Please note: This post is about healthy, uncomplicated pregnancies. While there is some evidence that post-dates pregnancy – and that means past 42 weeks – can involve complications, those complications have clear signs that are in and of themselves indication for induction, regardless of gestational age.
One of the most frequent comments I hear from women about their pregnancies is some version of “My baby was X days overdue so my doctor induced” or even “I just don’t go into labor.” A first-time mom was talking to me yesterday about her low(ish) birthweight baby, and I asked if the baby had been early. She said, “No, she was actually two days past the date they gave me,” as if that were some anomaly. And while lot of women do know intellectually that 38-42 weeks is a normal gestation, somehow anything past 40 weeks is still “overdue,” with all its attendant emotional distress, because it’s past their “due date.”
I have many issues with the concept of the “due date.” Since anywhere from 38-42 weeks is average, and anywhere from 37-44 (or more!) weeks can be normal and healthy, at the very least we should call it a “due month.” When you’re due in “late September or early October,” there’s no magic “due” date to make you feel like you’ve missed a deadline (more about that in a minute). And all of this assumes that your provider is counting from your exact date of conception, which simply is not the case unless you chart your cycle using basal body temperature. The typical margin of error for ultrasound dating is 8% (measured in days), so even a “highly accurate” 8-week ultrasound has a margin of error of five days, and the inaccuracy just increases from there.
Furthermore, the average length of an uncomplicated first pregnancy is over 41 weeks. But typical care providers don’t add a week to a first-time mother’s due date; they just let her, or even encourage her, to think that she is broken if she goes past that magic date.
While I would love to see the “due month” become the standard way of talking about when a baby will be born, I know change like that takes time. So what can mothers and those who love them do in the meantime?
Well, the current paradigm of the due date is that it is a deadline, and if you go overdue, you’ve failed. All we really need, culturally speaking, is a tiny shift in how we think about that date, and we don’t even have to take it out of the lexicon of the workplace: Some women can get all their work done in a 38-hour week, a large number do so in a 40- or 41-hour week, and others take 42, 44, or even 46 hours. Some women work the same number of hours each week; others have a variable workload and are all over the map. Women who are experienced at their job can usually get it done in a little less time than at first.
Going past your guess date is like working some extra hours to get the job done right. There is no more “failure” involved in gestating a 42-week pregnancy than there is in working a 42-hour week. You’re not broken, you’re working hard and finishing your project completely. Your baby IS going to be born, you WILL go into labor, and everything before that is like staying late on Friday to complete a project before the weekend: you may not particularly enjoy it, but it’s rewarding and it’s important. The baby’s healthy arrival is your goal, not a particular date on the calendar.
So if you go into labor at 39 weeks, you get to leave work a little earlier than expected. (Of course, moms know the work is just beginning!) If this is your first baby and you go into labor at 41 weeks, you’ve worked a normal first-time pregnancy. And if you go into labor at 42 or 43 weeks, you’re working overtime and you deserve some extra support (which includes reasonable monitoring of your health and the baby’s), not harassment or fear-mongering.
Here’s to the day baby registries only ask for a due month, and women feel confident and proud of growing their babies to natural term.