Let’s talk about “Due Dates” and the rise of Inductions
When a woman becomes pregnant and sees her care provider for the first time, she will be given an estimated due date. The biggest thing to remember with this date is the key word “estimated.”
Estimated Due Dates: How do you know when baby is coming?
How do you determine your estimated due date (EDD)?
Most all care professionals, doctors and midwives use a 3-step method called Naegele’s rule to figure out your EDD. Using the assumption that your period is a “normal” 28-day menstrual cycle, that you ovulated exactly on the 14th day of your cycle, care professionals will use Naegele’s rule and add 7 days to the first day of your last period and then count back three months, or count forward 9 months and you will have your EDD. This is also equal to counting forward 280 days from the date of your last period. With that being said, some health care professionals will adjust your EDD if you have longer or shorter cycles.
Many women know the exact date of conception after doing fertility tracking or in vitro fertilization and can calculate their EDD by adding 266 days to the date of conception. This form of EDD calculation has increased accuracy because it doesn’t make the assumption that every woman has the same 28-day cycle with ovulation on day 14. If you are planning on trying for conception and think you have the patience to track fertility, this is a great way to have a more accurate EDD! (https://evidencebasedbirth.com/evidence-on-inducing-labor-for-going-past-your-due-date/)
Let’s talk inductions. Inducing labor is the artificial start of the birth process through medical interventions or other methods. An Induction not done for medical reasons or as an emergency is considered elective. Inductions for non-medical reasons have been increasingly on the rise in the U.S. More pregnant women are being induced because they have reached their EDD of 40 weeks (https://evidencebasedbirth.com/evidence-on-inducing-labor-for-going-past-your-due-date/)
Care professionals recommend induction of labor in circumstances where the risks of waiting for the onset of spontaneous labor are determined to be greater than the risks associated with shortening the duration of pregnancy by induction.
These circumstances generally include:
Baby gestational age of 41 completed weeks or more
Prelabor rupture of amniotic membranes
Maternal medical complications
Fetal growth restriction
Vaginal bleeding and other complications.
In addition to medical reasons, the induction of labor is being used more and more at the request of pregnant women to shorten the duration of their pregnancy or to time the birth of the baby ato the convenience of the mother or the care professionals. In a 2013 survey titled “Listening to Mothers III,” more than four out of ten mothers (41%) in the U.S. said that their care professionals tried to induce labor. Out of all of the women induced, 44% said they were induced because they were told their baby was “full term” and it was close to their due date. Another 18% reported they were induced because their care professional was concerned the mother was overdue (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3894594/).
Like any other intervention, induction has risks, which should be balanced against the hoped-for benefits. And while the decision is clear when facing the risk of endangering the life of yourself or your baby, the choice isn’t so clear if you’re a few days or even a week or two overdue.
While induction is considered safe, it has been associated with some risks, a few examples of these include; uterine rupture in moms who’ve had a previous cesarean and are attempting a VBAC, increased close-together contractions that may reduce baby’s oxygen supply and medications that may prohibit breastfeeding success. If your EDD date is off, your baby might be born before 39 weeks’ gestation. These “early term” babies do have an increased risk of breathing difficulties and other health problems.
Babies can be born at different “terms” according to the weeks and days of gestation.
“Early term” babies are born between 37 weeks 0 days and 38 weeks 6 days
“Full term” babies are born between 39 weeks 0 days and 40 weeks 6 days.
“Late term” babies are born between 41 weeks 0 days and 41 weeks 6 days
“Post term” babies are born at 42 weeks and 0 days or later
Making the choice to have an induction
Obviously, the risks and benefits of induction differ depending on the circumstances of your situation, so you’ll need personalized information to make the decision that’s right for you. And the best way to get it is to ask your care provider lots of questions. Here are some sample questions to help get you the informations and answers you need, make sure you surround yourself with supportive people, having a doula may help you understand your options that you may not have known were available.
When it comes to make the decision on whether or not you should induce, remember you have a CHOICE. Using the acronym BRAIN could help you understand your options in depth before making a decision, if time is available.
B: What are the benefits?
R: What are the risks?
A: What are the alternatives, including non-medical, waiting or not inducing? What are the risks of these alternatives?
I: Ask for more information, or follow your intuition!
How likely is an induction to be successful?
Can you describe the procedure? If the procedure doesn’t work, what are the next steps?
N: What happens if we do nothing? What happens if I choose not to take your recommendation? (In some instances, some care providers may ask you to find another provider.)
The decision you make will be yours and should be respected. Like I stated before, surround yourself with SUPPORTIVE people because the stress of impending induction can be a heavy load on a mama.
There are other ways to prepare your cervix and induce labor naturally that you can explore before you make a decision for a medical induction. Review your dates, check the accuracy of your cycle and when your last period was. Consider keeping tabs on the baby with kick counts, periodic ultrasounds and twice-weekly non-stress tests.
Ask about membrane sweeping, an intervention procedure in which a care provider inserts a gloved finger into the cervix and gently separates the amniotic bag from the uterus. Membrane sweeping causes a release of prostaglandin, the hormone that softens the cervix and may start the labor process.
You can try acupuncture as well, and though it hasn’t been scientifically studied, some women find that acupuncture helps to get labor started. Or simply delay induction a few days, waiting until 41 weeks plus three days may increase the chances you will go into labor on your own.
Whichever path you choose at the end of your pregnancy, go with confidence and ease. You are strong, you have a choice, remember that mama. And always ask questions!!! That will be the best way to do what is best for you and your baby!
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