Going Past Your Due Date
Going Past Your Due Date
Understanding Your Due Date
An estimated due date is exactly that an estimate not a deadline. It is based on population averages and assumes a 28 day cycle with ovulation on day 14 which does not reflect the reality for many people.
According to the American College of Obstetricians and Gynecologists (ACOG) pregnancy is considered term up to 40 weeks and 6 days and many healthy pregnancies continue beyond this point. Going past your estimated due date is common and in many cases physiologically normal.
What Does Postdates Mean
Term pregnancy is defined as 37 weeks 0 days through 40 weeks 6 days.
Postdates refers to pregnancies beyond 40 weeks.
Postterm refers to pregnancies at or beyond 42 weeks.
Most people who go past their due date will still go into spontaneous labor without complication. However as pregnancy continues certain risks do increase gradually which is why ongoing assessment and individualized planning are important.
What Changes as Pregnancy Continues
As gestational age advances research and clinical experience show that meconium in the amniotic fluid becomes more common after 41 weeks and conditions such as preeclampsia occur more frequently in postdates pregnancies. The risk of stillbirth also increases slightly with each additional week though the overall risk remains low.
Estimated stillbirth risk by gestational age
40 weeks approximately 0.7 per 1,000
41 weeks approximately 1.1 per 1,000
42 weeks approximately 1.9 per 1,000
While these numbers reflect an increase it is important to note that the absolute risk remains low.
Induction Versus Expectant Management
Some studies suggest that inducing labor between 41 and 42 weeks may slightly reduce the already low risk of stillbirth and meconium aspiration. Other data show that induction is associated with a higher likelihood of epidural use longer and more medically managed labors and increased intervention overall.
Population data from Ontario found that people whose labor began spontaneously had lower cesarean rates than those who underwent induction for any reason highlighting that induction is not a neutral intervention.
In hospital based obstetric care induction is often offered earlier due to institutional policies rather than individual clinical need. In midwifery care decisions are typically based on maternal and fetal wellbeing rather than an arbitrary date.
Midwifery Approach to Postdates Care
As long as both parent and baby appear healthy waiting for spontaneous labor is a reasonable option. During postdates care your midwife may recommend increased fetal surveillance such as a biophysical profile, along with monitoring maternal vitals and symptoms. With ongoing discussions of changing risks and options.
If monitoring suggests that the baby or placenta may not be functioning optimally your midwife may recommend additional testing consultation or transfer to obstetric care to reduce risk and support a safe outcome.
Regulatory Requirements and Transfer of Care
Licensed midwives in Texas practice under state regulations that define the limits of midwifery care. Under these regulations a recommended transfer of care occurs at 42 weeks of pregnancy.
This means that if pregnancy continues to 42 weeks midwives are required to recommend transfer to a hospital based obstetric provider for ongoing management and delivery. This recommendation is based on regulatory standards rather than individual provider preference.
Your Choices Matter
At every stage you have the right to continue midwifery care with appropriate monitoring, request consultation, or collaborative care transfer to hospital based care for induction at any point and decline recommendations after discussion of risks and benefits.
Informed consent means understanding both the benefits and the trade offs of each option and choosing what aligns best with your values circumstances and comfort level.
A Final Word
Due dates are estimates. Babies are individuals. Labor begins when a complex interplay of hormonal fetal and maternal factors align not because a calendar says it is time.
Our role as midwives is to provide evidence informed information clinical judgment and support so you can make decisions with confidence as your pregnancy unfolds.
https://evidencebasedbirth.com/evidence-on-inducing-labor-for-going-past-your-due-date/
https://www.ncbi.nlm.nih.gov/books/NBK542240/
https://my.clevelandclinic.org/health/diseases/17952-preeclampsia
