Being overdue to have a baby means different things to people. Some pregnant women will be quite relaxed about it, confident that the baby will come in its own sweet time. Others are anxious, waiting nervously for something, anything to happen. Maternity care providers can have different views as well, and even opposing views on the need to induce an overdue pregnancy.
When you are 42 weeks pregnant, you will find your maternity care provider will check and re-check the accuracy of your due date. This is done by checking the first day of your last normal period as well as your ultrasound findings. You may have a vaginal examination this week so the suitability of your cervix for labour can be assessed. If your baby’s head has engaged and is applying pressure to your cervix, it is likely that this will be thinning and starting to dilate. Your maternity care provider may even try to stretch the cervix a little and strip the membranes from around your baby’s head. This will help to release prostaglandins from your cervix, as these chemicals play an important role in commencing contractions.
It is important that you are being monitored carefully if you do get to 42 weeks of pregnancy. Biophysical profiles and regular CTG’s (Cardiotocographs) are commonly recommended. The placenta is unlikely to be working as effectively as it was a few weeks ago and it is important that it is still able to support your baby efficiently.
Your physical changes this week
You are likely to have problems with swelling this week. Yes, you’re probably wondering if it’s possible to puff up even more. It is. Your ankles and feet look puffy and it may be hard to walk any distance or stay on your feet for too long.
Swelling may trouble you in your vulval region as well and there will be a general heaviness and feeling of congestion in your pelvis. The baby is likely to be sitting down low and you are very aware of having approximately 4kg+ (baby, placenta and amniotic fluid) of solid mass just waiting to get out.
You may need to empty your bowels more frequently this week. The pressure of the baby on your lower bowel and rectum means there isn’t much room for waste products to accumulate. If you have been constipated until now, you could feel some welcome relief as the baby’s head applies pressure to your rectum. Your bladder cannot hold as much urine as before, so you feel the urge to go to the toilet more.
You may notice a mucousy vaginal discharge which is tinged with blood. Your cervix is so engorged with blood now that some slight blood loss is common.
Your emotional changes this week
You are probably feeling a sense of relief that the end is in sight. Only a small percentage of women carry their babies past 41 weeks of pregnancy, and it is rare that a maternity care provider will allow a pregnant woman to go past 42 weeks of gestation. So be reassured, that this week you will have your baby.
You could get very tired of hearing people ask why you haven’t had the baby yet. You’re sick of telling them why and repeating the same information. Limit social interaction and stay at home with your partner. Aim for the simplest of lives this week.
You could be worried about the potential of your membranes rupturing (waters breaking) in public. Pregnant women can envisage a huge gush of fluid, similar to a tsunami washing away everything and everyone in its path. In reality, this is very unlikely. In less than 20% of pregnancies do membranes rupture before the uterus starts contracting. It pays to be prepared for everything so keep some towels and sanitary pads handy.
If your membranes have ruptured, but you haven’t started contracting or actively labouring, this can be a nervous wait. Most maternity units have a policy of inducing contractions if 24 hours has elapsed from when the membranes first ruptured. This is because of the risk of infection to the mother and baby. Amongst other functions, the membranes serve as a sterile, protective shield to the baby in the uterus.
Your baby’s changes this week
Overdue babes can have dry, peeling skin. This is because the vernix caseosa, which has protected it for so many weeks, has been reabsorbed and there have not been the benefits to its skin of a waterproof coating. Make sure you have some olive oil in the house to include in your baby’s bath water as well as for massages.
Babies who are born overdue or post-dates also tend to have long fingernails. They can easily scratch their faces so invest in some mittens and safety nail clippers. The best time to cut their fingernails is after a bath when the nails are soft. Ask one of the midwives to show you the best way to do this. It is easiest to do while baby is sleeping.
Overdue babies tend to be hungry babies. They haven’t been fed as well by the placenta in the last couple of weeks. They demand to be fed often and want to compensate for what they feel they’ve missed out on. Offering breastfeeds early and frequently after birth assists in establishing lactation and helps with creating close emotional connections.
Hints for the week
If you are keen to bring your labour on, try having a hot curry, hot sex (yes, it’s recommended) or even a long, hot walk. By this stage of your pregnancy, you’re probably willing to try anything which will just prompt your baby out of your body and into your arms.
Keep in close contact with your maternity care provider and seek their support and advice. They will speak with you about different induction techniques including ARM (Artificial Rupture of the Membranes), Prostaglandin Gel or a catheter to dilate your cervix and Syntocinon Infusion.
Most importantly, congratulate yourself for getting to the end of a long pregnancy. This is only the beginning!