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Old 10-09-2012, 09:57 AM   #11
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I do trust her. A lot of the reason I trust her is because every other ob around here that my ins covers is verrrry c-section happy it seems. But I'll be honest, I didn't like her at first

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Old 10-09-2012, 10:53 AM   #12
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I would get induced.


The rate of stillbirth increases after 38 weeks and significantly after 41.

She sounds like she is really looking out for you and your baby while still trying to accommodate your desires.

Good luck!
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Old 10-09-2012, 11:11 AM   #13
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Re: Going pat 41 weeks...really dangerous?

I delivered at 41+3 and my placenta had seriously degraded. I had not had any NSTs yet though. My midwife told me that I wouldn't have passed, and that we should be thankful things went as well as we did.

You've had 2 NSTs though, they would know if your placenta was degrading. I agree with talking with her about why she is being so pushy with an induction.
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Old 10-09-2012, 01:09 PM   #14
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Re: Going pat 41 weeks...really dangerous?

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Originally Posted by apurkeyp View Post
I would get induced.


The rate of stillbirth increases after 38 weeks and significantly after 41.

She sounds like she is really looking out for you and your baby while still trying to accommodate your desires.

Good luck!
38 weeks? I'm not saying you aren't correct, but no one in their right mind would consider an induction at 38 weeks simply based on the fact that the rate of stillbirth increases at that point. I'm going to go out on a limb here and suggest that the rate of stillbirth might go up at 38 weeks because the rate of deliveries start going up then. Rates rising significantly after week 41 is an entirely different issue.
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Old 10-09-2012, 01:17 PM   #15
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Re: Going pat 41 weeks...really dangerous?

My placenta looked very "aged" with my 36w 2d baby (and my due date was not incorrect.) Just something to think about.

ETA: I'm very healthy and I don't smoke or eat fast food, ect.
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Old 10-09-2012, 01:18 PM   #16
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Re: Going pat 41 weeks...really dangerous?

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38 weeks? I'm not saying you aren't correct, but no one in their right mind would consider an induction at 38 weeks simply based on the fact that the rate of stillbirth increases at that point. I'm going to go out on a limb here and suggest that the rate of stillbirth might go up at 38 weeks because the rate of deliveries start going up then. Rates rising significantly after week 41 is an entirely different issue.
My thoughts exactly.
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Old 10-09-2012, 02:08 PM   #17
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Re: Going pat 41 weeks...really dangerous?

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Originally Posted by ashley84 View Post
38 weeks? I'm not saying you aren't correct, but no one in their right mind would consider an induction at 38 weeks simply based on the fact that the rate of stillbirth increases at that point. I'm going to go out on a limb here and suggest that the rate of stillbirth might go up at 38 weeks because the rate of deliveries start going up then. Rates rising significantly after week 41 is an entirely different issue.
Thank you so much for saying what I was trying to say in such a nicer way than it would have come out if I'd tried to say it!!!

OP, this is a hard question.

You will have people who know someone or who themselves have had a baby still born at 40+ wks.

You will have some who have had babies perfectly healthy at 40+ wks.

You will have mothers who have stillbirths much earlier in pregnancy (my cousin had a stillborn baby around 20 wks).

It's just about your own comfort level and how much risk is acceptable to you, personally.

Would I consent to an induction at 41 wks, with tests saying the baby is healthy and having no issues, simply b/c someone told me the stillbirth rate goes up at 41 wks?

No, I personally don't think I would.

But whether you will or not is your choice and it has to be one you are comfortable with, no matter what happens.

...I will say this for you to think about...

Docs have been calling 42 wks the "magical" number at which stillbirth rates jump dramatically and have been inducing women with that reasoning for a LONG time. For the most part, that has been working fine. If we suddenly start calling 41 wks the "acceptable" time limit, what happens? We might save a handful of babies a year, which is WONDERFUL. But what happens to maternity care? More forced inductions, more difficult labors, more babies born too early b/c of incorrect dates.... I would be really surprised to see that standard change after so long.

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Old 10-09-2012, 02:28 PM   #18
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Re: Going pat 41 weeks...really dangerous?

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Originally Posted by apurkeyp View Post
The rate of stillbirth increases after 38 weeks and significantly after 41.
Interesting. Where did you find these facts?
Going by my own experiences, I have had 4 healthy babies, born at 39+5 or past.
And one stillborn baby. At 23 weeks.


OP - With Levi, I was wanting a VBAC. I talked to my OB at my 40 week appointment about what the plan was. I told him I had no problems going to 42 weeks, if that's how long my body & baby needed to decide it was the right time. At 42 weeks, I would agree to have AROM and possibly pitocin (depending on how things went after AROM) for induction.
He said that was exactly what he had been planning/thinking, and that was just fine with him. He didn't want any extra testing or anything from 40-41 weeks, but after 41 weeks he did ask that I come in every 2-3 days for that week (so it would only have been a couple times anyways) for a NST and a quick u/s (if the NST didn't look good) just to check on baby. If everything looked fine, we would keep going.

Levi was born, after labor started on its own, at 41 weeks 4 days.
FWIW, he didn't look or seem overdue - he was nearly the same weight/size as DD and DS1, who were both born at 39+5. He actually had some trouble breathing for the first couple hours, and was in the NICU for O2 and observation - I can't imagine how much harder a time or more of a NICU stay he may have had, had we been induced at 40 weeks or earlier.


Basic nutshell - personally, I have no issues going to 42 weeks. Again, personally, I would not go past 42 weeks. But I can understand others who do, if mama and baby are still looking good.
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Old 10-09-2012, 03:11 PM   #19
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My friend lost her baby at 42+ after a long induction. The cord may have been compromised and they lost his HR during the last moments before his birth. He was 8lb10oz so not gigantic, but she's kinda petite so big for her. He made it out but not alive. She didn't want to risk an unnecessary c-section with an induction at 40-41wks so she waited and tried acupuncture. Finally at 42wks she went in and 2 days later lost her baby boy. It was one of the single most traumatic and sad experiences I've witnessed. It really changed me to the core. She's since had another baby and they scheduled a c/s at 39wks and everything went great. After 39wks you're only adding risk to your pregnancy... All of my dr's have told me that. I've been induced for health reasons the last 3 pregnancies between 37-39wks.
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Old 10-09-2012, 03:55 PM   #20
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Re: Going pat 41 weeks...really dangerous?

DS1 was late, late I went into the OB at 41 weeks and we went ahead and scheduled the induction for a day after 42 weeks. He was born the day before. He did have some isssues, but nothing attributed to going longer. DS2 born 2 and a half weeks early at almost nine pounds and exhibited some early baby issues. No one really knows right?

I think if you've had the tests and you are comfortable I don't see any problem with going longer. Maybe dating was a little wonky, maybe ovulation came later who knows. I think you have to go with your gut.
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