Question about 42 wks gestation and it being more natural inspired by comments from Mears

[Wills]

Mears mentioned on a previous thread that I now can't find that pregnancies often last nearer to 42 weeks than to 40. If this is so why is there such enthusiasm to induce? I was induced at 40 + 4 and I look back at this with great regret as a medicinal crow bar did have to be used to get her out. Are the consequences of waiting for the little one to come out on their own that bad? Once you're over 40 wks is there serious health risks? Its just that it surprises me the number of people I've encountered that were induced and I'm finding it difficult to believe that the body regularly overcooks babies.

I was induced because I'd had a major, mega row with dh the night before and my blood pressure was naturally through the roof. I've told him that this time round even if he doesn't agree he's just to nod and say yes and leave arguing until after little one is born.

Good morning Wills. Glad you liked my reference to pregnancies lasting longer. This is not a new belief but one that has prevailed for a very long time. Term pregnancy is classed as 37-42 weeks. It used to be that a baby was 'premature' if it was born at 37 weeks! I do remember as a student midwife being taught all about placentas degenerating after 40 weeks, babies heads not being able to mould (bones of skull over-riding) at delivery etc. As I learned more I realised that not all pregnancies lasted the same length of time. Babies are not conceived at the same time during a cycle. Periods vary in frequency. Women are under intense pressure when their pregnancies come near the end. The magic date appears then the countdown starts. I was at a study day of Caroline Flint's a few years ago, and she spoke then about western pregnancies lasting nearer 42 weeks. She suggested then that women should be given a date 2 weeks later than they are given now. That would reduce the induction rate for a start. I am of course referring to healthy, uncomplicated pregnancies.
I have seen more women insisting on not being induced and going into labour spontaneously just past 42 weeks. It would be much better for women, I think, if the worry of going 'overdue' could be minimised. I also think that giving a later date would help as far as maternity pay/leave goes - that needs adjusting because that causes stress when you go past that magic date - but that is another thread in itself

Mears - I have read many times that the average gestational age is 41 weeks anyway.... so 42 weeks is not a whole lot later. In some countries EDD is 41 weeks anyway.
St George in London is no longer agreeing to induce normal pregnancies before 42 weeks - in the hope of reducing their intervention rate.
It's a bit of a strange situation I think as most women (especially first timers) get sad/depressed/fed-up at 40 weeks +1.... and so get quite interested to get induced as they just want their baby... not realising (always) the cons of inductions ! And on top of that all friends and relatives asking "Not there yet???"

I was that person Pupuce! I was getting fed up with family all going on at me, fed up of being tired and huge and desperately wanting to meet my baby. So I was induced 11 days overdue. I will not go through that again! This time I have given myself a later date so will not be expecting new baby to pop out on the due date. I really feel I missed out not knowing what it felt like for labour to start spontanteously.

I sort of know what you're saying forest in that labour didn't start naturally but my main concern here is not to go through what I went through last time! 30 hours of full on labour right from the start was b**y awful and I'm not saying that I wont have a naturally long labour but I do hope to get there slowly not nothing to full on every 1.5 minutes in the space of 3 minutes! I'm gearing myself up with the necessary knowledge to refuse to be induced. I'm very happy to be monitored daily but unless they can tell me that baby is at risk I see no need to "crow" bar it out! If baby's health is really at risk then I'm open to anything to help it but until that point I'd rather nature did as nature should do.

Thanks Mears - you have helped me in finding my resolve.

Hi All!
I felt strongly that I didn't want to be induced because of friends' experiences of things going downhill from there on. I went 12 days overdue, and I told friends/family in the nicest possible way to leave me alone, to get mentally ready for labour, which they did. The hospital booked me in for an induction on the Monday (which would have been 42 wks), but luckily I went into labour before then. I was really fed up with the huge bump and wanted desperately to see her, but kept busy working til the day it started. I tried all the tips for starting it off-pineapple, hot food, champagne but to no avail. In the end tried the last resort with much discomfort- a bit of nookie! It worked anyway! DD was born 3 days later.

It doesn't have to be all bad. I was induced at 40+13, with my first, and had a gradual increase in contractions and a 5 1/2 hr labour. I have heared that in France EDD is 42wks.
A friend was very worried at me going over as she had been going to SANDS group and they were all against going over 40 wks as some are then still born. maybe closer monitoring after 40 wks is the answer but for that we would need more MWs etc etc..... but that is another topic!!

I believe though that if there is any problem for the baby you should be induced once you are full term, a friend of mine was induced at 39 weeks because she had developed pre eclampsia and she is very happy they did it.

I am being induced tomorrow because the baby has low levels of fluids around so they think it's better if he/she's out, since I am already overdue.

KMS, thanks for your "It doesn't have to be all bad" that makes me feel better

Good luck with your induction happyspider. Just don't expect it to be quick (I did and was disappointed). Take lots of books!

My family has a history of going overdue, so I was quite well prepared. Whenever I was asked about my due date, I always said that it was xyz, but that I was expecting the baby to arrive a fortnight later. And when people asked if I still hadn't had the baby after xyz passed, I just joked that it couldn't arrive yet because I hadn't finished hemming the nappies. I think it definitely helped to be mentally prepared for a wait. dd was 15 days late in the end.

pupuce, could I ask you about the 41 weeks average gestation? What does average mean in that context, and how would it be measured? We've been inducing babies for quite a while in the UK now (my mother was induced when she was a fortnight overdue with me over thirty years ago), so I just wonder how we know what a 'normal' length pregnancy is now.

Goo Luck Happy Spider, I am really looking forward to hearing your news.

I do hope I've not upset anyone with this question and Happyspider - loads of good luck. Its just that I find many people are induced and most of them are unaware of how extra strenuous it can be. I certainly jumped at the chance of being induced thinking that it would be quick easy and over. Both dd and I ended up extremely stressed although not simply because I was induced. Its just that I can't believe that nature gets it wrong that many times - this is what our bodies are supposed to do. However saying all that if someone tells me that my little one needs to come out then so be it and I wouldn't hesitate. I just don't want to have to do it because someone says you're 40+14 time for a pessary.

Have a look here (sorry crap at links!)
www.birthlove.com/free/ten_month_mama.html

If you want to find out about 10 months pregnancy.

I just want to say thanks to Wills for starting this thread, I had no idea about being induced, although I was induced and it ended with an emergency c/s, any way I digress!

This thread is so interesting and it's made me think about me mentally extending my due date another two weeks and if possible allow the birth to happen naturally without being induced, providing the baby and myself are not in danger.

Thanks everyone.

I was induced and like most first timers had no idea what I was letting myself in for. I just thought it was great to have a data and know i would have my baby by then. I had a very traumatic experience and do not want a repeat performance this time. I plan to go as long as possible and wait for a natural birth and failing that a C-sec - there is no way I am being induced this time! It really annoys me that more information is not given to women re. induction and what to expect.

I was induced twice, in my second and third pgs. With the first induction (ARM and oral prostaglandin), baby arrived in four hours and was the easier birth of the lot. I was 41+3wks. DH reckoned I would have 'gone' that night anyway, as I'd been antsy and complaining of back pain, not that I recall it myself!

I was induced at my own request (tsk tsk!) with third pg at 41wks. I had a prostaglandin pessary, labour started 6-7 hrs later and lasted about nine hours. It wasn't as easy as No2 but was otherwise straightforward.

suedonim, what started me thinking weeks ago was that Mears has stated before that if baby is ready to come anyway then induction will speed things up. However if not then a crow bar is literally needed to shift them and honestly mine felt like a crow bar. Its knowing whether or not little one is ready and if so then induction seems a little pointless anyway.

I was induced at 36+6 due to obstetric cholestasis. I was really annoyed that I wasn't given more information about it, and the likelihood of it succeeding. If I had been I would have gone for a c-section straight away, rather than having 44 hours of semi labour (with practically constant monitoring) DD was so not ready to come I was still only and 1 cm dilated. The ospital insistd that I was tried inducing before considering a c-section. I do know about all the extra c-section risks, but I can't help thinking there was a cost issue involved.

Prufrock... can I add my 2 pence worth....

1. you might have been able to deliver vaginally - and it is safer
2. you can now have a good chance at a vaginal birth as if you had had an elective you would be in a different place (and agin a vaginal birth is safer and better for baby)

I am sorry the induction failed and that you had such a long and hard time.... hopefully next (?) time will be a much better experience?

Thank Pupuce - you just won't give up your quest to give everyone the perfect vaginal birth (and I really do mean that in the fondest and nicest way)

Problem is I'm 90% likely to get OC again, necessitating another inducement as soon as the drugs stop working and my bile acids go up, or 37 weeks, whichever is earlier. And because I haven't given birth vaginally before, my cervix will still be virginal so no more likely to perform than it did last time. And I thought they wouldn't induce after a c-section because of higher risk of uterine rupture?

I just really don't see the point of induction. Either let the baby come out naturally when it wants to if a woman goes past 40 weeks, or accept that the chances of forcing it out if it's medically necessary much before 40 weeks are low, and result in a more traumatic experience than a nice, civilised eletive c-section.

prufrock - if only it were that simple Induction of labour for a first pregnancy is always worth a go, rather than opting straight for C/S. Vaginal birth is safer than C/S. However, you are quite right in your case. If you need early delivery, it would probably be better to deliver by repeat C/S unless you laboured spontaneously. I was induced at 35 weeks and delivered vaginally. It worked because my body responded and I had laboured before. In your case it would be less likely, exactly for the reasons you describe. More women who are induced have vaginal birth than C/S. It is just the risk of C/S follwing failed induction should be highlighted to women who want induced because they are 'fed up'.

Wills, I hope you didn't think I was being critical or anything. I wasn't offering any particular viewpoint, it was just my experience of induction. Just to give it a bit more context - when I was induced the first time, way back in 1979, ten days was considered very overdue and dangerous. If I was in the same situation today and had all today's knowledge (and Mumsnet!), I'd wait longer. I requested induction the second time because my DH was going away for two weeks and I'd have been on my own with two other children. Given that same situation today, I'd still request induction - though probably would be refused!

I think it's wonderful that pg women have so much information now. It makes me sad that not all HP's have taken the latest thinking on board and women still suffer, as a result. I hope everyone is as enlightened as Mears & Leese, by the time my children come to have babies.

doesn't sound like much fun, prufrock, hope it goes better next time.

Prufrock... you know I can't

Your case may be different from the majority but as you can see from Mumsnet many women are unaware of the pros and cons of induction.... Also it is worth empowering woman if they want words of encouragement !

suedonim - no worries whatsoever. I didn't think you were critical for even a second, simply passing on experience - gosh now you've got me worrying that I came back a bit strong. No I was fascinated that you'd experienced it twice and the different results and proposing a theory.