The Dreaded "Due Date"

When we get pregnant, one of the first things midwife, our OB or we figure out is our due date. When in the next 9-ish months is my baby going to be born? The main thing I hate....or dislike.....about the due date is that once its passed we freak out!! We've been told that there is a higher chance of stillbirth once you've passed the magical Due Date and that drugs need to be used for induction. Well.... that is not exactly true.

From Midwifery today- (a journal written by midwives about the science and evidence behind out of hospital birth) "Postdates, by itself, is not associated with poor pregnancy outcome. Extreme postdates (passed 43 weeks) or postdates in conjunction with poor fetal growth or developmental abnormalities does show an increased risk of stillbirth. But if growth restriction and birth defects are removed, there is no statistical increase in risk until a pregnancy reaches 42 weeks and no significant risk until past 43 weeks. The primary "evidence" of a sharp rise in stillbirth after 40 weeks seems to come from one study based on data collected in 1958.(1)

Modern statistics show an almost flat rate of stillbirth from 40 weeks to 42, with a slight rise at 43 weeks (all numbers being close to 1/1000).(2)" 

Now its up to you to decide if this is true; to decide whether or not to read the data from the studies-both recent and outdated. I decided to read them. It's true. Being passed your due date, "late", or postdates is not dangerous--when other factors like the baby's growth and placenta function are good, and from my (semi-limited) experience most of the time babies do just fine between 40 and 42 weeks. We use ultrasound to determine if the pregnancy is still healthy and well to decide to carry on without drugs or surgery to deliver the baby. 

The laws that govern what midwives can/can’t do are currently changing, for better and worse. In relation to this topic, licensed midwives like me are only supposed to deliver babies between 37-42 weeks. Just a bit of info...

What I’m really trying to say here is once your due date comes and goes, try not to panic (even if your OB is).  As long as your baby is growing and there are no other complications, continuing to be pregnant is actually the best thing for your baby. Hopefully knowing this will help us be patient as our babies decide when they are ready to be born, instead of deciding for them.

Reference this Midwifery Today article at:  http://www.midwiferytoday.com/articles/timely.asp

justine

A Midwife Huh?

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We all get the question: "What do you do?" For me the answer is easy, I'm a midwife. But the reactions I get are not always so straightforward. Maybe this will clarify a bit...

For some reason, I've known what a midwife is years before I decided I needed to be one. My mom didn't use one, no one close to me in my family did. I am not sure where I first heard about midwifery but when I did, it immediately drew me in. I knew I needed to be a part of everything pregnancy, birth and babies. Pregnancy fascinated me and somewhere in me I felt a draw to the natural beauty of birth. 

A midwife is a woman that has been trained to help and guide women through pregnancy, birth and the postpartum period. We are devoted to helping healthy, low-risk women have their idea of an optimal birth. I am trained to screen women, through their prenatal care, for anything that would make it unsafe to birth anywhere but the hospital. Midwives know what to do in all situations that arise during birth--whether we treat it ourselves or transfer to the hospital to get medical help their depends on the situation and our training.  

Midwives have been used for thousands of years. Before birth became a medical event occurring in hospitals, everyone had home births with midwives! Babies have always been born and women--grandmothers, aunts, sisters, mothers-- have always been helping each other through the life-changing process of pregnancy and delivery. Midwives strive to preserve the traditional relationship of providing personal, warm, almost family-like care when helping pregnant women experience their births. 

To me, every woman needs the support of another to connect with, relate and open up to about everything their body goes through in the 40 weeks leading up to the birth of their baby. I am so pleased to be that woman for those who choose the path of unmedicated, out of hospital birth. I love being the one woman those around me ask questions to throughout their pregnancy. Mostly, I am able to reassure them that what they are going through is completely normal, and if it is outside of normal I am able to help resolve their problem or give them the resources to do so. I have seen the effects of women-centered care. I have seen that when a pregnancy is treated as a normal, healthy part of a woman's life and that woman is thoroughly and personally cared for she is much less likely to suffer through birth injuries, trauma or surgical birth. 

Luckily, I think the medical system is starting to realize just how safe, economical and practical out of hospital birth really is. In England, for example, women are encouraged to have their babies at home if they don't have any medical risk factors (diabetes, high blood pressure, etc). I can only dream about the day when OBs in California are telling their clients that "actually you don't need to birth in the hospital. Go have your baby with a midwife at home." That will be the day. Until then, I hope that blogs like this will help women to learn a little bit about what  midwife is and why we do what we do.

I will continue to blog as much as my life allows!

justine