Managing an Overdue Pregnancy: What You Need to Know

Highlights

• Pregnancy is considered overdue once you reach 42 weeks.
• The risk of stillbirth increases the longer pregnancy goes overdue.
• Induction of labour is recommended after 41 weeks, but it is your choice.
• Membrane sweeping may sometimes trigger labour to start naturally.
• After 41 weeks, you will be offered frequent monitoring, including ultrasound and cardiotocograph (CTG) of your baby’s heartbeat.

In This Article

• Defining Overdue Pregnancy
• Causes of an Overdue Pregnancy
• Potential Complications of Being Overdue
• Management of an Overdue Pregnancy
• Tests Required for Overdue Pregnancies
• When to Contact Your Doctor or Midwife
• Preventing an Overdue Pregnancy
• Tools And Assistance

Defining Overdue Pregnancy

Pregnancy usually lasts about 40 weeks, starting from the first day of your last period. You reach full term at 37 weeks. If your labour does not begin by the time you reach 42 weeks, you are considered overdue. This condition is also known as ‘postdates’ or prolonged pregnancy.

To estimate your due date, you can use a due date calculator. However, every pregnancy is different, and there is a range of what is considered normal.

Causes of an Overdue Pregnancy

The exact cause of why some pregnancies go overdue is not clear. However, there are factors that may increase the likelihood of pregnancy going overdue, such as:

• Being overweight or living with obesity
• Having never given birth before
• Being over the age of 30
• Carrying a male baby
• Having gone overdue in a previous pregnancy
• A family history of overdue pregnancies

Potential Complications of Being Overdue

If your pregnancy goes overdue, there are certain risks involved, especially for your baby and you. Some of the complications associated with overdue pregnancies include:

• The placenta may not function well enough to provide sufficient oxygen and nutrients to your baby.
• The risk of stillbirth or neonatal death increases as the pregnancy goes past 42 weeks. However, the risk is still low, with only 2 to 3 out of every 1000 overdue babies dying before or shortly after birth.
• Your baby is at higher risk of not receiving enough oxygen or blood flow.
• There is an increased risk of meconium aspiration, which can lead to breathing problems.
• Your baby may have a large birth weight, which can cause complications during delivery.
• Other potential risks include seizures, birth injuries, and infections.

As a mother, you may also be at higher risk of:

• Experiencing a long or difficult labour
• Developing postpartum haemorrhage
• Suffering a 3rd or 4th degree perineal tear
• Developing an infection in your uterus

Management of an Overdue Pregnancy

If you are overdue, your midwife or doctor may suggest a ‘membrane sweep’ around 40 weeks. This procedure involves a vaginal examination where your midwife or doctor sweeps their finger around the inside of your cervix. This is intended to stimulate the cervix to produce hormones that may trigger natural labour. The decision to undergo this procedure is yours, and you can discuss it with your healthcare provider.

If your labour does not begin naturally after a membrane sweep, your doctor or midwife will recommend scheduling an induction. Induction involves using medications or other methods to start your labour. For low-risk pregnancies, induction is usually scheduled within the first few days after 41 weeks.

Induction is planned ahead of time, and you will have the opportunity to discuss the benefits and risks with your healthcare provider. Ultimately, the decision to proceed with induction is up to you.

If your pregnancy reaches 42 weeks, you will be advised to deliver in a hospital setting rather than at a birthing centre or at home.

Tests Required for Overdue Pregnancies

To ensure both your health and your baby’s health, your midwife or doctor will perform regular checks. These may include an ultrasound scan and monitoring your baby’s heartbeat with a cardiotocograph (CTG). These tests are usually done twice a week starting at 41 weeks.

If the tests show that your baby’s health is at risk, your healthcare provider will recommend induction. However, if your baby appears healthy and your health is stable, you may choose to wait for labour to begin naturally.

If your pregnancy exceeds 42 weeks and you opt not to have induction, your healthcare provider will likely recommend more frequent monitoring.

It’s important to note that these tests reflect your baby’s condition at the time they are conducted. They cannot predict future changes in your baby’s health.

When to Contact Your Doctor or Midwife

If your pregnancy is overdue, it is crucial to pay close attention to your baby’s movements. If you notice any changes, such as a sudden increase, decrease, or absence of movement, contact your doctor or midwife immediately.

Preventing an Overdue Pregnancy

One possible option to help start labour is having a membrane sweep (also known as a stretch and sweep).

There is no scientific evidence that methods such as acupuncture, homeopathy, hot baths, herbal treatments, or sexual intercourse can induce labour if your pregnancy is overdue.

Tools And Assistance

If you need further support or information, your midwife or doctor is the best source of advice. They can offer a personalized plan and walk you through the risks and benefits of each option available. You can also ask questions regarding your health and the condition of your baby during these critical weeks.

Tools and Assistance

1. Due Date Calculator
   Estimates your due date, but remember every pregnancy is different.
2. Cardiotocograph (CTG)
   Monitors your baby’s heartbeat, especially after 41 weeks, to check for any issues.
3. Ultrasound Scan
   Used to check your baby’s growth and health, especially if overdue.
4. Membrane Sweep
   A procedure to help start labour by gently separating the membranes from the uterus.
5. Induction Methods
   Includes medications or methods like artificial rupture of membranes (ARM) to start labour if overdue.
6. Frequent Monitoring
   Additional scans and CTG tests are recommended as you approach 42 weeks.
7. Healthcare Provider Support
   Your doctor or midwife will guide you through your options, answer questions, and monitor both your health and your baby’s.