Monday, September 12, 2011

When Are You Overdue? (Hint: It Ain't What You Think it is)


I was led by a friend to this post HERE and it rocks. Really, go read it. The American Congress of Obstetrics and Gynecology (ACOG) has a brochure discussing what normal gestational time is for most women. And it's actually good! While most (if not all) obstetricians are members of ACOG, they very often, however, don't follow these guidelines. Normal gestation for human babies is 38-42 weeks which means a whole month of normal. And THAT means you are not "overdue" until you are 42 weeks plus 1 and a woman is not overdue the minute she passes her "due date." Simply reaching an estimated due date is not considered a medically valid reason to induce a birth solely. But it is done and often. Women want to be "done" being pregnant. Perhaps the doctor wants to attend during the day (rather than in the middle of the night or a weekend which is obviously much more likely to happen with a natural onset of labor). I know and hear of births often where the mother was induced because she was close to or a few days past her estimated due date. We have come to view the due date as an expiration date and women who are still pregnant on or after that magical date often feel pressure to have that baby right away or even like they've "failed" or something must be wrong with them that they haven't had their baby yet. 

It needs to be noted here, and is often overlooked, that this whole 42 weeks plus 1 is also assuming that an estimated due date is even correct, a very large assumption to make. The EDD is calculated for most women by the date of their last period AND assumes that every woman ovulates and conceives on day 14 of her cycle. Many women make an educated guess as to the date of their last period because it is not written down. In addition, most people with only a fundamental understanding of a woman's fertility know that every woman's fertility is different and that most women do not ovulate exactly on day 14. It is impossible to guarantee when conception took place (provided the baby is conceived within the marital act). We can know within days and some women can feel ovulation happen but depending on when intercourse occurred, how long the egg lived, how long her fertile signs lasted, there is a lot of flexibility there. We would be well to help mothers think of a due 'month' rather than a single date on which her baby is due to arrive on.

Study after study shows that the unnecessary induction of labor introduces a large amount of risk to both the mother and the baby, both before and after birth. Fetal distress, breathing issues, greater pain, increased narcotic and anesthesia use to deal with pain, longer labor, and more are greatly increased by artificial induction. The list increases as these complications lead to further complications, some longterm and some we are only in the beginning stages of understanding. Artificial induction raises a woman's risk of a caesarean section which also is riskier to mother and baby than a natural birth and carries long term consequences. Of course, there is a disturbing ideology and apathy that accepts survival as the goal. It can be seen in many areas of life, but for me, it is most visible when it comes to birth and the treatment of the unborn and newly born.  Our sights should be so much higher than the goal of not having someone die during birth. We should do everything possible to ensure that birth is a healthy, positive, and wonderful experience for both mother and child. We should do all that we can to protect the immediate AND longterm health of both. The dignity of mother and child demand that but it seems to be so often ignored. The best course of action, provided there are no other signs of complications, is to wait until the baby and the mother's body naturally begin the course of birth. Let's always provide encouragement, evidence based care, and help during those last difficult weeks of pregnancy...not timetables, ultimatums, and fear.

There is so much more to this subject that can be researched. This little post is not meant to be in any way an exhaustive synthesis of the vast amount of information out there but rather a personal reaction to the ACOG brochure and the post linked to above. It is my hope that women will take more and more responsibility for the birth they give their child and will be informed about their own bodies and birth. Mothers and babies deserve that. If this post helps in that, I'm happy :)





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2 comments:

  1. Great article! I am currently waiting on baby #6...tomorrow will be 43 weeks. I have also had all my babies at home so loved reading over your birth stories.

    ReplyDelete
    Replies
    1. Wow! Good for you and how patient you are! May you be blessed with a beautiful, peaceful birth!

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