How to Stay On Course for the Birth You Really Want
In this series of blog posts, I’m going to dive deep into 4 big moments in birth that challenge our plans for birth. Firstly, we’ll look at how going past your due date can affect your choices in birth. Also, I’m going to share how due dates are typically calculated (which can be sketchy). I will offer my insight on this common challenge in birth. Lastly, I’ll offer you some questions to ask your care provider so that you can make sure you’re both on the same page for birth.
How are due dates calculated anyway?
Most providers use a system developed in the 18th century called Nagele’s rule. To calculate your EDD according to Naegele’s rule, you add 7 days to the first day of your last period, and then count forward 9 months (or count backwards 3 months). This is equal to counting forward 280 days from the date of your last period.
BUT this assumes that all people have 28 day cycles. And as time went on, this rule became adopted in a variety of ways to the due date calendar used by most doctors today. This method adds 7 days to the first day of your last period, and then counts forward 9 months—a rule that is not based on any current evidence, and may not have even been intended by Naegele.
Sounds sketchy? Yeah, kinda.
Imagine this scenario…
•You’re totally psyched about having a great pregnancy and you’re prepared for birth. You’re feeling confident, calm, and supported. You’ve practiced every strategy and tip and you’re ready to rock your birth.
•You hit 39 weeks and your provider says, “let’s schedule your 41 week induction just in case!”
How does that feel?
Multiple studies show that the true average length of a pregnancy is 40 weeks and 5 days for first pregnancies and 40 weeks and 3 days for subsequent pregnancies.
What to do when you go past your due date…
Firstly, there are many different ways and models providers use to support pregnancies that go “past your due date.” For a variety of reasons, some providers are more supportive than others and that is based on their experience, preferences, beliefs, and model of care. Secondly, there are a variety of different personal risk factors involved when faced with an induction for going past your due date. Each family has a unique set of needs and risk factors in their pregnancy.
It is very common for doctors and midwives to recommend an induction of labor for pregnancies going beyond 41, or sometimes even 40 weeks.
If you’re concerned about going past your due date, then consider doing the following:
1) Advocate for INFORMED CONSENT if your provider suggests induction for going past your due date. This means that you are given information on all the benefits, risks, and alternatives and you are able to make a decision based on what is right for YOU. This must be free of coercion from your care provider. Ideally, you want to know your provider’s policies on going past your due date BEFORE you’re at that point.
2) If your provider is recommending an induction for non-medical reasons because your pregnancy has gone past your due date, consider asking the following questions:
•How accurate is my due date? Is it determined from my last period or through an early ultrasound? (early ultrasound is most accurate)
•What is your induction rate?
•What are the benefits and risks of an induction?
•Are there any alternatives?
•Ask yourself – how do I feel about this? Use your intuition.
•Is there any reason I can’t wait for labor to start on its own? What is the risk of waiting for labor to start?
•How might an induction affect my labor? How can it affect my baby?
Asking these important questions can help ensure that you are on the same page as your provider. Also, it will help you be as prepared as possible so you can make the best choice for your family. We’ll look at 3 other big moments in birth over the next several weeks so you can navigate common challenges in birth like the birthing boss you are.
Do you want to learn more about how to have a physiologic birth? I’m offering a FREE WEBINAR where I’m going to discuss 4 BIG MOMENTS in Birth and give you strategies to handle them like a boss. In this webinar, I talk all about 4 challenges that come up in birth and give you ALL the tools you need to have a confident and powerful birth experience. Webinar is December 30th at 7pm. Check it out! Space is limited.
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