How long would you be willing to go overdue? **Content warning - title edited by MNHQ**

[rachiro]

41+5 and since baby is doing well I'll be waiting for another few days at least. My baby just doesn't seem ready yet. I wonder why some babies just don't come on their own/why some of our bodies do this 🙄

I wouldn't go overdue at all. The placenta stops working as effectively and risk of stillbirth increases massively.

Does anyone have any actual evidence to back up this argument that "risk of stillbirth increases massively" after 40 weeks?

It increases, yes. But isn't it something like 0.05% to 0.1% per day or something? (I just made that up, btw. But my understanding is that the risk is small.)

Not a risk most women would be willing to take, of course. But I think it's scaremongering to overstate it. It's a small risk with devastating consequences - hence most women choosing to avoid the risk, albeit small.

It just makes me uncomfortable when people seem to be telling pregnant women "you must have an induction or your baby will die" Actually sometimes babies die - or come close to dying - when inductions go wrong. There's a crisis in maternity services atm (and firing unvaccinated midwives will fix that, won't it ) and if i was pregnant in today's circumstances, I would pick ELCS over induction if I felt (following medical advice and evidence) that baby was better out than in.

Wouldn't have been happy to go overdue at all with either of mine. Luckily I went into labour naturally with both of them on their due dates and they were born the day after.

Even though my son was born only a day after his due date the midwife told me the placenta had started to deteriorate already.

DH's placenta failed really early and he was born a week early, he only weighed 4lbs and was very ill for a long time.

Our bodies are not calibrated machines, things go squonky all the time and the people to listen to are medical professionals, not social media echo chamber inhabitants.

Sorry but I feel I need to mention that the UK stillbirth/neonatal rate is something like 17 x higher then the one for SIDS (cot death).

Pregnancy, labour and delivery are risky.

I feel like there is some quite questionable advice on this thread. I remember NICE changing their guidance last year when I was pregnant. Good luck to all those waiting for their babies.

www.nice.org.uk/news/article/nice-recommends-inducing-women-in-labour-earlier-in-new-draft-guidance

9/10 days over.
More and I'd be really pissed off.

For the OP and anyone else on this thread currently pregnant and considering induction, you might find this guide helpful in making an informed decision.
shop.aims.org.uk/products/aims-guide-to-induction-of-labour

[quote PeterPipersPepper]I feel like there is some quite questionable advice on this thread. I remember NICE changing their guidance last year when I was pregnant. Good luck to all those waiting for their babies.

www.nice.org.uk/news/article/nice-recommends-inducing-women-in-labour-earlier-in-new-draft-guidance[/quote]
Bear in mind that this article relates to the draft guidelines which were published in May 2021 I think and which were revised before the final version was published in November 2021.

This is relevant I think:

There was evidence that caesarean birth, perinatal mortality and neonatal intensive care unit admission are reduced by earlier induction of labour (at 41+0 weeks) compared to later induction (at 42+0 weeks or after). However, there was not enough evidence, so the committee made a recommendation for research to identify the optimal timing of induction more precisely.

The committee were aware that data from the 2020 MBRRACE-UK report on perinatal mortality had shown that babies born to certain groups of women may be at higher risk of stillbirth and chose to highlight this in the guideline. As there was no evidence, the committee made a recommendation for research to identify the optimal timing of induction in groups of women who may be at higher risk of stillbirth.

(From www.nice.org.uk/guidance/ng207/chapter/rationale-and-impact#induction-of-labour-for-pregnancy-lasting-longer-than-41-weeks)

I've found some data.
Risk of stillbirth (perinatal death to be precise) when inducing at 41 weeks is 4 in 10,000, compared to 35 in 10,000 at 42 weeks. So it goes from 0.0004% to 0.0035%.
Obviously even 4 is too many and no one wants to be the mother of those 4.
But the numbers were are talking about, statistically speaking, are tiny.

Sorry forgot link
www.nice.org.uk/guidance/ng207/resources/appendices-a-b-and-c-10883967373/chapter/Appendix-A-Risks-associated-with-different-induction-of-labour-timing-strategies

I wouldn't go too far over, known too many sad incidents. As a baby, I was very overdue and the placenta was failing, I needed oxygen immediately at birth.

Glad you find the numbers so comforting @NameChange30. It is utterly devastating for not just the mother, but the father too. And their families. And has long term impacts.

Pregnancy genuinely shouldn't be seen as a time to stay pregnant for as long as possible.

Once past your due date, please, please take advice from medical professionals and not from someone anonymous on MN who has pulled out a pamphlet from Google. I know people who have had sudden and emergency labours and births at 35 and 37 weeks, if they had just gone with their feelings then who knows how things would have turned out. I know someone who had a stillbirth a week before their due date who still doesn't know why it happened.

I know statistics can support people in feeling comfortable advocating a more relaxed approach, but when you are talking about pregnancy and birth, speak to your midwife and your doctor about your specific circumstances.

So it goes from 1/2500 to just under 1 in 250. 1/250 sounds quite high to me, in terms of rolling the dice on the potential death of my baby.

French due dates are 41weeks not 40 but they start monitoring every 48 hours at that point and start inductions at 41+4. They want the baby out by 42weeks at the latest. You could probably argue with the midwives and drs about it but I’m pretty sure you’d be very strongly encouraged into either an induction or C section at the 41+4 appointment. I didn’t argue and had a successful and very positive induction and my child was born 3 days later.
OP an induction when you’re this overdue will either work because your body is close to ready anyway and so you’ll reduce that stillbirth risk by getting baby out before the placenta deteriorates further, or it would never have worked for you for whatever reason and you’ll have a C-section.

A pamphlet from Google?!
I was sharing the Nice guidelines.
And the Aims guide, Aims is a recognised organisation campaigning for better births and informed decision-making.
I'm not telling anyone what to do. Just sharing information and encourage people to make informed decisions.
Looking at those stats, I may well have chosen to accept induction before 42 weeks. When I was pregnant with DC1, I chose to wait, went into labour naturally and DC was born at 41+4, all fine. Of course for some (a very small minority) it's not fine and I'm not dismissing that risk.

Lots of still birth horror stories on this thread. I know some induction horror stories too but I'm not going to share them. Induction can sometimes be the right choice and can go well. Not always.

Agree with everyone who has advised OP and others to discuss their personal situation with HCPs. However, it is also helpful to do your own research as long as you stick to reliable sources. Nice and Aims are both reliable sources.

I went to 42 weeks with my firstborn. I was 29. This was 23 years ago. At that point they induced. My second baby was born when I was 42. I was told in no uncertain terms that going past 40 weeks wasn't an option. I was slim, fit, healthy. As it happened I went into Labour spontaneously on my due date otherwise it would have been an induction. Personally I'd not leave it more than 42 weeks, so much can go wrong and it's not worth it.

"I know someone who had a stillbirth a week before their due date who still doesn't know why it happened."

What's your point? Do you think everyone should be induced before 39 weeks because this tragedy happened?

@NameChange30

"I know someone who had a stillbirth a week before their due date who still doesn't know why it happened."

What's your point? Do you think everyone should be induced before 39 weeks because this tragedy happened?

@NameChange30 What's my point?! My point is not to be so glib and relaxed with other people's pregnancies. I'm not advocating induction for everyone at 39 weeks. I'm suggesting that people speak to their medical care team rather than having strangers telling them its fine to wait till 42 weeks and beyond.

It's a hard one. I was 41+2 with DD1 when they started crying to induce me. Nothing worked. She was stuck fast and rather comfortable! Ended up with the drip, epidural, back to back baby, unable to push as I couldn't feel contractions, episiotomy and ventouse delivery and a blue baby who needed lots of extra care after oxygen supply being compromised. Thankfully the midwives and consultants moved fast enough with the delivery to avoid any long term effects.

I'm not having any more babies but if I was to - I would be very very apprehensive about induction.

@NameChange30

I've found some data. Risk of stillbirth (perinatal death to be precise) when inducing at 41 weeks is 4 in 10,000, compared to 35 in 10,000 at 42 weeks. So it goes from 0.0004% to 0.0035%. Obviously even 4 is too many and no one wants to be the mother of those 4. But the numbers were are talking about, statistically speaking, are tiny.

The overall risk of stillbirth in the U.K. is about 1/250. It's actually quite high.

@ParishSpinster

"My point is not to be so glib and relaxed with other people's pregnancies."
Read all my posts on this thread and tell me where I've been "glib and relaxed" about other women's pregnancies. You'd have to be very selective indeed and wilfully misread my posts.

"strangers telling them its fine to wait till 42 weeks and beyond."
I have not said this. Again, read through my posts.

I went to 42+1 though the maternity unit inisted on daily checkups after 41 and (I feel) bounced me in to having my waters broken when did noting so I was put in iv induction meds. This was admittedly after a 3rd sweep has started contractions that then petered out. The placenta was perfectly healthy as it turned out.

@SpookyScarySkeletons

It's a hard one. I was 41+2 with DD1 when they started crying to induce me. Nothing worked. She was stuck fast and rather comfortable! Ended up with the drip, epidural, back to back baby, unable to push as I couldn't feel contractions, episiotomy and ventouse delivery and a blue baby who needed lots of extra care after oxygen supply being compromised. Thankfully the midwives and consultants moved fast enough with the delivery to avoid any long term effects.

I'm not having any more babies but if I was to - I would be very very apprehensive about induction.

Sorry this happened to you and your baby

Personally I wasn’t prepared to go to 39 weeks. I had an induction booked at 39 weeks due to GD and hospital policy (which I could have fought but didn’t want to). I had reduced movements and happily accepted an induction at 38+1 because my anxiety was building and I wanted baby here. My induction was positive, pessary worked and baby was born vaginally at 38+2.

The thing with inductions is if your body is ready and baby is cooperative, they’re a positive experience. If your body isn’t ready or baby isn’t cooperative then it won’t be a positive experience but I think the question then becomes at what point will your baby and body be ready? You can’t know that, so you have to take the risk of a potential negative induction or the increased risk in stillbirth. My personal view is that at 41 weeks induction will either work quickly or you’ll have needed assistance anyway because of baby’s position/size.

Wouldn't want to go more than a week to be honest. Placental insufficiency is a thing unfortunately when you're at/over term. Definitely wouldn't go two weeks, I know of two tragedies when left that long.