where is the evidence for inducing "post term" pregnancy at 42 weeks

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Hi, I'm a first time Mum and am 41 weeks today. I'm feeling under pressure to have an induction but believe the official date is one week off and that I am only in fact 40 weeks today.
I'd like to look at the scientific evidence for not going over 42 weeks (I have a background in science) and wondered if anyone could point me in the right direction?

Gemma -with the greatest respect, what you state is not backed up by the research evidence, which OP is more than capable of reading and analysing for herself. Can you provide links to research studies or clinical guidelines that support what you have said? The ones linked to above, and also the UK NICE guidelines do not. You view of 'precious' babies is extremely offensive .

3littlefrogs -I agree monitoring is key. If deterioration occurs or there are signs of fetal comprimise/distress then that must not be ignored. There can, however, be a discussion about whether elective c-section or induction is preferable.

One of the practical difficulties for mothers who make an informed decision to choose expectorant management, is that some health professionals are not evidence-based in their viewpoint and the behaviours I have personally seen and also heard about sometimes displayed to mothers whose notes indicated that they have gone past T+10 or T+12 or whatever local policy is can sometimes verge on bullying, even where it is clearly documented that the mother is aware of the risks. I have heard fears genuinely expressed that problems will be 'found' on monitoring, by some practitioners because they are so personally uncomfortable with the mother's decision. People genuinely get into a state going in for monitoring in case they are bullied into not being allowed to leave . This is awful, and the attitudes encountered often make mothers anxious about going in for monitoring, which is not helpful for anyone.

OP -accurate dates are crucial. If you are certain for good evidence-based reasons that your dates are the correct ones, then you can insist they work by them. I'm not advocating it, but I have met one person who changed her EDD with a biro and then all HCPs she encountered simply assumed another HCP had done it. Extreme, but in the circumstances (her DH was abroad for a couple of weeks at the time they insisted she conceived) understandable.

Ultimately, of course, all people who are mentally competent can decline any medical procedure or intervention, even where they are advised it is to the detriment of their health or could actually lead to their death (would anyone try to bully a Jehovah's Witness into a blood transfusion?). This is enshrined in the principles of informed consent and the guidelines from the NMC and BMA.

A baby born at 40 weeks is INFINATELY more likely to die of SFIDS in the following two weeks than if they were born at 42 weeks. Why risk it?

Declutter, I also changed my EDD with a brio on my notes for my second. Wish I had also done so for 3rd.

i didnt say SHE was vile, i said what she said was vile, or rather her insinuation that she loves and cares for the well being of her baby more than someone who goes overdue is vile, there is a difference.

seriously insinuating that i didnt care if my babies died is a vile thing to say.

As a mum of a stillborn born son who would be here if I had been induced earlier ...

I would say get your baby out while they are healthy

I know there are risks to inductions/c-sections etc but please dont take the risk of letting your child die if you can help it.. i wouldnt want anyone to walk this crappy path we are walking

I realise this post is emotive and its not meant to make you worry/stress or cause you upset .. I just wouldnt want you to suffer what we have

Gemma's remark about easily conceived children is one of the most offensive and unpleasant things I've ever read on mumsnet.

OP - read the information linked here and take it from there. Sadly no option is risk free. Stillbirth is an awful tragedy and we have far too many in this conutry - but I don't think induction at 40 or 41 weeks would drop that number.
Please pay close attention to your baby's movements and if they change from the normal for them go straight to hospital. You probably know this but it's a myth to say movements naturally slow before birth. They don't.

I had my first at 40 weeks 10 days. At 41weeks I had to be on a monitor for about an hour every day. The docs said best to induce at 40+10.

2 hours before the appointment labour started, and ds was born very quickly.

With hindsight I am glad I was not induced, as the natural labour was nice and quick, but I woud have gone with induction otherwise.

It is hard to know, what to do, I has a doctor I knew well and trusted hs advice.

My second one was aso 10 days late, but I had the same doc and he was less keen to nduce as it was obvious to him that 41weeks fr me was normal.

Good luck, best wishes, have a happy birth!

So sorry for your loss frasersmum, that is so absolutely horrible.

frasersmummy i am very sorry for you loss :( i cant imagine the heartbreak, but as northern luker says induction at 40-41 weeks wouldnt change the outcome for many, ultimately it needs to be looked at on an individual basis. i for example went 2 wks overdue, 3 with one and my placenta was fine everyday, yet a mum from toddler group went for her check up on her due day, baby fine and wriggling when she had a shower, by the time she got to her chck up an hour later the midwife couldnt find the heartbeat :(

i think i am right when i say they often dont find the cause for a stillbirth? certainly for those that i know who have suffered it no cause has been found.

the op is trying to find out the statistics and facts so she can make an informed decision, they all have risks and the risks of induction can include things doing horribly wrong and a still birth, we all have to weigh them up individually.

and i agree with northern again when she says watch babies movements and get checked out, this is one of the reasons with my 5th baby that i was induced at temr plus 10 rather than waiting asi wanst happy with the movements, it was just a niggly feeling, but i followed my instinct and insisted on a scan that showed lowered fluid levels, which can be a sign the placenta isnt working as well?

isnt there a 'count the kicks' campaign to help try and reduce stillbirth rates?

yes here is the website for count the kicks

Obviously a very emotive subject. Fwiw for me it is not the percentage risk you are taking that is too high but rather what you are risking. If you become that 0.3% suddenly it doesn't seem like a very low risk.....

At what point do you say enough is enough? +14 +16?

Oh and whilst I don't agree entirely with gemmas sentiments. She is correct that failure of placenta is the most common preventable reason for stillbirth at 40 weeks plus.

Starlight you are very misinformed re SIDS being more prevalent than stillbirth. In the UK approx 300 babies die from SIDS each year. Over 6200 babies every year in the UK are stillborn. Obviously these are for a multitude of reasons but it frustrates me that people still believe that SIDS is more common.

It is a very emotive subject and naturally personal experience colours how you feel about it. I'm not planing anymore dcs but if I were....I went to 41 weeks with both dd2 and dd3 and was adament with dd3 that I would not be booked in for induction before 40 +14. Were I doing it again, now with the background of a stillbirth in my circle of friends, I suspect I would take 40 +10 at least. That's not based on any 'facts' and the stillbirth my friends suffered was before 40 weeks so nothing to do with going past dates. I think you just come down on this debate one way or the other and nothing is going to shift your position. It's such a personal issue. And of course indcution is not risk free and can put the baby in to distress and lead to other intervention. It's very difficult. I don't think there is a 'wrong' choice. There are choices you can come to regret but that's not predictable.

Sorry northern you are right. Personal experience does hugely come in to it. For objectivity's sake I probably should have said I have a lost a baby near term, though nothing to do with going overdue. But once you have suffered a loss like that it becomes inconceivable why anyone would take the risk, however small. My DD has fetal cancer - 1 in a billion apparently - I guess that's why I can't take any comfort in statistics.

To balance it I'm having a c-sec in 4 weeks at 37 weeks with my dd3 which a lot of people would say is bonkers given that there is no 'clinical need' for her to be delivered early. Like Northern says personal experience leads to personal choice.

Good luck with the birth op xx

I didn't say anything about whether stillbirths were more or less common than SIDS

But, out of interest, are those 6000 plus still born babies all born after 41 weeks?

FrasersMummy I'm truly sorry for your loss and resulting heartache.

Whatever - in your place I would opt for a c-section like that too. I hope everything goes super smoothly. We're all rooting for you.

Whatever, x-post. Sorry for your loss and bad luck too. Like you, I am influenced by past experience and see a hospital vb as a huge risk to the well-being and health of my baby and neither an induction nor c-section can be conducted anywhere else.

no i think that includes all stillbirths, so some of those will be early some will be late, at what point in pregnancy does it become a stillbirth rather than a late miscarriage? isnt there a certain cut off point?

good luck whatever xxx

Of course not starlight but you said that if a baby was born at 40 weeks it is INFINITELY more likely to die of SIDS in the following 2 weeks than if it were born at 42 weeks which is nonsense.

X post again starlight thank you. And thank you Northern and 5madthings. Stillbirth is classed from 24 weeks onwards

I suppose I was just giving an example rather than focussing on SIDS. A baby born at 40 weeks has more of a risk of being dropped in in the following 2 weeks than a baby born a 42. I was just highlighting that there are risks of not being in the womb too.

i thought it was about 24wks, but couldnt remember exactly.

whatever can i ask why the section at 37wks rather than 38? only i thought i read that its better to do it at 38wks now or consultants prefer that? but then you have your own personal circumstances and reasons which may mean that 37wks is best for you and i undestand if you dont want to answer, its a very personal decision.

A variety of reasons 5madthings one of the main ones being if I waited another week I would be just 3 days away from dd2's first anniversary which is just too close.

Most subsequent pregnancies after a stillbirth/neonatal death end up in induction or c-section at 37 weeks or earlier as it does become a very scary test of nerve where you just feel the baby is safer out than in where you can see what is happening. My cons would do a c-sec for me from 35 weeks onwards without any objection if I felt I just couldn't cope any
longer

In my NCT classes I talk about the fact that nothing is ever as it seems and in the case of induction you CAN request a doppler scan to see how well the placenta is doing especially if you feel your dates are wrong, i.e. say, only 40 1/2 weeks when the computer says you are 42 weeks. It is generally offered anyway. You can always ask to speak to a Supervisor of Midwives - their number is in the front of your notes.