'My first baby arrived on her due date. What are the chances?! It made life pretty simple in so far as we didn’t have lots of people texting and calling to see if the baby was here. I was happily pregnant...ready to not be pregnant but was not at the hanging in there, oh-my-god-I-am-STILL-pregnant stage that seems to set in anytime from 40+1.
When my second was due, I was completely and utterly convinced that she would be early. I was SURE she would be here by 38 weeks. They (my dad always asks me who “they” are?!) always say that subsequent babies tend to come earlier.
At the first scan, our due date based on my last menstrual period was four days earlier than our due date based on the scan. At the hospital I gave birth in, the policy is that they only adjust the date if it is five or more days out. I had done a lot of hypnobirthing preparation and considered myself to be pretty well informed about my choices, so I raised it with my midwife. I explained that I would prefer to move the date – it was nearly five days out – I wanted to buy some time before we would have to tackle the induction conversation. I also explained that I have a long menstrual cycle, around 6 weeks rather than the 4 weeks that the whole 40 week thing is based on. I didn’t honestly think I would get to that point, but I knew I would be mindful of the fact that with an adjusted date, I would be 4 days behind where “hospital policy” would have put me.
But 38 weeks passed, 39...until finally she came at 40 + 14. If we hadn’t moved the date that would have put us at 40 + 18. Interestingly, the very first thing the midwife said – before we announced the sex of our new baby – was “oh my goodness that baby is not full term”!!! The midwife said they look “more wrinkled”, have less vernix and have long nails, none of which Milly had. If we had left the date, she would have been nearly 3 weeks “overdue”.
My third came at 40 + 13, having moved the dates by a couple of days based on the scan, after a chat with the midwives. This time we would have been at 40 + 15 if we hadn’t moved the date. These last two pregnancies were so very different to the first. Not only was I massive and running round after one/two other small people, but I also felt such pressure from many people for the baby to arrive. Texts, calls, “oh my god you are still pregnant”-type chat. “YES I AM STILL FRICKIN’ PREGNANT!!!” Those two weeks with M & W felt like an absolute lifetime. In all honesty I was pretty fed up and really would not wish a super long pregnancy on anyone. On top of this, there is pressure for induction from people telling you stories about how the placenta will stop working, you will run out of amniotic fluid and more…
Why did I choose to put off induction? Why didn’t I want to get that baby the hell out of there? Because induction can be hard if the baby isn’t ready. In natural labour the uterine muscles flex and release, but when labour is started with synthetic hormones the muscles never fully release so your muscles remain tense throughout birth. The mother also does not produce the same levels of hormones: endorphins – for their pain relieving properties, and relaxin - to help the cervix to soften and open. The result is that induction can be long and drawn out, or very quick and forceful, both of which put pressure on the mother and the baby.
In my case of a long menstrual cycle, it seemed to add up that I would have longer pregnancies (this is my personal view, I am not a doctor, or a midwife; it seems to make sense to me and would be interested to see if it works the other way round too…) I recently read an article published by Evidence Based Birth - here. It explained that we use Naegele’s rule to determine an EDD. To calculate your date based on Naegele’s rule, you add seven days to the first day of your last period and then count forward 9 months. This rule was based on work done by a Dutch professor - Hermann Boerhaave - in 1744. However, Boerhaave did not actually explain whether you should add seven days to the start of the last period of to the last day of the last period. He simply said add seven days to the last period (Basekett & Nagele, 2000). According to this article, by the 1900s, most doctors were adding seven days to the first day of the last period, “a rule that is not based on any current evidence, and may not have even been intended by Naegele”.
Now I am not a crazy lady. I am mindful of the risks of a longer pregnancy* (and indeed of any pregnancy). I was mindful of how I was feeling but putting the date forward seemed absolutely the right thing to do for us. Based in part on my history and in part on my long menstrual cycles. I felt informed and confident thanks to my hypnobirthing training and the support of some fabulous midwives. I am absolutely not saying that this is the case for everyone, induction can be a life saver for some women. This goes without saying. And there are positive induction stories out there. However, being aware of your own, personal situation and having the confidence to question hospital policy is so valuable. The knowledge that I did have a choice, that hospital guidelines are just that – guidelines, based on an average. But we are not all average! We are unique, individual, strong and powerful to do what is right for us, with the right information behind us.'
* NOTE FROM POSITIVELY BIRTHING: Very new research is now actually showing a reduction in the risk of still birth once associated with pregnancies lasting over 42 weeks. It is not yet clear why this seems to be the case, but may be to do with women receiving increased levels of monitoring after this point. If you are facing a decision of whether or not to have an induction based on 'dates' alone, as with anything, please discuss with your midwife or qualified healthcare professional.
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