post-dates/induction question

Specialties Ob/Gyn

Published

How long are pregnant women usually allowed to go past their due date before being induced?

I was talking with a non-healthcare friend about how he was two weeks late, and we got into a discussion of women being induced for being overdue. He's dead-set against it, and feels nature should run its course. My argument was that post-term babies have problems from being too late, the same as preterm babies have problems from being too early, and if Mother Nature ain't doing her job, someone has to intervene. But then I started thinking, and I don't know how long is too long before problems can occur. Thanks!

in Las Vegas, lots of lawyers...

therefore, no one goes over 41 weeks!!

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I'm not an OB nurse, but I had an experience! My 23 year old daughter was due June 1 and not born until July 29. Yes, firm dates, and yes, confirmed by US (I worked in radiology at the time). I went through the OB clinic because insurance coverage was horrible.

I'd been on bed rest for PIH since the beginning of May, I'd been in and out of hospital having 2-day inductions attempted without breaking the since week 42. In the labor room from 0600 - about 0100 the next day, NPO after midnight, of course, fetal monitor, I felt like I'd been tied to the bed.

They did an emergency CS (after asking my hubby if it comes down to it, should they save me or the baby - can we be a little MORE soap-opera about it?)

My daughter lived. She looked like a monkey, she was so skinny. She was 25" long and weighed less than 10#, she needed her fingernails clipped the day she was born, and I could see the bottom teeth almost ready to emerge. She had NO normal newborn reflexes - and she was battleship grey when I first saw her!

I don't know if it was cause and effect, but she's about 30 IQ points below her sister, she has hearing deficits and she's never been as robustly healthy as her sister. I know they offered me free pediatric care for her at the peds clinic. I declined.

This all happened at a VERY large regional hospital with a big reputation for taking care of sick babies.

Love

Dennie

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Specializes in NICU.

NurseDennie,

So, your daughter was actually 47-48 weeks at birth?

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KRVRN,

Actually, I think it was more like 100-150 weeks at birth. No I guess 47-48 is it.

There were some funny aspects of it, but it took a few years to look back and laugh. I figured they'd decided that I'd die if they tried to do a CS. Nobody would make a decision and I got all bent out of shape. A couple of weeks before she was born, one of the residents asked me what I wanted to do!!!!! I of course burst into tears and got hysterical. I'm sure he enjoyed that.

I called the clinic and cancelled one of my appointments to go in for induction, telling them I didn't feel well enough to go to the hospital. You'd think one of those nurses would have followed up on that, wouldn't you?

I was tied to the labor gurney day after day after day with no progression, and once the nurse came in to check me and joked "I know - you feel like pushing, right?" That REALLY hurt my feelings and I think I cried for two or three days about that.

After she was born, I was on major pain meds, and not very with it. The resident came in to the room and sat at the BS and asked me something, I don't know what. Then he said "ha. ha. You're disoriented." I turned my head to look at him, and he was gone. I wonder how long that head-turn took?

Love

Dennie

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Specializes in NICU.

Damn.

I actually asked because I was wondering if you mistyped the June and July! Unbelieveable. Glad she was okay.

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Specializes in ER, NICU, NSY and some other stuff.

I have worked NICU for about 6 years and a post date baby scares the bejeebers out of me way more than an premie anyday. I have seen more than one post day. I am a firm believer that we need to move away from the current trend of inducing for convenience. I always get verynervous when I come in and we get report from L&D that we got a 42 wk induction in the back.

Those old meconium stained kids are the scariest and worst to take care of.

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Yeah, the inductions for convenience irritate me too, babynurselsa. It just kills me how often a 37-38 weeker will come in, moaning that they're sick of being pregnant, can't we just induce? I understand the whole miserable pregnant chick thing, but man....why don't these doctors take into consideration that an induction has an UP FRONT 50% risk of c/s?

Anyhoo...on the post dates thing...have seen one go past 42 weeks because the pt. refused. Finally consented and came in @ 42.4 days. Delivered via c/s after failed 3 day induction. 10+# baby. Here's the weird thing....no mec, and the whole time the kid's strip was GORGEOUS. Textbook reactive.

KRVRN, you poor thing. Gawd. I just am speechless.

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Specializes in ER, NICU, NSY and some other stuff.

Yeah shay, in our facility we have a huge walk in crowd who will come in for their inductions. Only to be scanned at 32-33 wks. No PNC, just decide they are ready to have their baby couse they are sick of being pregnant.

I have seen post dates kids come out fine but many of the sickest kids I have cared for have been post date babies. I have seen a couple who have been swimming in mec so long their skin is stained so bad it don't wash off. Meconium in the lungs for that long causes damage to the lungs that can equate with chemical burns. They go immediately into PPHN and at the least end up on Nitric Oxide and more often ECMO. Usually bad bad outcomes.

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Specializes in NICU.

Shay,

Thanks for the thought, but I think you meant it for NurseDennie!

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One of my favorite OBs used to say, when a colleague remarked that old favorite "the apple falls from the tree when it's ready", "Haven't you ever seen an old withered apple on the tree in January?"

In fact, I must have a half bushel of old withered apples on my tree--and it's February!!

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