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Ready, Set….Wait? Managing a Post-term PregnancyWhat happens when the countdown is over and the baby shows no signs of coming out?by Dr. Natasha Balbas .
Photo from galwaydailynews.com
A “post-term” or “prolonged” pregnancy is one that goes beyond 42 weeks of gestation (normal gestation is 37 – 42 weeks). It’s usually after this point that excitement turns to anxiety, especially among new moms-to-be. In order to keep worries at bay, it’s important to know some basic facts and understand the risks or possible complications for both you and baby.
Not all extended pregnancies are post-term
About 10% of all pregnancies are considered post-term, but as it turns out, when ultrasound testing confirms an actual due date, only 2% of pregnancies are actually post-term. The due date is usually calculated at 40 weeks or 280 days starting from the first day of the last menstrual period, but this is only a general (albeit effective) guideline. It’s possible that your pregnancy may be normal and not post-term at all, but rather just a result of miscalculation. Typically, calculating a due date is easier for mothers with regular menstrual periods. Also, ultrasound testing during early pregnancy can provide a more accurate due date. Nonetheless, it’s good to give yourself about a two-week window of your expected due-date.
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Post-term pregnancies are manageable
The first thing your healthcare practitioner should do is recalculate the due date. Many will use uterus height, the time of your first fetal movement, time of the first fetal heart sounds, and other events to reassess a due date and correct it, if necessary.
Once it’s been confirmed that you are truly post-term, testing the condition of the fetus is next. A major concern is the decrease in amniotic fluid, which may disrupt normal blood flow and oxygen transport to the baby. Additionally, the baby may inhale meconium (baby’s first bowel movements) into its lungs, making breathing difficult when he or she is born. A third concern is macrosomia- a condition in which the baby weighs over 4.5 kilos (9lbs, 14 oz.)- causing prolonged labor, injury to the perineum (the area between the vulva and anus), and birth trauma to the baby.
In a process called ante-natal fetal monitoring, several tests can be done to see if baby is well enough to last another few days in the womb, or if he/she needs to come out immediately. Some of these tests include non-stress testing, biophysical profile, and contraction stress testing. The American College of Obstetricians and Gynecologists has stated that it is only necessary to start antenatal fetal monitoring after 42 weeks (294 days) of gestation. Based on these test results, your prior health history, and history of your pregnancy, your doctor may either decide to do a “wait-and-see” approach, or induce labor as soon as possible. Many experts recommend twice weekly testings, but there is little support for this in the scientific literature.ADVERTISEMENT - CONTINUE READING BELOW
Vaginal, natural birth is still possible in many cases. As C-sections are already inherently risky, be sure to understand all possible complications that may arise, should you be advised to undergo one. As a general practice, labor is induced after 43 or 44 weeks, the point at which the risks of complications can increase significantly.
Related: Induced Labor Poses Risks for Mom and Baby
You can still take control of the situation
While the cause of prolonged pregnancy has yet to be determined, you can still be proactive about maximizing your and baby’s health during gestation. Even though no method has been proven to effectively prevent post-term complications, you can be sure that proper nutrition and exercise is always the best approach. Some women have successfully induced labor naturally through walking, sexual activity, and eating special recipes passed down from previous generations. Consult your doctor before starting a new exercise or nutrition program.
If you’re looking for a non-medical route, realize that you have plenty of options as well. There are well-trained acupuncturists who can reportedly induce labor naturally. Homeopathic doctors can also recommend specific herbs to help. Midwives can teach methods to monitor baby’s health post-term without the use of ultrasound, such as daily counting of fetal movements. A chiropractic doctor can also provide natural healthcare throughout your pregnancy to help ensure smooth sailing for both you and baby during your 9–month (or more) journey. No matter whom you choose to entrust your family’s health with, don’t be afraid to ask as many questions as you need in order to feel good about your decisions.ADVERTISEMENT - CONTINUE READING BELOW
Suggested reading: 10 Ways to Stave off Boredom during Pregnancy Bedrest
A little late, but worth the wait
Post-term babies tend to have a distinctive look when they are born. Scalp hair and nails appear longer, and arms and legs can be long and thin. Baby’s skin may appear dry in the thigh/buttock area, and typically have no vernix, the whitish coating frequently seen in newborns. However, most post-term babies enter the world safely, and grow up looking no different than babies born “on time”. More importantly, they enjoy the same quality of life as their more punctual counterparts. Happy, healthy kids- what more can you ask for?