The Waiting Game

39 Weeks

It's my due date today... yahoo! 

In the midst of a million emails and text messages asking, "Is it here yet! Is it here yet!" I would like to confirm that only 5% of women give birth on or before their due date. Using my very basic mathematical prowess, that's only 5 out of 100 women. 

What's up with that? 

If most women don't have their babies until they're overdue (past 40 weeks) and women are more likely to be overdue than anything else, it invites an obvious question: are they really 'overdue'?

The concept of a 40-week pregnancy was popularized nearly 200 years ago by Franz Naegele, director of a maternity hospital in Germany and author of a textbook for midwives. In a method called "Naegele's Rule", he calculated the date of birth by adding 280 days to the date of last menstrual period.

 Naegele borrowed this idea of a 280-day gestation from the 18th-century Dutch physician and botanist Herman Boerhaave who created the modern teaching hospital. Boerhaave based his estimate of a 280-day gestation on evidence from the Bible that pregnancy lasts 10 lunar months.

There is one glaring flaw in Naegele's rule. Strictly speaking, a lunar (or synodic - from new moon to new moon) month is actually 29.53 days, which makes 10 lunar months roughly 295 days, a full 15 days longer than the 280 days gestation we've been lead to believe is average!

I'd like to add that Naegele’s Rule assumes that women are having regular periods and ovulating on day 14 of her cycle. Of course for many women, including myself, this isn't the case. 

There is also the assumption that the routine pregnancy is 280 days based on our current calendar system, yet many months contain 30 days or 31 days. And what happens in a leap year, or if you're pregnant over the shorter month of February?

So here's what I'm thinking, Naegele’s Rule seems a bit archaic and inefficient; especially if we are using this dating method to determine the necessity of medical interventions. So what do we “do” with the “due?” date? 

One of the most vital pieces of information to keep in mind when your phone starts buzzing, or you doctor starts at you with a pitocin drip, comes from the the ACOG (American College of Obstetricians and Gynecologists)itself. The ACOG does not recommend interfering with a normal pregnancy before 42 completed weeks. In fact, the ACOG says the following:


“Waiting for the birth of a child is an exciting and anxious time. Most women give birth between 38 and 42 weeks of pregnancy. But very few babies are born on their due dates. It is normal to give birth as much as 3 weeks before or 2 weeks after your due date... The average length of pregnancy is 280 days, or 40 weeks from the first day of a woman’s last menstrual period." 

Did everyone get that? Let me write it again. A postterm pregnancy or a post date mama is once she passes 42 weeks. Not 40 weeks, not 41 weeks 2 days, but 42 weeks is considered post date.

 

This information can help mama and baby avoid unnecessary trauma throughout the labor and delivery. Remember, babies can't read calendars; medical issues aside, most come on their own time and almost always without complication when left alone to be born when they are truly ready.

For more on what ACOG says about due dates, moms can read their Education Pamphlet.

So with this in mind, there are plenty of non invasive natural ways to help to encourage labour and pass the time if a mama is feeling antsy. As far as I know none of these methods have been medically researched or proven, but I've heard they worked for some moms and when you're 40 weeks pregnant and have no-so-much to do except wait for baby to bust out of your vagina... anything helps:

1. Keep Busy.** A watched pot never boils! Wax your snatch. Clean the shit out of everything. Organize the shit out of everything. Read books that have absolutely nothing to do with babies. Pick the crusty stuff off your nipples. Rub oil all over your body. Bake five different kinds of cookies. Talk on the phone like a teenager. Cry into your baby's new soft plush bunny toy for no reason in particular. When strangers ask when you're due, tell them you're not pregnant: you're just fat. 

**I may or may not have done all of these things.

2. Sex, Sperm and Orgasms. If you feel up for sex, it's a great way to help bring on labour. Sex could trigger the release of oxytocin, the hormone that causes contractions. The sperm help soften and dilate the cervix. Orgasms cause contractions by stimulating your uterus. It's fun, safe, and a game the whole family can enjoy! Just don't do 'it' once your waters have broken, OK?

3. Acupuncture. I've talked to tons of moms who said acupuncture brought on labour when they were at risk of getting medically induced. I plan to visit Acumamas here in Vancouver if I hit 42 weeks and baby hasn't arrived yet. 

4. Evening Primrose Oil (EPO). As recommended by my midwife, stick 8 500mg capsules up your nether region to help ripen the cervix. Won't induce labour, but helps soften it and get everything down there ripe and ready to roll.

5. Castor Oil. I don't know too much about taking castor oil personally, but it's supposed you give you the shits and the subsequent bowel movements induce labour. I have one acquaintance that took too much, went into labour within 24 hours, and spent the whole time spraying her medical professionals with poop. 

I think I might shit, I mean sit, this one out if that's OK with you? 

6. Eat Dates! This one has a recent study behind it:

“We set out to investigate the effect of date fruit (phoenix dactylifera) consumption on labour parameters and delivery outcomes… 69 women consumed six date fruits per day for 4 weeks prior to their estimated date of delivery, compared with 45 women who consumed none. The women who consumed date fruit:

    • Had significantly higher mean cervical dilatation upon admission compared with the non-date fruit consumers (3.52 cm vs 2.02 cm, p < 0.0005)

    • Had a significantly higher proportion of intact membranes (83% vs 60%, p = 0.007).

    • Spontaneous labour occurred in 96% of those who consumed dates, compared with 79% women in the non-date fruit consumers (p = 0.024).

    • Use of prostin/oxytocin (for inducing/augmenting labour) was significantly lower in women who consumed dates (28%), compared with the non-date fruit consumers (47%) (p = 0.036).

    • The mean latent phase of the first stage of labour was shorter in women who consumed date fruit compared with the non-date fruit consumers (510 min vs 906 min, p = 0.044).

It is concluded that the consumption of date fruit in the last 4 weeks before labour significantly reduced the need for induction and augmentation of labour, and produced a more favourable, but non-significant, delivery outcome. The results warrant a randomized controlled trial."

Get 'em in ya! 

7. Galloping. Many women claim that imitating a horse can help start labor. Make sure you wave when you see me trotting down Main Street!

(Camel-toe optional)

8. Pineapple. Best taken fresh and raw. Statistically speaking, the chemicals pineapple contains, which are said to start labour, aren't very high. So that means about 7 pineapples should put you into labour. 

Ya, good luck with that.

I'd rather gallop around in tight white pants.

YEEHAW.