What to do if you go past your due date

You’ve spent the past 40 weeks waiting to meet your new baby. Then your due date comes and goes and… no baby yet.

A day passes and then a maybe even a week goes by and still no bundle of joy. It’s hard when you have a date in mind for delivery and it goes by – especially when you’re feeling big and uncomfortable.

You may be tempted to ask your doctor to induce labor – or even to perform a cesarean section. But be patient. Unless there are medical complications, your body will let you know when it’s the right time to go into labor.

When is my due date?

I dislike the term “due date.” The only pregnancy in which we know the date of conception 100 percent is when pregnancy is achieved through in vitro fertilization (IVF), when we combine the egg and sperm in a lab.

For all other pregnancies, determining how far along you are is a little hazier. There’s no true due date calculator. Not every woman ovulates on day 14 of her menstrual cycle, and not every woman conceives on that date. Even if you know you had sex on a certain day, the egg and sperm can sit in the body for up to a week before connecting.

Early ultrasounds at six to eight weeks can give us a good idea of the conception date, but that date can still be off by five days each way. So don’t be married to your due date.

I loved the answer Prince William and Kate Middleton gave when asked about their due date; they were vague and said the baby would come in "mid- to late April 2015." Accepting a due date range instead of a single day is the perspective I encourage all my patients to have.

How long is too long to be pregnant?

There’s no clear answer to how long a pregnancy can safely go. Some Ob/Gyns are comfortable letting a woman go one week past her due date, and others may let her go two weeks past her due date.

We’ll probably never know for sure exactly how long is too long. We may have some better information in the future. There is a national study going on in first-time moms to look at outcomes in pregnancies that last 39 to 40 weeks versus those allowed to continue to 41 weeks. Certain complications do increase in pregnancies beyond 41 to 42 weeks —but we are not exactly sure what exactly causes this. So we look for a balance between letting your body go into labor naturally and making sure mother and baby stay healthy.

It’s sometimes difficult to convince a healthy mom that it’s OK to go past her estimated due date. But there is a lot of soft data about the benefits to your baby going to term:

• They are neurologically mature after 39-40 weeks and not before.
• They sleep better.
• They nurse better.
• They do better in school later in life.

Also, labor tends to be shorter if the body gets to decide when it’s ready. So let nature take its course.

Inducing labor or having a C-section is not always the answer

Without a doubt, there are medical reasons for inducing labor or doing a cesarean section. We want the best outcome for mom and baby, and sometimes that means intervening to get a baby delivered.

But for moms and babies who are healthy, I feel letting the body do its own thing is best for everyone.

If you aren’t scheduled for induction or C-section and have had an uncomplicated pregnancy, we’ll tell you to stay home, time your contractions, and come in when they are five minutes apart for an hour. During this time at home, you can move around however is comfortable, you can eat, or you could take a shower if you want. You have a lot of freedom.

However, if you have an induced labor, your care will be subject to hospital protocols. This can include having to lie flat on a bed attached to a fetal monitor and not being allowed to eat or drink anything other than clear liquids.

And sometimes, no matter what we do to try to induce labor, you may end up needing a C-section because your body just wasn’t ready to deliver. The risk of C-section is definitely higher with induction of labor compared to spontaneous labor.

As for C-sections, they are major surgery, with increased blood loss and risk of infection. Unfortunately, they are so common now that most people don’t think of them that way.

Planning for labor past your due date

We are such a “now” society. We expect to get what we want and get it quickly. But children are not convenient or necessarily accommodating. No one says your child has to walk at exactly 12 months old, so why do we try to rush childbirth? Every child has a developmental curve, and every woman has a labor curve.

I do see patients who ask to be induced or to have a C-section right at 40 weeks or on a certain day. Reasons I’ve heard include work schedule conflicts, a grandparent wanting to fly in for the birth, wanting to make sure a certain doctor is available, and not wanting a certain birthdate such as 9/11.

There are a few things we take into account when deciding whether a planned delivery date is an option:

• Have you had a previous delivery? Inductions are more successful in women who have had a vaginal delivery already.
• Is the cervical exam favorable? A cervix that has softened and started to dilate may respond better to induction of labor.
• Is the date request reasonable? Both in terms of gestational age and making sure your doctor is available.

If there’s no medical reason to deliver, I encourage you to stick it out at least 41 weeks. Your little one is worth the wait.

If you want more information about pregnancy, labor, and delivery, visit our Your Pregnancy Matters blog. We publish new stories every Tuesday.