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| |    Passing Your Due Date by Elisa Ross, MD reviewed and revised by Marjorie Greenfield, M.D. Many expectant parents are disappointed when their due dates come and go, and still there's no baby. If you find yourself in this situation, you are in good company. Mother Nature doesn't see fit to get labor under way until after the due date in a full one third of pregnancies. In reality, due dates indicate a four-week period in which your baby is likely to arrive, not a specific day. In fact, to avoid raising false hopes, some practitioners find it more helpful to talk to their patients about a "due month" rather than fixate on a certain day. Although each day seems longer than the one before, we advise you to do what you can to distract yourself, knowing that waiting for natural labor is best in most cases. Even as your abdomen gets heavier, remember that babies are quieter while they are inside than after they are born and take advantage of what sleep you are able to get before your baby arrives. Does the baby continue to get the nutrients he needs? Starting about a week after the due date, and earlier in some situations, practitioners want to be reassured that the baby has not outgrown his placenta. While the placenta stops growing at about 37 weeks of gestational age, the baby keeps growing at a rate of one-third to one-half pound a week. However, most babies are able to manage quite nicely with their placental size even when they do pass their due dates. In some instances, babies may show signs that the placenta is not supplying their needs as well as could be hoped. For this reason, many practitioners request more frequent office visits after the due date. They also may monitor the baby's heart rate for a longer period of time with a non-stress test (NST) or order an ultrasound to evaluate the amniotic fluid volume or fetal movements. Inducing labor when the due date has come and gone If the results of these tests suggest that the baby should be delivered, induction of labor may be recommended. If the baby's tests remain reassuring, the practitioner may wait until one or even two weeks after the due date to suggest inducing labor. The dilation of the cervix, the confidence that the due date is correct, and the size of the baby may influence the decision about timing. Some parents-to-be want to request an induction of labor soon after they pass the due date. They may be getting frustrated with the waiting, or worried that the baby is growing too big to be delivered vaginally. It turns out that in first-time mothers, inducing labor because of the fear of the baby getting too big results in more caesarean sections (because the cervix doesn't open) than just waiting for spontaneous labor. Even a big baby has a good chance of being delivered vaginally if he tucks his head just right and contractions are strong. However, sometimes it's clear that induction of labor is the best course of action. Induction of labor is usually recommended after 41-42 completed weeks of gestation (one to two weeks past the due date) or if the testing is not reassuring. Your practitioner should review the pros and cons with you. Newborn appearance A so-called overdue baby may look as if he had been left in the bathtub too long. Aside from a set of wrinkles, he may have long fingernails and lots of flaky skin. Don't worry--post-date babies soon plump up and look as cute as the other babies. And anecdotal evidence suggests that they actually may have a head start in the sleeping department! You deserve at least that much.
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