Going over 40 weeks: elective induction or wait it out?
We all know that a baby’s ‘due date’ is really just an educated guess — only 4% of babies are actually born on their due date. Nevertheless, it’s a really important marker used to assess the baby’s development and to give you an end date! It is also, in the UK, the date that your baby is considered full term – 40 weeks. This is different in other countries – in France it’s 41 weeks. After 40 weeks, in the UK and USA you are given until 42 weeks before you’re advise to be induced as the risk of a still birth increases. Provided everything is OK with you and baby, it is your decision whether to wait until the 42 week marker or have an induction. This is quite a big decision! Not surprisingly, this is a topic Em and I have a STRONG difference of opinion on. Em chose to have an induction at 40 week exactly, Kate chose to wait until 42 weeks – The Girl arrived at 41 1/2 weeks!
We argue candidly about why we chose to do what we did — we realise this might be a sensitive topic for some. We’d love to hear from you, your reaction, and if you agree / disagree with either of our arguments.
The argument for inducing at 40 weeks (Em)
I felt so strongly about being induced that waiting until 40 weeks was a compromise – my preference was to be induced at 39 weeks in line with clinical research from the American College of Obstetricians and Gynecologists.
Initially I wanted to be induced due to personal experience – a few people I knew had complications during late term births (41 weeks + ) that ended in stillbirth or severe disability. Additionally, my mother had previously worked in Obstetrics as a junior doctor and her experiences had led her to believe that the risks of going over 40 weeks were far stronger than any benefits.
In fact recent evidence shows that induction or elective C-section at 39 weeks is the safest option for your unborn child. Women induced in the 39th week of pregnancy were more likely to need help breathing in the first three days, and women were less likely to have an emergency C-section or pregnancy-related blood pressure disorders, such as preeclampsia. Developmentally there is no extra benefits for your unborn child of going post-term and the risks are higher – so why not choose to be induced and stop those risks.
Being induced was the best decision I ever made – it stopped any anxiety I had around what might happen to The Boy while I was in labour and gave me confidence that I was doing the safest thing for him. I would always choose to be induced myself for any subsequent children we might have and I continue to talk to friends and family about the benefits of induction at term.
The argument for waiting until 42 weeks (Kate)
Like we said in the beginning of this post, I really believe a due date is just an educated guess of when your baby will be born between 37 and 42 weeks. So, with that principle, why let the 40 week mark push you into ensuring your baby is born at that day/week? The concept of a due date arose in the 1800s and there been research to suggest that the way it is used now is incorrect (!!). I never let it hold much weight in my mind, except it being the officiall date I started maternity leave at work!
Once you make a decision to have an elective medical intervention (most do, as did I!), it can increase your chance of having further medical interventions. The prospect of an elective induction scared me because I saw it as the first step in leading to more medical interventions (forceps, breaking water, episiotomy, cesarean) – and research from NICE supports that fear.
Taking a page from hypnobirthing, there is a mantra that say “I trust my body knows how and when to birth my baby” – and that’s because we have been doing it for THOUSANDS of years. Women being pregnant and giving birth is a natural process – only recently has it been such a medicalised, doctor-oriented event.
This last year of parenthood has shown me how many of our decisions we make in adulthood are influenced by our childhood. For me, my Mom went past 40 weeks (I was 42 + 3 days!) with all her babies and she breastfed all her babies – so when I went into my first Happy Birth Club antenatal class, that’s the mindset I had. It worked for her, it’ll work for me. I was worried about what to do if I went past 42 weeks – after being advised by Dr Donald Gibb, my midwives, researching it and talking with my husband, we decided I would continue until 42 week, after which I would choose an elective induction.
Throughout the ‘overdue’ stage, I never doubted my decision and I’m really thankful to Em that we didn’t discuss it. There’s something to be said for mum’s listening to each other, supporting each other but not giving advise unless asked. I was so anxious and worried whilst pregnant that if Em had said something, it could have put me into a tailspin. Even though I was generally anxious, I completely trusted my body knew how and when to birth my baby, but it was still HARD going over 41 weeks. I wouldn’t change my decision, and if we decide to have a second kid, I will carry until the 42 week mark. The Girl came when she was ready, and I am glad I waited.