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Overdue Pregnancy

Updated: Oct 26

A pregnancy that's going on beyond your due date.


This article is pending medical review.

Contributors

Written by Alizeh Ahsan

Reviewed by Julian Zeegers

Edited by Juliëtte Gossens

Visual overview of overdue pregnancy
Visual Overview: Overdue Pregnancy, by Selina Voßen

 

Are you confused why your baby hasn’t come yet? It's been days or even weeks since your due date passed but there’s no baby, still? Well, even though you might feel like you’ve had enough, we are here to tell you to try and enjoy these last few days of pregnancy but to also keep a close eye on yourself and familiarize yourself with your situation.


pregnant person in nursery
© Toa Heftiba

What we're covering


Risks and Reasons

Labor Induction

Self-management














 

The basics of an overdue pregnancy – risks and reasons


40 weeks of pregnancy are defined as a full course or full term pregnancy. Births before 37 weeks are referred to as preterm births and births after 42 weeks are post term births (1). Usually, about 5% of pregnant people surpass the 42 week mark, due to unknown reasons (1). However, it is suspected that risk factors for post term pregnancy are genetics (you may be more likely to be overdue if your previous births were also post term), you have obesity, or it could simply be that your due date hasn’t even arrived yet! Sometimes, healthcare professionals miscalculate the due date, so rest assured, there is only a very low chance that something is wrong.

It is important to know that when your pregnancy surpasses 42 weeks, there may be some additional risks for your baby. There are two types of risks, both for the baby and for delivery.


  • The first risk that can occur is called fetal macrosomia, which is when the baby is too big (2). This complication can cause a delayed delivery. However, it might also reduce the chances for a natural delivery as the baby can no longer fit through the birth canal (3).

  • The second risk is that of an infection in the womb. This may be treated with an antibiotics course. Symptoms for this include fever, sweating and rapid heart rate in the parent (4).

  • The third risk may scare you, though it only has a 0.4% chance of happening: the risk of stillbirth increases after the pregnancy surpasses 42 weeks (1). Labor is commonly induced before this can happen (2).

  • Lastly, you may be at risk of low amniotic fluid, which can cause complications in the delivery method. This means that the baby may experience issues and often the doctor may recommend a C section or alternative mode of delivery (5).

After reading about these complications it is completely normal to panic a little, but rest assured: they are very uncommon, and your baby's health is checked routinely. During your visit to your health care professional you may be subject to a cardiotocography test (CTG) and an ultrasound scan. These tests can help your doctor/midwife determine the state of the amniotic fluid volume, measure your and your baby's heart rate, exclude womb infection, and assess the body size of the baby. After these tests are done, your health care provider will come up with the best solution for you. In some cases, this may be to simply induce labor (1-2).


Inducing labor at the hospital? What to expect?


Firstly, the induction of labor is defined as stimulating contractions of the uterus (womb), which allow for higher chances of a natural vaginal delivery. The first thing you might be prescribed is meant for the softening and ripening of the cervix (1). In an ideal scenario, your own hormones would make your cervix more relaxed (6). The main hormones that play a role here are called prostaglandins. To stimulate labor, you may be prescribed a gel containing prostaglandins (1, 6). Otherwise, a catheter containing a ‘balloon’ may be inserted into your cervix. This balloon is filled with saline and its position in the cervix helps dilate it. In some cases, the ripening of the cervix is sufficient to induce labor. However, if this is not enough there are other medical procedures that can help (1, 6).


A second procedure may be the bursting of your amniotic sac (3). You may know this as ‘the water breaking’. When the amniotic sac is not intact anymore, the baby is no longer held afloat by it, and labor is very likely to begin shortly after. A hook may be inserted in you which can help create a hole in your sac. The amniotic sac can no longer be closed, hence providing a higher chance that labor begins.


Lastly, your health care provider may prescribe medications to you; they help stimulate contractions. One such medication is Pitocin, which contains a synthetic version of oxytocin. Oxytocin is a hormone that causes contractions of the uterus during labor (3).


Can you induce labor yourself?


Historically, many different ways have been tried by pregnant people and their midwives before modern medicine was developed. Even today, some of these methods are commonly used in many cultures. Firstly, sexual arousal may be a potentially effective method, due to the theory that arousal causes the cervix to naturally dilate. Other methods include consumption of castor oil, which is a laxative, to simulate labor, going on walks, and eating spicy or sour foods. Lastly, raspberry leaf tea is a traditional approach which is thought to help stimulate labor. These methods are common around the world, and occur in many different cultures (1, 7).


It is, however, our responsibility to tell you that there is no strong scientific evidence supporting these remedies. They are traditional methods, widely used by people in the past, but have weak evidence nowadays. Therefore, it is always best to consult your healthcare provider to discuss the best approach for you.


All in all, if all else fails, then you may be recommended a C-section approach. Nevertheless, the chances of this are relatively low, as the medical procedures described are usually enough to stimulate a vaginal birth.

In the end, all that matters is that after these last, long few days you will have your baby with you, so take care of yourself, discuss all your thoughts and emotions with your healthcare provider. Try to enjoy these final special but difficult days of pregnancy!

 

References


  1. InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006.

  2. Postterm pregnancy [Internet]. Uptodate.com. 2022. Available from: https://www.uptodate.com/contents/postterm-pregnancy-beyond-the-basics

  3. Overdue pregnancy: What you need to know [Internet]. Mayo Clinic.

  4. Chorioamnionitis: Causes, Symptoms, Diagnosis & Treatment [Internet]. Cleveland Clinic. 2022 [cited 11 March 2022]. Available from: https://my.clevelandclinic.org/health/diseases/12309-chorioamnionitis

  5. What Does Low Amniotic Fluid Really Mean [Internet]. intermountainhealthcare.org. 2022. Available from: https://intermountainhealthcare.org/blogs/topics/intermountain-moms/2018/05/what-does-having-low-amniotic-fluid-really-mean/#:~:text=Later%2Dstage%20pregnancies%20that%20experience,the%20delivery%20of%20your%20baby.

  6. Labor induction - Mayo Clinic [Internet]. Mayoclinic.org. 2022.

  7. Zamawe C, King C, Jennings H, Mandiwa C, Fottrell E. Effectiveness and safety of herbal medicines for induction of labour: a systematic review and meta-analysis. BMJ Open. 2018;8(10):e022499.


Please note: the information we provide to you here is for educational purposes only. If you’re experiencing any discomfort or have any complaints or questions about your health, please contact your doctor or other relevant health professional. We don’t provide medical advice.