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    Questions? Ask Henci!


    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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    Archived User

    Hello,

    I'm 40 wks, 4 days - 4 days past my due date.  The expected baby is a mini-IVF baby.  I understand that Lamaze's healthy birth practice is to let labor start on its own.  Are there any reasons why this may not apply to IVF babies?  I did some googling and it appears that some doctors are very nervous about having IVF babies go past their due date, perhaps because of concerns that the placenta may not hold up as well as for non-IVF babies due to deterioration of placenta.

    My doctor would like to start induction tonight because the baby is past its due date, because the head size is in the 99th percentile, and also there was a blip on the non-stress test which may possibly indicate impingement of umblical cord. He says there is increased risk of sudden fetal death syndrome if one waits past the due date.  Of course, I'd prefer the natural route if at all possible if safe for the baby and myself. 

    Would appreciate your thoughts - thank you!

    Henci Goer

    I am sorry not to have responded sooner, and I do try to stay reasonably current, but this Forum isn't meant for questions as time limited as yours. I will respond anyway in case it is still relevant to you or for others who may be interested.

    I do not know whether IVF poses any excess risk to the baby after an otherwise healthy pregnancy compared with babies conceived without the use of technology, but I can tell you that risk in general does not rise after passing a 40 wk due date. According to an analysis of U.S. national data, the rate of antenatal demise holds steady in weeks 40 and 41 at 1 per 1000 and then rises in the 42nd week to 2 per 1000. Moreover, that is in the population overall. Many factors affect the risk of stillbirth, so the risk is undoubtedly less for a healthy woman carrying a healthy baby.

    I can also tell you that women are not "overdue" at 40 wks. The whole concept of a 40-week due date arose from a German obstetrics professor who declared by fiat that pregnancy lasted 10 lunar months (10 months of 4 weeks each) starting from the beginning of the last menstrual period. In actual fact, a large study found that, depending on age and and whether this a first or subsequent birth, at least 25% of women had not given birth by 41 completed weeks (287 d) whereas by 42 weeks, only 10% remained undelivered. Ten percent is a defensible definition for postterm; 25% or more is not. Moreover, in population studies, preterm births and induced labors pull the statistical curve to the left. A study of healthy women with a single, healthy baby who reached term found that the median length of pregnancy in 1st-time moms was 41 wk 1 day. That is, half the population gave birth before that day and half after with all but a few percent going into labor by 42 completed weeks. For women with prior births, the median length was 40 wk 3 days.

    The reason all this matters is that inducing labor is not harmless. In first-time moms, it roughly doubles their likelihood of cesarean surgery, which has potentially serious adverse effects not only for the mom and babe of the current pregnancy but of future pregnancies as well.  

    ~ Henci


    All Times America/New_York

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    Please note that this Forum is intended to help women make informed decisions about their care. The content is not a substitute for medical advice.



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