Should I have my overdue baby induced?
Guess how many babies are born on their due date.
Half? Most? 30%?
In fact the figure is just 4%, according to data from the Perinatal Institute, a non-profit organisation.
How are due dates calculated?
Estimated dates of delivery, or 'due date' (EDD) are calculated using the date of the expectant mother’s last period and adding 280 days, or 40 weeks. That sounds pretty mathematical. Then she has an ultrasound scan where another estimate is made, depending on the size of the foetus. If there is a discrepancy of a week or more between the "due dates", the scan is considered the more accurate measure.
But EDDs are rarely accurate, and a more realistic approach would be to advise women that their baby is likely to arrive any time between 37 weeks (259 days) and 42 weeks (294 days).
This is the period known as "term" when the baby has reached full maturity. And that, many mothers argue, is the point. Babies come when they are ready to be born.
That may be a week, two weeks or even three weeks after a woman’s EDD.
The pressures for induction
After 42 weeks, some feel under intense pressure to have their baby induced – pressure from anxious relatives, excited friends or a health service working to “average” guidelines.
Expectant mums may be warned that if they wait, the placenta may fail or the baby grow too big for a vaginal birth. Though as Dr Rachel Reed highlights in a blog on her website titled 'Post-Dates induction of Labour: Balancing Risks', these are myths that contradict each another: how can the baby get so big if the placenta is failing?
For labour to start, the pregnant woman needs to feel safe and as relaxed as possible, so added pressure and stress can increase the delay.
The Cochrane review on induction states: “Women should be appropriately counselled in order to make an informed choice between scheduled induction for a post-term pregnancy or monitoring without induction (or delayed induction).”
Be informed about your options
Of course, sometimes induction is absolutely right: if there are signs of a problem, if a medical condition makes it safer to give birth sooner, or if your instincts just tell you it’s right. Induction can save lives and plenty of women have positive stories to tell about their induction experiences.
Women have to give their consent for induction to take place. And it makes perfect sense to read around the subject so you're informed about your options, to think through what is right for you, and to have the confidence to question hospital policy.
Guidelines, after all, are based on an average, but we are all unique individuals.
My advice is to do what you feel most comfortable with, but have the tools ready to argue against induction if you so wish. It’s your birth.
Your final hours of life-as-you-know-it!
I’ll close with wise words from American midwife Jana Studelska:
“The last days of pregnancy — sometimes stretching to agonizing weeks — are a distinct place, time, event, stage. It is a time of in between. Neither here nor there. Your old self and your new self, balanced on the edge of a pregnancy. One foot in your old world, one foot in a new world.”
It is, she reminds us, the chance for parents-to-be to enjoy the last hours of this life-as-they-now-know-it.
Because once your baby is born, life won't ever be the same again…