Due Dates & Inductions

The average length of pregnancy is 280 days from the first day of the last menstrual period. Most babies are born between 38-42 weeks gestation with very few arriving on their estimated due date.
Studies show that monitoring pregnancy while waiting for spontaneous labor results in fewer cesareans without any rise in the stillbirth rate. It is true that the stillbirth and fetal distress rates rise more sharply after 43 weeks, but it is also true that less than ten percent of babies born at 43 weeks suffer from postmaturity syndrome (over 90% show no signs).
Post-term isn’t until after 42 weeks. ACOG states:  “Health risks for the baby and mother increase if a pregnancy is prolonged. The more prolonged the pregnancy, the greater the risks. But problems occur in only a small portion of postterm pregnancies. Most women who give birth after the due date have healthy newborns. After 42 weeks, the placenta may not work as well as it did earlier in pregnancy. Also, as the baby grows, the amount of amniotic fluid may begin to decrease. Less fluid may cause the umbilical cord to become pinched as the baby moves or as the uterus contracts. For these reasons your doctor may recommend delivery before 42 weeks of pregnancy.”
The risks of inductions include hyper-stimulation of the uterus (where the uterus contracts too frequently, decreasing blood flow to the baby), the use of extra interventions such as continuous fetal monitoring and the need for additional pain relief, and a failed induction leading to a Cesarean (NICE Guidelines, 2008). Induction multiplies the risk of cesarean section, forceps-assisted delivery, shoulder dystocia, hemorrhage, fetal distress and meconium aspiration. Inductions should only be given as an option when the benefits outweigh the risks involved.
As with anything it is a discussion you should have with your provider. Everyone has a unique situation and medical history so there isn’t one blanket course of action that will be right for everyone. The important thing is to ask questions and ensure you are making an informed decision regarding your options for delivery if labor doesn’t start on it’s own before 40 weeks what the next steps for you would be.
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