmail.com · September 2013

I am 39 and a FTM. My OB has already mentioned that she doesn't want me to go to 40 weeks, but we are leaving the final decision to see how baby and I are doing as the final weeks go.

kellyk17 · September 2013

I'm 36, with no problems so far and my OB said she would prefer I don't go longer then 10 days past my due date. If I go past that I will push to go 13 days before being induced. If baby and I are healthy I will not consent to being induced early. All the newest research invalidates the AMA diagnosis before 40. It drives me crazy that our OB's haven't caught up.

ceh789 · September 2013

My clinic's protocol is to induce at 39 weeks for AMA. I also have pre-existing hypertension, and am very concerned about pre-eclampsia so I don't expect I'll fight it but we'll see once the time comes.

Rubygirl · September 2013

kellyk17 said:

I'm 36, with no problems so far and my OB said she would prefer I don't go longer then 10 days past my due date. If I go past that I will push to go 13 days before being induced. If baby and I are healthy I will not consent to being induced early. All the newest research invalidates the AMA diagnosis before 40. It drives me crazy that our OB's haven't caught up.

I haven't seen this research. Do you have links? Are these peer-reviewed articles in medical journals?

Rubygirl · September 2013

I'm 37. Forgot to include that in the OP. Appointment is tomorrow. My only concern with induction is the recent JAMA study on induction/augmentation and potential correlation with autism. Yes, I know it's already received criticism and I've asked my OB about it and she's going to read the research before our appt tomorrow. Obviously if I'm weighing the risk between this *potential* correlation and baby's survival, I'm going to go with induction.

palomaLuna · September 2013

I was 37 when I delivered my first. I went in for a non stress test at 40 weeks, and since everything looked good, I was allowed to continue the pregnancy until I went into labor naturally a week later. My LO had no problems, and was born without complications at 41 weeks, almost to the day.

Whatever you and your physician decide, I wish you a fulfilling birth experience and a healthy, thriving baby.

lsonger · September 2013

Hmmm interesting. My OB said they wouldn't let me go any further than 2 weeks over. Average FTM is 8 days overdue.

desertmouse39 · September 2013

I was 40 when I had my first and my OB suggested inducing about 3 days after my due date, but I really wanted to wait and she agreed (lots of monitoring and check-ups said everything was fine). I ended up being induced at 41 1/2 weeks and although everything went fine with L/D, there were significant issues with the placenta and umbilical cord at birth and my baby ended up being somewhat malnourished in the first few days of life. No one is positive why this happened - could be general deterioration due to my age and length of gestation, they are also looking into my having a MTHFR gene mutation but in short, now that I am pregnant with my 2nd (42 at delivery) they will NOT allow me to go past my due date and I am more in agreement with that now.

I would talk to you OB about your specific concerns, let her know that part of your birth plan is to start labor naturally, and see if they can agree based on the known health of you and the baby.

kellyk17 · September 2013

@rubygirl I have to dig it up, I found it on Pubmed months ago, so yes from medical journals. Let me see if i can find again. Just anecdotally living in NYC, all of my friends were over 35 when they had thier first kid and all were allowed 10-14 days after due date. So I'm so baffled by everyone's responses that they are forced into induction. If you have a healthy pregnancy what magic think goes wrong because you are 35 vs. 34?

happyturtle03 · September 2013

Rubygirl said:

I'm 37. Forgot to include that in the OP. Appointment is tomorrow. My only concern with induction is the recent JAMA study on induction/augmentation and potential correlation with autism. Yes, I know it's already received criticism and I've asked my OB about it and she's going to read the research before our appt tomorrow. Obviously if I'm weighing the risk between this *potential* correlation and baby's survival, I'm going to go with induction.

Seriously, though, what hasn't been correlated in one study or another to causing Autism? To be honest, everything about my daughter's conception, the pregnancy, the delivery were all completely normal other than that I went into labor at 38 weeks instead of 40, and even though I was supposed to have been induced, I actually went into labor on my own except for a cervical ripening suppository they gave me the night before in preps for induction. No one knows why she has autism. She just does, and I saw signs of it from very early on, so I can't blame vaccines or any of the other so-called causes. My second child does not have autism, and I had all sorts of complications with that pregnancy and went into labor at barely 37 weeks, though no induction, we didn't make it that far that time either since I went into labor as soon as I got out of bed to pack after a month and a half on bedrest. You know, as a parent of a child with autism, sure I'd change it if I could, but it just is, and all the reports left and right and theories out there of what causes it and the blame game basically is just ridiculousness! I'd say worry more about having a healthy delivery for you and baby and not try to guess the what-ifs... truth is, they really have no idea what causes autism, it's all speculation at this point.

Doublegreen · September 2013

This post makes me so angry at my doctor. I don't mean to frighten anyone, but two weeks ago, we lost our beautiful baby boy at 41 weeks and a few days because his umbilicle chord was around his neck. After his due date had passed on Aug 25th, I asked my doctor if I could be induced (just so my child could be born before September 1st in time to make school enrollment requirements), but he suggested that we wait and see after the 40th week. My labor pains finally appeared later on the 41st week and we went to the hospital. Everything seemed normal until we found that his heart rate was suddenly dropping and then I had to go for an emergency C-section. I woke up to find that my child didn't make it. This was supposed to be my firstborn child!! I'm not totally blaming my doctor and believe that this is totally out of everyone's hands and tragedies like this does happen, but I cringe as I anticipate hearing my doctor tell me that I may have to wait 6mos to a year for my body to heal before we can try for another baby. I will be 37 by then!

Doublegreen · September 2013

LOL. I have to admit that I have to look up AMA.

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