What to Expect When Going Overdue

Anticipation is a lovely part of pregnancy, and it’s even better when put into proper context. Week by week pregnancy updates. Preparing for baby’s arrival. Picturing their birth month. Counting down. Measuring, planning, tracking growth. The estimated due date is a helpful way to track progress, as long as we remember that forty weeks is an average duration of pregnancy. In other words, many babies are born before forty weeks, and many are born after. Today, we’re going to cover what you need to know about going over your due date.

What to Expect When Post Dates

A pregnancy “due” date can be calculated in multiple ways – from your LMP (last menstrual period), an early ultrasound, fundal height measurements, or from the conception date. Each method varies in how feasible it is or how reliable it is. Your care provider will use as much information as possible to determine your due date. This is why we refer to it as an estimated due date.

Still, dates give us a good idea of how to monitor your development and the baby’s progress. Early babies might have lung or low-weight issues, for example, and it’s important to be prepared for that when labor begins. 

Truly being overdue, or post-dates, begins at 42 weeks gestation. Sometime after 40 weeks but certainly after 42 weeks, you can expect some added monitoring in order to make sure the baby is still healthy.

• Non-Stress Test (NST)  – This is an easy test to do and in my practice once a mother reaches 41 weeks we perform an NST twice a week. An NST is performed by listening to the babies heart rate until they see good variability and fetal movements.  If you are birthing with midwives, they will probably listen with a doppler and count the heart rate and then plot the results on to a piece of graph paper.  If you are seeing an OB, they will listen for about 30 minutes with the same type of monitor that you will be using in labor.  They place the two belts around your belly and measure the heart rate and baby’s movements.  Essentially, an NST shows how the baby’s heart responds to movement and stimulation in a non stressful situation, making sure she is coping well, has enough oxygen, and can handle the stress of labor.

• Bishop’s Score – This is the cumulative tally of markers that would indicate the likelihood that labor is coming soon. It calculates cervical dilation, position, effacement or length, and the baby’s position in the pelvis.  This score helps your care provider to know whether you are progressing toward spontaneous labor and, if induction is chosen, how it might go.  For example, if a woman is 2-4 cm dilated, the cervix is soft and the baby's head is deep in the pelvis, she is likely to give birth soon, or if she gets induced it will probably go smoothly and lead to a vaginal birth.  Verses, if the mom is not dilated, her cervix is hard and the head is still high, then she is probably not going into labor right away and if she gets induced she, may or may not, push her baby out vaginally.  

• Fetal kick counts – You can monitor your baby’s movements on your own. When you go overdue, monitoring fetal kick counts can give you a window into your baby’s health. Simply lay down – on your left side, with a pillow between your legs is a good way to do so – and count the movements you feel baby make. If you’d like, drinking juice or a sweet, cold drink before this might help baby wake up and become active. Time how long it takes to get to 10 movements. When you do this every day, once a day (around the same time), you can catch a drop in movement or a sluggish baby that takes a couple of hours or more to get those movements in. If you notice anything abnormal, let your care provider know right away. Otherwise, enjoy this special time feeling your little one in the way only you can.

• Biophysical Profile (BPP) – A biophysical profile test includes a non-stress test accompanied with an ultrasound.  This way you can check the amount of amniotic fluid, the size of the baby, the placement of the placenta, as well as, the fetal heart tones and movement giving you and your care provider a good assessment of fetal well being.  BPP can help determine if you can be patient and wait for labor to come on it's own or if it is best to induce.

Take each test and step as they come.  Sometimes, depending how far over your due date you go and your care provider's protocols, you may have to repeat some of these test every week. As you and your care provider learn about your baby’s wellbeing and your own wellness, you can make informed decisions about waiting or encouraging the onset of labor.

How to Cope When Past Your Due Date

They say that toward the end of pregnancy, weeks aren’t comprised of seven days but of dozens – hundreds, even! It’s silly, but also conveys the feeling of the days dragging on as you wait and wait for your baby to come. If you were ready for a due date to be a birthdate, even a day or two longer can feel miserable.

The most important thing you can do to cope with the end of a post-dates pregnancy is to take care of yourself. No guilt, no stress, just preparation. Nesting may keep you busy, but it’s more likely that you’ve gotten all of that out of the way by then. Go for rest and self-care activities that will distract you from counting the minutes and wondering if every contraction is “it.”

Listen to your body, your heart word, and know what you need. If you want to be surrounded by doting friends and family, then settle in! If you need space and to not be bothered with constant check-ins, turn your phone off and kick back to a Netflix binge.

• Enjoy things that will take a backseat after baby is born. The movies, nights out with friends, pedicures, a massage (bonus! The pressure points might spark labor).
• Ignore the Facebook posts and phone calls from all the people who act like you had the baby and did't tell them.
• Read books, take naps, start a project.
• Make more freezer meals to prepare for postpartum weeks.
• Make something for the baby.
• Spend time outdoors. Swim, walk, explore.
• Direct your supportive friends and family on ways they can plan to take care of you after birth.
• Don’t hold back from starting something just because the baby might come! It’s better to be interrupted by labor than to wish your days away.
• Hold a blessingway.

Exercises like squats and walking can help to move baby down toward the cervix, which is what will help to trigger contractions that lead to the birth. Red raspberry leaf tea – included in Lady in Waiting – is a uterine tonic that can help prepare the uterus for the work of labor and might help to encourage the onset of labor.

As a midwife, I shy away from induction methods unless the baby or mother’s health calls for it. I’ve written about natural labor induction methods here. Some of them are simple labor-preparation tasks that you can start toward the end of pregnancy. Others should be discussed with your care provider and herbalist.

Whether or not your pregnancy requires an induction, your baby will come. Take one day, one step at a time, and know that this will not last forever. You’ll be holding your sweet baby soon – take care of yourself until then!