42 Weeks is Not That Bad

It can be a little socially isolating.  Most of the time, if people don't avoid me completely (like my mother has done for the past few weeks), the only thing they have to say is "No baby yet?" or some equally obvious question.  My mother in law keeps asking us that, and if I thought she'd see the humor in it, I'd answer with "Oh yeah!  We forgot to tell you!  We DID have a baby!"  Even my own husband, who is completely aware that the baby will come when it's good and ready, often greets me with questions like "Any contractions?"  Sigh.  I can't make myself have a baby today, no matter how much I may want to get this show on the road.

That being said, I haven't tried everything in my power to make it happen.  There are some home remedies that are decidedly unpleasant.  Castor oil, for example, beyond tasting disgusting, begins your labor by either causing you to puke or get the runs, neither of which are my idea of a good time.  I have tried a few things, eating pineapple, a glass of wine, a long walk, sex.  The bottom line is: it will happen when it happens.

Some people have tried to make me feel better, or appease their own nervous tension by insisting that I must be wrong with my dates.  Everyone that knows me knows how much I hate to be wrong, but that's not the only reason this bothers me.  Since my last daughter was born, I have used fertility awareness as a method of birth control successfully for four and a half years.  This requires women to keep track of their cycles and know when they ovulate.  For anyone who would like to do the math, my last period happened on Christmas day, and I ovulated on day 18 of that cycle.  40 weeks from Christmas gives a due date of October 1st, which I adjusted for the later ovulation.

A friend and midwife/TBA I know insists that we ought to be counting 40 weeks from our ovulation day, rather than our period, so I looked up the history behind how we measure due dates.  It seems around 1850, a doctor determined that the average length of a human pregnancy is 266 days from conception or 180 days from the first day of the last period (assuming ovulation on day 14).  But in modern times, the length of human pregnancy is being extended due to better prenatal care, nutrition and education on risk factors.  It is suggested that, for Caucasians, we add 15 days for the first time mother and 10 days for subsequent pregnancies.  So coming up with an actual "due date" can be a bit ambiguous.  Besides that, 40 weeks is an average.  Both midwifery and modern obstetrics recognize that a normal pregnancy is anywhere from 37 to 42 weeks for most women.  Technically, a women is not considered overdue until after 42 weeks.

If all this is true, why does being post EDD make people so nervous?  Why are we all so impatient, and quick to assume that something is wrong or more likely to go wrong?  Unfortunately, the medical system has overblown the risks of going overdue, and minimized or completely ignored the risks of induction.  As a pregnancy extends, the placenta can become less effective at doing its job.  This happens gradually, and begins at about 42 weeks.  This is a problem in about one percent of women over 42 weeks.  But about 35% of women are being induced, or having labors augmented with pitocin.  Even non-chemical forms of induction, such as the cervical stretch and sweep or artificial rupture of membranes, are not without risks.  "An induced labor forces the baby out before the body is ready, before the complex hormone interaction has primed the cervix and often before the baby has reached his full intrauterine maturity." (Gail Hart, The Postdates and Postmaturity Handbook)  With an induced labor, there is an increased risk of ineffective contractions, fetal distress, meconium aspiration, shoulder dystocia, vacuum or forceps extraction, and cesarean.

So with all this in mind, it is clear that routine induction at 41 weeks, as is common now in hospitals, is a pretty irresponsible practice.  Obviously, the safest and healthiest thing for me and my baby is to wait for labor to progress naturally.  In the meantime, my baby is kicking (often) and moving around like crazy.  My belly has dropped, and I'm getting a lot of infrequent contractions and menstrual-like cramps.  My cervix is mostly effaced and about a centimeter open.  These signs of early labor have been going on for about a week now.  I am not really bothered by the duration of this pregnancy so far.  My last labor started 2 weeks and 2 days after my due date, so I am not really surprised either.  For now, I feel just fine.  I am a bit uncomfortable, and it's taking me longer to get around, but I can still do what I need to do.  For the most part, I can't really complain.  42 weeks isn't that bad.