Overdue pregnancy causes, risks, and how to manage it

Overdue pregnancy: Are you past your due date? Take deep breaths, and keep calm. “No woman should feel nervous or anxious if she’s still pregnant after her due date,” maternal-fetal medicine researcher and practitioner Dr. Alex C. Vidaeff told Fit Pregnancy. “Due dates can be off by a week in either direction.” You could even be off by two weeks! Here are some things that you should do when you’re past your due date.

Overdue pregnancy

Approximately 280 days from the beginning of your last period, or 40 weeks, make up the typical gestational period. Most women give birth within a week of this day, while some do so sooner or later than anticipated.

If your labor doesn’t start by the time you are 41 weeks pregnant, it is considered an overdue pregnancy.

Over 60% of mothers give birth to their babies on or before the due date. However, only one in ten babies are truly born late or after 42 weeks of pregnancy.

Overdue pregnancy symptoms

The American College of Obstetricians and Gynecologists (ACOG) uses the definitions below about pregnancy terms or timelines:

• Pre-term: weeks 37 to 38
• Full term: 39 to 40 weeks
• Late term: 41–42 weeks
• Post-term: after 42 weeks

Babies born prematurely or post-maturely are those who arrive before 37 weeks of gestation or after 42 weeks, respectively.

Overdue pregnancy causes

You may be more prone to experience an overdue pregnancy if:

• This is your first pregnancy.
• You went two weeks past your due date in a prior pregnancy.
• Your growing baby is a boy
• You have a BMI of at least 30
• Your due date was calculated incorrectly. This can be the case if you’re unsure when your last menstrual cycle started. Additionally, it could happen if the due date is established with an ultrasound after 22 weeks of pregnancy.
• Genetics could also be a reason
• Rarely, a late pregnancy may be caused by problems with the placenta or the baby.

Benefits of baby being overdue

According to Reuters, children born in the 41st week of pregnancy, considered “late-term,” have better test scores and are more likely to be labeled as gifted in elementary and middle school than children born “full-term,” that is, at 39 or 40 weeks.

Although it is “well-established that late-term births are associated with higher levels of neonatal health problems” Dr. David N. Figlio of Northwestern University in Evanston, Illinois, told Reuters that data limitations have prevented us from examining past birth to determine whether these issues continue or if there are any other possible advantages to having a baby late in pregnancy.

He said that the most recent research, “shows not only that children born in late term continue to have an elevated risk of health problems when school-aged, but also that they have an elevated rate of cognitive benefits.”

As Dr. Figlio and his team conducted a study, they found that, overall, the performance of late-term infants was superior, as seen by their higher test scores, a larger proportion of giftedness, and lower proportion of poor cognitive outcomes.

On the other hand, late-term infants also had a higher likelihood than full-term infants of having abnormal physical characteristics at birth and physical restrictions when they were of school age.

While there was only approximately one-third as many physical impairment differences between late-term and full-term newborns, there were roughly half as many cognitive differences between full-term and early-term kids as there were between late-term and full-term babies.

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Overdue pregnancy risks

When a pregnancy reaches 41 weeks, 41 weeks, and 6 days, or longer, it is referred to as late-term. When a pregnancy lasts 42 weeks or more, it is deemed post-term. The likelihood of a late-term or post-term pregnancy can be increased by several health conditions, including the following:

• Being larger than usual at birth, or having fetal macrosomia can significantly increase the risk of shoulder dystocia, which is when a shoulder becomes stuck behind the mother’s pelvis during delivery and requires a cesarean section.
• Postmaturity syndrome is characterized by long fingernails and toenails, dry or “loose” skin, and weight gain that stops before the expected time.
• Low amounts of amniotic fluid, can impair a fetus’s oxygen levels and the heart rate of the developing child by causing the umbilical cord to contract during labor
• Baby’s lungs having meconium in them can lead to serious respiratory problems
• Stillbirth or when a newborn infant passes away before being delivered

What happens when you’re past the due date of your pregnancy?

If you are more than a week past your due date, your doctor may do a test to check the baby’s heart rate). An ultrasound exam may be added to that test to measure the baby’s heart rate, breathing, muscular tone, and movement (biophysical profile). The amniotic fluid is typically also inspected.

More tests include:

• Non-stress Test (NST)

This briefly measures your baby’s heartbeat (usually around 20 minutes).

• Contraction Stress (CST)

Observing your baby’s heartbeat while the uterus contracts measure fetal pain.

• ​​Biophysical profile (BPP)

An ultrasound scan is being done while keeping an eye on the fetal heart rate. With this panel of tests, the doctor can check the fetal heart rate, movement, and muscle tone. Amniotic fluid levels can also be checked during ultrasonography.

1. Cervical exam

With this examination, the doctor can evaluate your cervix. Since the cervix fully dilates and effaces during labor, your doctor will be on the watch for changes like ripening and other indications that labor will start soon.

Based on the outcomes of these tests, your doctor might suggest inducing labor.

How to avoid overdue pregnancy

The following recommendations from your doctor may help to induce labor:

1. You might be given a drug to soften and expand (ripen) your cervix. Alternately, your doctor might insert a thin tube (catheter) with an expanding balloon on the end into your cervix to ripen it.
2. “Stripping the membranes” is performed by a medical practitioner by gliding a gloved finger along the surface of the amniotic sac close to the fetus. The cervix and lower uterine wall are cut off from the sac.
3. If your amniotic sac is still intact, your doctor might make an opening in it with a tiny plastic hook to let the fluid within out. The opening causes the water to break.
4. A hormone called Pitocin, a version of “oxytocin,” which causes the uterus to contract may be used to induce labor.

Overdue pregnancy tips

1. Don’t stress

While it’s important that your doctor monitors you closely as you pass your due date, you shouldn’t stress. Here are some of the things you should do to keep you busy, as suggested by PopSugar:

• Get started on those books you’ve never had time to read—and not just baby books.
• Get your nails done.
• Write a letter to your baby about your hopes and dreams for him or her.
• Go on a nice date with your partner.
• Talk to your mom and ask her about your own birth story.
• Choose an outfit for your time at the hospital. Choose an outfit for your baby too, while you’re at it!
• Spend time with your friends.
• If you already have kids, spend quality time with them.
• Rest as much as you can. You’ll need it.

2. Remember that your due date is just an estimate

It takes around 38 weeks from conception for your baby to fully develop in your womb, but very few moms-to-be know exactly when they became pregnant, according to BabyCenter. That’s why doctors just usually count from the first day of your last menstrual cycle and add 280 days or 40 weeks to that.

According to WebMD, you are also more likely to deliver late if:

• This is your first pregnancy
• You have delivered late in the past
• Other women in your family have delivered late
• You were born late yourself

3. Know the risks of giving birth late

When you reach 40 weeks, your doctors will probably start monitoring your pregnancy more closely, as delivering two weeks after your due date have risks.

After 42 weeks, the stillbirth and early neonatal mortality rate are twice than of the term. Other late delivery problems include breathing problems, fetal distress, and slowed growth.

4. Talk to your caregiver (your doctor or midwife)

Should you induce? Most doctors won’t recommend induction until you’re 41 weeks, but you might want to wait until 42 weeks. Ask your caregiver for advice and take your own circumstances into account.

In the end, it is up to you whether you want to induce labor or not, but make sure that you get monitored every other two to three days.

Additional information from Margaux Dolores

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