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    Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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    Jan 28
    2011

    Placenta aging in pregnancy

    Archived User

    Hello, Henci, I am a doula with a client who is 40 years old. She has been informed by her doctor that if she goes over her estimated due date that she would medically induce her. Her reason is that due to her age, her placenta may not be good, or 'expire'. Do you know of any research or studies done regarding this? What I have found so far is one study in pubmed that states that placentas do not generally undergo aging.  Are you aware of any published information regarding woman in their 40's that showed their placentas would stop functioning? In all my years as a doula I have never heard of this.
    Any information you have would be greatly appreciated. Thank you. Debra

    Henci Goer

    The idea that reaching term starts a race between the onset of labor and the deterioration of the placenta is an old one arising from the medical model of pregnancy, but, no, I am not aware of any good evidence that supports it. There are, I should add, some population-based studies floating around that older women are at increased risk for stillbirth, but those studies fail to take into account factors more common in older mothers that increase their risk such as prior cesarean surgery. We do, on the other hand, have solid evidence that inducing labor in first-time mothers roughly doubles their chances of cesarean. Some studies also find increased risk in women who have had babies before, but the difference is smaller and probably has to do with whether the cervix was ready for labor. (FYI: Cervical ripening agents do a great job of ripening the cervix, but they don't reduce the excess cesarean rate associated with induction.)

    If your client is trying to decide what to do, you might turn the tables and suggest your client ask her doctor for the studies showing that her placenta has deteriorated past the bounds of safety at 40 weeks. If the doc has some, well and good and maybe we'll all learn something new, but if the doc doesn't, as I suspect will be the case, she'll learn something about her doctor: that her doctor doesn't practice evidence-based medicine. 

    -- Henci


    All Times America/New_York

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