What does it mean when your baby is overdue?

For most women, the 9 months of pregnancy are already long enough to wait for their little ones to arrive. But there is such a thing as an overdue birth. This means your baby stays inside the womb for longer than the normal 37 weeks it takes for gestation. It can be quite a frustrating time for an expecting mother to wait around for labour to kick in, especially if it is well after the given due date. If you pass the 42-week mark of pregnancy and there are still no signs of labour, then your baby is medically termed as overdue. There are some causes for concern if this happens. However, there are ways to deal with an overdue pregnancy.

Let’s begin with understanding why babies go overdue. There are many factors that make a late delivery happen, but an underlying cause is yet to be discovered! Before we get into the possible factors, let’s talk about due dates. When your due date is calculated, it is always based on the last menstrual cycle you had. Because it is still never certain when exactly you conceived, the due date generally tends to be inaccurate for most women. A due date is simply a reference for a window of time that you could expect to deliver. Women are known to deliver anytime 5 weeks before or after the due date. So, a couple of weeks late is totally normal and expected for some deliveries!

1. Breech position: If your baby has its head up and bottom or feet down, this is a probable cause for a late pregnancy. This position is not ideal for childbirth because there could be problems with your child’s shoulder getting stuck or dislocated while pushing.
2. Prior history: If you have had an overdue birth before, chances are you might have an overdue birth again.
3. First-time pregnancy: If this is your first child, then it could be overdue baby.
4. Overweight mother: Sometimes, excess maternal weight can interfere with the hormonal changes that actually induce labour, causing a late delivery.
5. Disease: Liver and endocrine system diseases can cause late deliveries, so can sexually transmitted diseases.

If you’re afraid you might be overdue, here is a shortlist of the signs and symptoms that indicate a late birth. Remember that overdue pregnancy symptoms should always be communicated to your doctor or gynae.

• The skin over your belly that should be tight, firm and elastic, will go back to its normal texture if the baby is overdue.
• Your doctor might note a premature aging of the placenta that could be a sign of an overdue birth.
• If you start to notice breast milk production, this is a sign that the baby might be ready to come out.
• A drop in amniotic fluid that can result in minor weight loss for the mother is seen right at the time of delivery. If this happens, and you still haven’t had labour signs, then it is an overdue pregnancy symptom.

Passing the 42^nd week generally becomes a cause of concern for the baby inside and the mother. There are certain pregnancy problems associated with an overdue baby and there are varying risk factors. It’s important to be aware of these risks as an expecting mother in order to know exactly how to combat them.

Drop in amniotic fluid: After 42 weeks of pregnancy, amniotic fluid drops significantly and this causes issues with the placenta. The baby might suffer because the placenta is the only way it gets nutrients.

Distress for the unborn child: The foetus runs out of room inside the womb after a certain point and this can cause cardiac or respiratory issues for the baby.

Delayed or stunted growth: Because of the lack of room, the growth of the foetus can be stunted inside the womb.

Meconium passage: Meconium is the first stool that your baby will pass. If this happens in the womb, then there are chances of your baby inhaling the meconium causing it to have respiratory complications or infections.

Stillbirth: This is the most serious implication of an overdue pregnancy. Because of the lack of amniotic fluid at the time of birth, the placenta stops working effectively. The baby doesn’t get the oxygen and nutrients it requires and it could pass away in the womb, resulting in what is known as a stillbirth.

Neurological damage: Due to the prolonged time in the womb, the brain can become more susceptible to damage. Sometimes, an overdue pregnancy is linked with cerebral palsy in the child.

Complications such as lacerations, large vaginal tears, excessive bleeding during childbirth, trauma to perineal muscles, urinary problems, infections and other injuries can happen to mothers who go through a late delivery.

Now that you’re aware of the complications an overdue birth has, let’s talk about how it can be overcome. For most of us, the answer is simple: have a C- section birth. But, there are many ways to induce labour before considering a C-section.

Generally, even if the baby is a week late, then doctors don’t suggest inducing labour. But, if there are certain complications that are discovered, then labour induction might be considered way before a C-section is.

Your doctor will be monitoring your overdue pregnancy and doing frequent tests to check how your little one is doing inside. They will check up on factors like how big the baby has grown inside, how overdue the baby is, what the age of the mother giving birth is, what she weighs, whether the mother indulges in habits like smoking or drinking. After assessing all of this, if there is any sign that the baby is in danger, then different ways to induce labour are tried.

Ways to induce labour naturally:

None of these have been scientifically proven to work, but they are safe to try! Some of these are more commonly known than others.

• Having sex to stimulate the cervix to relax and open up.
• Going on long walks or doing mild exercise.
• Stimulating your nipples.
• Drinking raspberry leaf tea or consuming castor oil. (Always ask your doctor whether it’s safe to consume these.)
• Eating small amounts of spicy food.
• Acupuncture done safely after consulting your doctor.

Ways to induce labour medically:

• Membrane sweep: This is not a medical procedure, but it should only be done by a professional mid-wife or doctor. The mid-wife will insert her finger into your cervix and gently sweep it at the opening to induce labour. This is known to produce prostaglandins, a hormone that triggers labour.
• Gel application: The hormone prostaglandins can be applied as a gel to the wall of the cervix to induce labour.
• Balloon catheters: These are used to stretch open and stimulate the cervix to induce labour.
• IV drip: Drugs that contain the hormones oxytocin or prostaglandins can be infused into the bloodstream to induce labour in pregnant women. Syntocinon drips contain a chemical that is an artificial form of oxytocin that is gradually administered into the bloodstream through a needle in the arm to help your womb contract.
• Tablets or suppositories: Again, the same hormones can be given in tablet forms or inserted into the vagina to stimulate labour and soften up the cervix.

Labour induction can occur over 2 days. If you’re at the hospital, constant monitoring of the baby’s heartbeat will be done to check if all is well. Certain tablets and suppositories can be given to you at home if you don’t want to wait around at the hospital for your labour to start.

How does induction affect labour?

• You still have all the pain relief options that any mother with natural labour has.
• You might not be able to move around as much.
• There is a high possibility of having an assisted birth, which could mean your little one might need a little suctioning through forceps to come out.

Always remember that this is a viable option to take if it has been suggested by your doctor. Certain risks and side effects like bleeding through the vagina, nausea, vomiting, diarrhoea and water retention are seen when using oxytocin and prostaglandins do occur commonly.

However, if any method of induced labour doesn’t work, then you will either be prescribed another round of induction or you will have to undergo a C-section. This decision will be made after assessing your and your baby’s health and should be made by the doctor in charge of your delivery!

While it can be a mammoth task to endure long hours of waiting around, frustration, feeling uneasy and heavy because of an overdue pregnancy, remember to have faith in yourself! Modern technology and medicine will always be there to fall back on. Surviving an overdue pregnancy will be much easier when you and your doctor have an open communication going on about the status of your child and your health as well. Open yourself up to asking for help, medical or not and try to surround yourself with the people you love. Once the mental battle is won, then the physical battle can be taken care of!