What to do when you are over 40-weeks pregnant

Nine months is a long wait to meet your unborn baby. As the days get closer and closer to delivery, you become excited and anxious at the same time. But the anxiety can weigh in more on you when you reach 40 weeks of pregnancy and there’s still no sign of baby arriving any time soon.

The last few weeks of pregnancy are difficult. It’s almost impossible to sleep, you need to pee every five minutes, you’re uncomfortable and irritable and everybody says you look as though you’re ready to “pop”.

Going beyond your due date is like missing your flight, the next, and the next.

Not sure why

Fact: some babies are overdue and come later than the expected date of delivery. Experts admit that they are not really sure why some babies come late, but it may be because birth dates are miscalculated. The due date is based on a woman’s last period, but the actual date of conception happens some time between periods.

Added to this, baby boys are conceived at the time of ovulation, but little girls can be conceived as many as five days after having sex. Confusing right? These are just the wonders of nature.

Also Read: Here are 10 quick fixes for those pregnancy aches and pains

What causes labour to take longer?

There are many reasons why labour may be delayed. Usually a first child may arrive a few days to two weeks late. This is because the mom’s muscles and ligaments are still firm and tight, which means labour takes longer to get started.  The cervix, where the baby emerges into the vagina, needs to be soft and ready to open.

Hormones (mainly oxytocin, progesterone and prostaglandin) kickstart this process. But, it’s also important that pressure from the baby’s head pushing against the cervix stimulates dilation. Babies in the breech position (bottom first) or lying across fail to do this.

Other problems that may delay the start of labour are placenta praevia, a short cord or insufficient amniotic fluid.  

What are the dangers?

“Late” babies can encounter some problems after 42 weeks. The placenta starts to “age” after 38 weeks, which means its efficiency in transferring vital nutrients and oxygen to the baby and taking waste and carbon dioxide away, is weakened.

This can also make labour and birth more stressful for the baby. For mom, baby is getting bigger, the skull is becoming harder, and labour could be longer, the birth more painful and interventions unavoidable. Your doctor will take precautions to prevent these.

Also Read: Here are 10 quick fixes for those pregnancy aches and pains

What to do when you are overdue

It is best to find out what is causing the delay by going to your gynae, who will check what is happening to your cervix. If the cervix is flat, soft, ripe and ready to open, labour is likely to start soon. The best way to do this is with an internal examination. If the cervix is long, firm, hard, tight and feels like a “nose”, it means labour is a long way away.

There are things you can do to help yourself.

You can stimulate labour by having sex. Not only does it lubricate the vagina and stimulate the cervix, it also helps prepare the perineum -the area between the vagina and the anus.

Women may be impatient and opt for traditional herbal medications to induce labour but this is not recommended.

After 40 weeks, your gynae may suggest keeping a kick-chart. This involves making a note of when and how often your baby moves, and making sure this happens at least 10 times during this period.If your baby has not moved after two hours, call your healthcare provider. He or she may suggest monitoring your baby for a while to make sure there are no problems and your baby isn’t stressed.

Women younger than 25 and those older than 35 will be monitored more carefully as they are more likely to have problems. After 42 weeks, an induction or C-section becomes unavoidable.

Also Read: WATCH: This woman was in labour for five days

Induction

According to the book, What to Expect When You’re Expecting, about 20% of expecting moms end up needing an induction, which is said to be more painful. Contractions are monitored and an epidural usually helps the mother cope with pain.

Stimulating labour artificially is invasive.

Usually, using oxytocin or Pitocin, the cervix may be softened and stimulated, or your healthcare provider may use a combination of both these methods. The cervix is softened with a pessary, usually prostaglandin, inserted into the vagina.

Another method is to use a small balloon catheter, called a hygroscopic dilator, that’s inserted into the cervix and gently inflated. This usually falls out on its own when the cervix is about 3cm dilated.If natural labour is imminent, inductions are usually successful, but if not, a C-section will be done within a specific time frame.

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