What should I expect if my baby is overdue?

It's just a fact of life that most first-time moms deliver between 39 1/2 and 40 1/2 weeks. That means that your due date may very well come and go. And it's a sad day if that happens, but if it does, then your doctor will recommend testing after 40 weeks just to watch things until you actually go into labor or are induced for medical reasons. This testing will involve going to either the doctors office or the hospital, and they'll put monitors on your belly and watch the pattern of the baby's heart rate. They'll also watch for contractions and ask you about how you're feeling. And the best test that we have to see how well a baby is doing inside of a mother is to watch the pattern of the heart rate. It shows us how well-oxygenated the baby is, and so if we see any signs of distress or we have any questions about it, then we'll want to watch you for a longer period of time. And if, after prolonged monitoring, your doctor decides it's time for you to deliver, then they'll recommend induction. But if everything looks good, then they may very well send you home and just tell you to come in when you're having contractions, or you have bleeding, or your water breaks, or you're not feeling your baby move, so that you can have testing done again. If everything is pretty uneventful and you get to 41 weeks, then your doctor will likely induce you. And the reason why it's so important to get a baby out at this point is because the placenta has an expiration date - it's just not stamped somewhere where we can see it, but we know that the placenta will stop working well. Its peak life is at about 37 weeks and then it starts to decline after that, and after 41 weeks, nothing good happens, the rate of stillbirth goes up significantly, so it's time for the baby to come out. They're now better out than in. In addition, you're baby is growing rapidly and they're getting bigger, and that will decrease the chances of them fitting through your pelvis, and so 41 weeks is the cut-off. Your doctor will recommend induction at that point. So if that happens, how do they do it? If you go into labor on your own spontaneously, your body starts to release prostaglandins (or hormones) in the days to weeks leading up to the delivery of your baby that prep your body for labor. They ripen your cervix - that's the actual medical term we use. It softens your cervix, moves it forward, thins it out, and then your brain starts to release oxytocin at some point in time, and you begin to have regular and intense contractions. Your cervix will respond to regular and intense contractions when it's ripe by dilating (or opening up) so the baby can fit through and be born. But the whole problem with being 41 weeks is that most of that usually hasn't happened yet, so we need to mimc what your body would have done if you went into labor spontaneously, and just cram it into a day or two. So you'll likely be brought into the hospital and be given some cervical ripening agents. Those are those prostaglandins that soften your cervix, move it forward, and thin it out. Sometimes it's a pill, sometimes it's a little insert, sometimes it's a gel. Whatever it is, it will help ripen the cervix, and that usually takes a while. It can take 12 hours or more just to do the ripening. And then after that, we start pitocin, which is the hormone that makes your uterus contract. And once your contractions are intense and regular, then your cervix will start to dilate. And the true definition of labor is cervical change from hour to hour, so again, expect (if you're being induced) that there will be a ripening time and then there will be the labor time. So all in all, especially for first-time mothers, this can take 24 to 36 hours, so expect it to take a long time. And if it just ends up being faster than that, then you'll be pleasantly surprised. After you've already had a baby before, things are entirely different - so your 2nd, 3rd, 4th baby. Your doctor may talk to you about an elective induction. This is just inducing you "for fun" between that 39th and 40th week. We bring you to the hospital, we start pitocin, and you have a baby, on average, about 7 to 8 hours later. It works really well and there's nothing wrong with it. It doesn't increase your chances of C-section when it's done under the right circumstances. And so, again, your doctor will screen you and decide if it's a good plan for you. Most women love it, because it's an ultimate due date, and dad can get work off, and you can get a babysitter for your other kids, and you know you won't have to go past that point - you won't have to go to 40 weeks or 41 weeks. If you have any questions about how this information applies to you, talk with your OB provider. And based on their knowledge of your circumstances, they'll be able to give you tailored advice. If you have questions for me in the future, feel free to ask them on our Facebook page, and recommend us to your friends and family too.