Q: Hi Dr. Please I have passed my due date, am 40+3 and my baby has not engaged yet. What do I do? I’m confused
A: Hello dear, thanks for writing in.
Your confusion and worry is understandable.
In our part of the world, Nigeria, especially, people tend to think that this is related to witchcraft or having run-ins with ‘bad’ people. I’d like to state unequivocally that this is not witchcraft 😀
Usually pregnancy lasts for 40 completed weeks plus or minus 2 weeks. This is usually through pregnancy dating using ultrasound scan in the first trimester. Generally though, from 37 weeks, your baby is good to be born…all things being equal. And so, if a woman gets to 40 weeks without any sign of labour, she is tentatively given 2 more weeks, especially if there are no other risk factors present in the pregnancy. This is called watchful waiting and during this period, the baby’s kicks are counted, baby’s heart beat is monitored and indeed, baby’s growth and other parameters are monitored. From the 41st week, if she does not spontaneously go into labour (without help), then there is a plan made for induction, having fully informed the woman of all possible scenarios.. Some women do not like the idea of induction and so, having discussed with the medical team, may opt for a sweep of the membranes. This involves the separation of the membranes (the ‘bag’ in which the baby lies) from the lower part of the womb (uterus). This releases prostaglandins which help stimulate labour.
When a pregnancy goes beyond the Expected Date of Delivery (EDD) which is 40 weeks, it is called a post-dated pregnancy. If the pregnancy lasts beyond 42 weeks, it is called post term.
It is not really clear why some pregnancies become post-dated but some associated risk factors include previous post dated pregnancy, first pregnancies, mothers with high BMI and advanced age.
The main challenge with allowing a baby to remain in the womb beyond the 42nd week is that of the placenta no longer being able to supply sufficient amounts of oxygen to the baby. This can lead to brain damage or even death of the baby. The second issue is the threat of the baby having its first poop inside the womb and then aspirating (breathing in) same.
So, have a long chat with your medical team and discuss options available and the ones you are comfortable with.
All the best! Let’s know when the baby is born! Lots of love and hugs.
Have a good night, people 😀