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What to Do When You're Overdue

If you're at least 40 weeks pregnant and haven't gone in to labor, your baby is overdue. Learn why some women don't go into labor until after 40 weeks, and what can be done to induce labor, including stripping the membranes, monitoring and induction.
overdue pregnant woman
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You're 41 long weeks into your pregnancy, and your baby has still not made his or her arrival into the world yet. By the third trimester, you're tired, bloated and so ready for this baby to come out, so what's the hold-up? Why haven't you gone into labor yet?

An abnormally long gestation period or an overdue pregnancy can be an incredibly frustrating time for expectant mothers. 

While doctors aren't entirely sure, there are definitely things they can do to help. Here Dr. Chloe Zera of Brigham and Women's Hospital and the experts of Pregnancy Day by Day (Dorling Kindersly, 2009) break it down.

Dr. Chloe Zera of Brigham and Women's Hospital in Boston weighs on what you can do if you're overdue.

Why Are Some Babies Overdue?

The exact trigger that sets off labor is unknown, so it's not clear why you're past your due date. But you're more likely to be overdue if this is your first baby if you've had an overdue baby before or if overdue babies run in your family.

Some think a post-term pregnancy is more common in well-nourished pregnant women, and there's even evidence that pregnancies are longer in the summer than in the winter (sorry, moms-to-be suffering through your 41st week of pregnancy in the middle of July!).

One thing to keep in mind: if your due date was figured out from an early ultrasound, this gives a more accurate dating of your pregnancy than the date of your last menstrual period, and you'll be less likely to be classified as overdue.

If your pregnancy has crept into the 41st or even 42nd week (it happens), there are things your doctor can do to help move the process along.

Risks of an Overdue Pregnancy 

When pregnancy lasts beyond 41 weeks and 6 days (late-term pregnancy) and continues for 42 or more weeks (post-term pregnancy) both mother and baby may be at risk of certain health issues. Common risks associated with post-term pregnancies include:

  • Low amniotic fluid (oligohydramnios), which can affect the  baby's heart rate and compress the umbilical cord 
  • Larger than average birth weight (fetal macrosomia). Fetal macrosomia can cause issues with vaginal delivery. For women who have had previous C-sections, Fetal macrosomia increases the risk of uterine rupture during labor where the uterus tears open along the C-section scar.  
  • Babies with gestational periods longer than 42 weeks are at higher risk for passing their first bowel movement (meconium). According to the healthcare experts at John Hopkins University, Meconium aspiration syndrome occurs when a newborn breathes a mixture of meconium and amniotic fluid into the lungs around the time of delivery.

Ways to Bring On Labor in an Overdue Pregnancy 

Can I Be Induced?

Many doctors induce labor by 41 or 42 weeks.

Many doctors induce labor by 41 or 42 weeks of pregnancy. 

After 41 weeks, there is a slight risk to your baby's health caused by the reduced efficiency of the placenta. After 42 weeks the risk increases, but it's still small. Depending on your hospital's policy, you may be offered an induction around 41 weeks to avoid that risk.

In cases of delayed labor over two weeks, doctors may also use a hormone called Pitocin to stimulate your uterine muscles. Pitocin is a synthetic version of the hormone oxytocin that naturally causes labor to begin when released. This drug is generally considered a safe and effective alternative if your body is not making enough oxytocin on its own.

What If I Don't Want an Induction?

Many doctors induce labor by 41 or 42 weeks. If your pregnancy goes beyond 42 weeks and you don't want to be induced, your doctor may offer monitoring with scans to measure the baby's pulse and the volume of fluid around the baby; or you may have an NST once or twice a week until labor to pick up any signs that the placenta is failing. If a problem is found, you'll be advised to have a cesarean or an induction.

Another method sometimes used to bring on labor without medically inducing labor is acupuncture. In a 2017 study, researchers found that therapies such as acupuncture which creates sensations by inserting small needles into the body may be effective. Another technique used to encourage cervical ripening included acupressure or using the fingers to apply pressure to specific points on the body. If you are considering any of these techniques, be sure to first consult with an OB-GYN or other healthcare professional. Do not try this on your own.  

Stripping the Membrane or a Membrane Sweep

After 40 weeks, your doctor may do an internal examination to "strip the membranes." Don't worry, this is nothing to be nervous about. She'll insert a gloved finger into the cervix and pull the membranes in a circular pattern. This can soften the cervix and increase the chance of your going into labor by 30 percent in the next 48 hours. It's safe for you and your baby, but it can cause cramps and slight bleeding.

How to Relieve Pain and Anxiety During the Wait 

woman getting a nonstress test for overdue pregnancy

Let's face it: No one wants to be pregnant for 42 weeks. The physical and mental stress of being pregnant beyond your due date is exhausting, but it can help to know that unless you have a medical condition, being overdue does not significantly increase your health risks.

You may worry that your baby will grow too large, causing difficulty in labor, but your baby isn't likely to put on enough weight in the last week or so to make a big difference, and most overdue babies have a normal birth weight.

If you are anxious that your overdue baby may have health issues or you are worried about the risk of stillbirth, you should be getting regular fetal monitoring at your checkups. One method doctors may use to safely check on the health of your baby is a nonstress test (NST). A nonstress test monitors the baby's heartbeat and is an easy and painless test that typically only takes around an hour to complete. The doctor will examine your baby's movements by monitoring the rate of your contractions. 

So if you're overdue, do your best to stay calm and relax. Your baby will be here before you know it, and any extra stress you're feeling right now will soon be just a distant memory.

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