Your pregnant. Your EDC is coming up soon. Everywhere you go, people are asking you when you are due, or telling you that you look like you're about ready to pop. The doctor is talking about inducing labor. Is it a good idea to let him?
The first thing to remember is that an EDC is an ESTIMATE of the due date, not an expiration date.
Years ago, people didn't know what actually caused women to go into labor. It was a great mystery. Though there is still much uncertainty about how everything works together, scientists have now discovered that the baby actually sends out a hormonal signal to the mother's body to let her body know when it was time for labor to begin.
Unless there is a clear medical indication for getting the baby out in a hurry and induce, the most prudent course of action is to sit back and wait. Let it happen when it happens. As a general rule, women do not stay pregnant forever!
Is your EDC even accurate? Most experts say no. The EDC is a guestimate at best. Most people seem to believe that it is an exact science, but determining the due date is a notoriously inexact process, even by the experts.
Most obstetricians use Naegele's rule for calculating the due date, which is based on the date of the last menstrual period. The EDC is calculated from the first date of the last period by adding one year, subtracting three months, and adding one week.
There are several factors that this formula does not take into account. First of all, it is based on a 28-day cycle, from day one of a period to day one of the next. Conception generally happens at the time of ovulation, which is about two weeks before the next period would be. Many women have differing lengths in their cycles. If a mother has five or six week cycles, their EDC will necessarily be later than expected.
Women gestate for different lengths of time within a general time frame. It's a lot like how babies get their first tooth, or babies weigh differing amounts, or babies gain weight at different rates. We are all similar, yet different. We don't do things at the same pace. One baby may be ready to be born and weigh 8 lbs. at 39 weeks. Another may not be ready until 42 weeks and still weigh 8 lbs. There is great variation within normal parameters.
Tall brunette white women typically gestate longer than other women. The AVERAGE for a first time mother who is uninterfered-with is 41 weeks, not 40 weeks.
Sometimes women are absolutely positive of the date of conception, only to find that their doctor tells them differently. If an EDC is based on a conception date of September 18, but the only partner the mother had left town on September 10 for a business trip, then the doctor's EDC is simply wrong, by more than a week. This happens more commonly than one would expect. There tends to be an assumption that the mother is either mistaken or lying.
Early ultrasounds to verify EDC tend to be more accurate than later ultrasounds for estimating dates. However, ultrasounds have never been proven safe. In fact, a U.K. study published in the Lancet found that babies who were exposed to two or more ultrasounds to check on the placenta were more than twice as likely to experience perinatal death than those babies with no ultrasound exposure. There is no evidence that, in most cases, the benefits outweigh the potential risks, so why chance it?
But what if you are fairly certain of your EDC and that date has come and gone?
First of all, you aren't actually "overdue." You are just past the EDC, and there is a difference. Even according to ACOG definitions (the trade union of obstetricians and gynecology), "a postterm pregnancy is one that lasts 42 weeks or longer." That is 42 completed weeks before a pregnancy is considered to be overdue.
Next, unless there is a valid medical indication that labor needs to be induced, such as eclampsia, the risks of induction of labor, even after the EDC, outweigh the benefits. Convenience of the family or the doctor's vacation are examples of reasons for induction where the benefits do not outweigh the risks.
Health News lists the "top 5 reasons to avoid labor induction," whether or not a mother is past her EDC. The reasons include the following:
Induction of labor is more dangerous for both mother and baby, whether or not the EDC has come and gone. Inductions for invalid reasons and flat-out made-up reasons occur on a daily basis, according to The Unnecesarean, increasing those risks. The Inquisitr recently reported that the maternal and neonatal mortality rates are on the increase in the U.S., while they are decreasing in most of the rest of the world. One of the reasons for that is unnecessary inductions, leading to unnecessary cesareans, leading to further complications, and sometimes death.
- Induction with Cytotec (Misoprostol) increases your risk of uterine rupture
- Induction with synthetic Oxytocin creates a more difficult, painful labor experience (pitocin)
- Labor induction increases your likelihood of cesarean birth
- Labor induction can lead to delivery of a pre-term baby
- Labor induction robs the baby's chance of signaling when she's fully developed and ready for birth
Inducing labor at even a week or more past the EDC can cause more harm than good, according to a study in the BJOG:
"The 'evidence' on which current practice and popularity of routine or as we prefer to think of it, ritual induction at 41 weeks, is based is seriously flawed and an abuse of biological norms. Such interference has the potential to do more harm than good, and its resource implications are staggering. It is time for this nonsensus consensus to be withdrawn."Midwifery and childbirth educator Gloria Lemay shares this vivid analogy:
"Attending births is like growing roses. You have to marvel at the ones that just open up and bloom at the first kiss of the sun, but you wouldn't dream of pulling open the petals of the tightly closed buds, and forcing them to blossom to your time line."
Gail Hart has been attending birthing mothers for decades as a midwife. She says, "There is a sort of chemical 'combination lock' that starts labor. Everything has to be lined up just right to 'unlock' a good labor pattern. When we interfere with that, it can be as frustrating as using the wrong combination of numbers to open a locked safe."
It is time to rethink the concept of inducing labor when a mother goes a day or two, or even a week or two, past her EDC. Maybe she, or her baby, simply isn't ready. "Baby doesn't need to be served an eviction notice," according to Carla Hartley. It will happen. Give it time.
[images via bing]