The Estimated Due Date and Preventing "Being Late"

Photo by Melissa Oosting

Photo by Melissa Oosting

Most mamas like to count baby's toes and fingers. The amount of creases in the baby's feet are simply one of several signs this healthy baby is "post term", born in the weeks past estimated due date, when this baby was ready to be born. It is one of the assessments we use to calculate the new baby's gestational age (how many weeks baby was in utero). I marvel how this calculation often differs from pregnancy dating. I had a mama in my practice who came to me with her last 4 pregnancies. She told me her first 4 babies were born 4 weeks past her estimated due date, but they were all evaluated as term at birth, without any indications of being "late." Her last 4 babies were also born 4 weeks after her estimated due date, had I calculated it based on the first day of her last period alone; but they actually arrived at just the right time, all evaluated to be term - as I used a variety of other assessments, including past history, cycle characteristics, and when she had intercourse, to get a more accurate dating for her pregnancy.

Art by Catie Atkinson @spiritysol.

Art by Catie Atkinson @spiritysol.

What is this due date and how can you more accurately help calculate it to prevent false diagnosis of postdates and its associated risks of induction? The estimated due date is just that - an estimate of when mom and baby of a healthy pregnancy will go into labor; it is an estimate of how many weeks old your fetus is at any stage of your pregnancy - which is important to know, as this impacts your maternity care and the well-being of you and your baby. If you go into labor, it would be important to know that your baby is term and there are no issues with the baby's gestational age. For example, if you go into labor at a certain point before your estimated due date, it's important to know if it is too early for your baby to be born, your preterm baby would be at increased risk and need intensive care, so efforts would be made to try to stop it. Likewise, if you are past your given due date, in many modern obstetrical practices, in an attempt to avoid small risk of postdates for babies that increase after 42 weeks, there is a cascade of interventions from frequent testing of fetal well-being to induction when you are not really due or ready to labor yet; this can lead to increased stress, more painful harder labor, anesthesia and other unnecessary interventions that may culminate in an unplanned cesarean birth. Actually, only 5% of women give birth on their due date, even with the most accurately assessed pregnancy dating.  I like to use the language due month, as most babies come a few weeks before or after that date - more commonly a week or more after it for first time mamas.

@yogawithalanna

@yogawithalanna

 

So, when speaking about due dates and postdates, I like to start with education and prevention during preconception, before a women gets pregnant. And even if pregnant, we can still do some detective work and might come up with helpful information that may impact your pregnancy dating. I advise women to know their fascinating bodies and menstrual cycles, to track how often their periods come, when they have signs of ovulation and when they had or did not have intercourse.

Art by Catie Atkinson @spiritysol.

Art by Catie Atkinson @spiritysol.

With this knowledge, mamas can TAKE CHARGE OF THEIR FERTILITY to either prevent pregnancy, or try to become pregnant, learn when they conceived and even when they are pregnant before a positive pregnancy test. This is one of my favorite books on the subject.

Mamas who know their date of conception, more details about their cycles, and their past pregnancy histories (when they went into labor previously and what the gestational age assessment was of each of their babies), have a much more accurate due date than basing it on first date of last period alone. This is one of many ways mamas can become empowered and proactive.

It also helps to connect with nature, and your connection with it - your body is nature, has its own biological clock, and you might want to look into how it relates to the moon cycles (a very interesting study). It helps to connect with the rest of who you are - your heart, your gut, your spirit, and get out of the busy overthinking, worrying, calculating mind that has become way too dependent on manmade, digital precision of industrialized time, stay present in each precious moment, the only place where life exists, surrender to what you can not control of the natural world anyway, and learn ways to self relax and tap into a state of inner calm (why I love yoga and mindfulness so much). As a midwife, I certainly have other date assessment skills I use, and other suggestions to help each mama on a more personal level, but these are great places mamas can start. But no obstetrical provider or any human, can predict when a mama will go into labor. So one of the great lessons of pregnancy is being ok with not knowing. Might as well enjoy the journey, as this is as real as life gets.

Art by Catie Atkinson @spiritysol.

Art by Catie Atkinson @spiritysol.

Red Moon
By Miranda Gray

But in today's times,  I do feel compelled to debunk some myths. As I indicated above, the due date is not written in stone. It is an estimate around an average time of when mamas go into labor, plus or minus a few weeks on either side. Although I like referring to the 'due month', that has not taken hold in the modern obstetric community, obsessed with measurements. At least we can use it between us and with your extended families, who tend to call you every day after your estimated due date, to find out if you had your baby yet. Yes, now we have ultrasound that, if done in the first trimester by a practitioner with expertise in pregnancy dating, the accuracy of the estimated due date increases a bit. But not all mamas want a sonogram. Again, only about 5% of babies are born on their estimated due dates anyway. And it is often miscalculated, if based alone on the first date of the last menstrual period. That date calculation only applies if a mama’s cycle comes every 28 days, assuming she ovulated day 14, and that still could mean baby could be born on average between 37 and 42 weeks. Healthy term babies can also be born before or after this time frame.

 

This is my pregnancy dating wheel that has been with me as long as I can remember. Now its online. I like the ones that take cycle length and date of conception into consideration. Most women having regular cycles have variation, with sometimes as much as 21-45 days between them. And that is normal. There are many factors such as stress, illness & travel, that can prolong the time between last period and next ovulation, but once a women ovulates, the next period comes close to 14 days later - unless she conceived shortly before or at ovulation.

As a nurse since 1985 and a midwife for over 20 years, I meet many women who are well informed and know their bodies and histories, and many who are not familiar but are very eager to get empowered and learn more. I have had plenty of women know their exact date of conception from fertility treatments and go into labor weeks before or after their due dates. I have had women who knew exactly when they conceived as they were keeping track, only had intercourse at or before ovulation once as for example they were or partner were busy or not together. And they give birth close to estimated due date. Each mama and story is different. And I have had women not have a clue about their cycles or when they got pregnant. But more often than realized, modern medicine does not know nearly as much as people might expect. Women can empower themselves with some knowledge and they have more wisdom than they think; too much trust is often placed in technology and 'experts' over themselves. I question the value of of having to be so accurate with exact calculations when it comes to healthy women experiencing healthy pregnancies. These are illusions, manmade constructs, industrialized time applied to horticultural biological time that no human can control or predict. This is a fascinating study and discussion if one has an open mind to consider other perspectives, and the more I practice the humbler I become, the more awe I have in a process that has far more wisdom and power than any human being, no matter what their training and background. 

Oh the journey of waiting and not knowing when, has been a journey traveled by billions of women since the beginning of time - it's part of the sacred wonder and surprises along the way. Welcome to the Tribe De Mama where we get more and more familiar with nature's own clock, realize there is so much we can not control, and get comfortable with not knowing.

This gorgeous shot of @heidijohnson13 was captured by darling mama's sister @sarahandthewave.

This gorgeous shot of @heidijohnson13 was captured by darling mama's sister @sarahandthewave.

For personal questions and need for individual guidance you can schedule an online consultation with me- this is one of passions and areas of expertise. Many mamas ask to consult with me about their fears of going past their due date, & want to know what they can do, as they don't want to be medically induced & have the barrage of testing which can cause much angst, and the subsequent interventions which increase risk of cesarean. I love helping mamas in person, and now with this global IG community, via Skype or phone conversation. You can also take my unique online ROCK and LOVE YOUR BIRTH course, which basically guides you through your pregnancy to birth and postpartum journey, as I guide the families in my midwifery practice - without the hands on care, to prepare and plan for an experience of their dreams.

Photo by Megan Hancock Photography

Photo by Megan Hancock Photography

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Do you need supplements for preconception and pregnancy? Here are some of my favorite I recommend to mamas in my practice.

Make your Red Raspberry Leaf and Nettle herbal infusion.....rich in needed nutrients and specifically nourishing for pregnancy, birth and postpartum. Place 1 oz of dried red raspberry leaf, 1 oz of dried nettle leaf in a quart-sized glass canning jar with strainer, fill it with boiling water, cover and steep for at least 2 -4 hours at room temperature. Strain and place in a covered pitcher. You can make it in larger quantities and store in the fridge. For taste, dilute with water or steep for less time (but no less than half an hour), add lemon or lime juice, mint leaves or a teaspoon of honey. Drink 1-4 cups daily hot or cold.