Although it’s totally normal to have an ‘overdue’ baby, it can be very frustrating. The ideal is to prevent it early on by knowing when you conceived and getting accurate pregnancy dates.

Try to keep busy past your due date by continuing to exercise as tolerated and planning some daily pleasurable activities to keep your morale upbeat and positive.

There is a five week time frame around the estimated due date, when babies are considered term, in which it is normal and most common for moms to go into labor.

In a well-nourished, healthy woman whose pregnancy has been accurately dated, the actual time of delivery often extends 1-2 weeks past the estimated 40-week due date. This is especially true with first-time moms.

Only a small percentage of women give birth on their due date, and most babies are indeed born at the perfect time for them.

A pregnancy is actually “postdates” when it exceeds the 42nd week of gestation. In this case, it’s still best to wait for labor to occur naturally, assuming:

• Your baby is still as active as usual

• The amount of amniotic fluid is adequate

• Your baby has a normal heart rate

• The size of your baby is estimated to be compatible with the characteristics of your pelvis

• You are healthy and there are no other pregnancy complications

Monitoring a Postdate Baby

There is an increased risk of complications associated with postdate pregnancies, mostly related to an aging placenta that ceases to function as well as it did earlier, or to a baby that continues to grow to an exceptionally large size. Therefore, there will be a need to monitor you and your baby more closely after 41 weeks. Rest assured, though, that the majority of postdate babies do just fine.

FETAL MOVEMENT COUNTS

Fetal movement demonstrates adequate nourishment and oxygen from a healthy placenta. A baby will significantly decrease its movement as the condition of the placenta deteriorates. With that in mind, a wonderful way you can monitor the continued well-being of your baby throughout the third trimester is to do daily fetal movement counts. 

Pick a time when your baby is usually most active, often this is after meals, when resting or at night when lying in bed. Make sure you count at least 10 distinct moves in 2 hours. If you notice less, the baby may be sleeping. Try again a little later after drinking 2 large glasses of fruit juice, a cup of coffee and eating a complex carbohydrate and natural sugar meal, such as peanut butter and jelly sandwich on whole grain bread. Lay down after 30-40 minutes and count the number of moves. If baby is not moving after this, or you still feel that the baby is moving less than usual in a 12 hour period, contact your practitioner right away. The baby needs to be evaluated, and if in trouble, will need to be delivered as soon as possible.

IN-OFFICE TESTING

Two tests commonly done in the office to monitor the condition of the placenta and baby’s well-being are the twice weekly NST (non-stress test) and the weekly BPP (biophysical profile sonogram).

The NST uses an external electronic fetal monitor to note the character of the baby’s heart rate and its response to fetal movement. A desired response is a fetal heart rate that varies from beat to beat within the normal range, and increases at least twice when the baby moves, 15 beats per minute for at least 15 seconds within 20 minutes. Out of hospital midwives are asked and can use a fetoscope or doppler to check fetal heart rate and record accelerations manually, but it is less accurate, without a recorded tracing, not the standard of care nor evidence based; it is also not supported by modern medicine, or most of the collaborative obstetricians midwives work with.

The BPP uses ultrasound to examine the fetus and its environment in utero by assessing a variety of parameters including the baby’s movements, muscle tone, the placenta and the amount of amniotic fluid. The ultrasound can also provide estimates on the baby’s growth and weight, but they are only estimates and not always accurate at this late stage of pregnancy. Try to schedule this test during a time the baby is usually active and moving the most. On the day of the test, make sure you are drinking your usual daily 8-10 glasses of water so the baby has plenty of amniotic fluid. 30-40 minutes before the test, make sure to have 2 large glasses of fruit juice and a natural sugar/carbohydrate meal or other foods that usually wake baby up and causes lots of movement. You can even have a cup of coffee or tea just in case the baby is still sleeping after the meal. The test is somewhat dependent on the baby moving, and we would not want a false report of no fetal movement indicative of fetal stress, when the baby was just sleeping healthfully.

Natural Measures to Help Prevent Problems Related to Postdates

These recommendations are especially helpful if you had complications from postdates in prior pregnancies, you are attempting a vaginal birth after a previous cesarean, or you have other complications such as diabetes or high blood pressure and it is not advisable to let the pregnancy extend past term. Research on natural induction methods is sparse, but growing. Sometimes one remedy or a combination of them does the trick, and all is well. Sometimes, no matter what we do, we can not get labor started. Nothing works consistently, including the medications used in hospitals. Ultimately, unless there is a scheduled cesarean birth, when a baby comes into the world is ultimately not in our human control.

KNOW YOUR STATUS

If you are planning a pregnancy, keep an accurate record of your cycle and know the first day of your last menstrual period. Or better yet, the day of conception around the time of ovulation. If there is a question about your dates (if you are breastfeeding, recently miscarried, went off the birth control pill, or have long  or irregular cycles), an early first trimester ultrasound can accurately date your pregnancy. This will prevent a lot of aggravation later on, like unnecessary testing, pressure to deliver and induction based on miscalculated dates.

EAT RIGHT FOR BABY

Maintain a healthy well balanced diet including lots of:

• Organic fresh fruits and vegetables

• Whole grains

• Seeds and seed products like tahina 

• Nuts and nut butters

• Beans

• Organic tofu and tempeh  

• Organic whole eggs

• Turkey or chicken

• Beef, lamb, or wild game

• Wild Alaskan salmon 

• Organic fresh raw whole dairy-ideally goat or sheep

Use healthy fats for cooking, such as organic cold pressed extra virgin olive oil, coconut oil or goat butter. Drink at least 64 ounces of filtered, spring or well water or herbal tea per day, at least 20-30 minutes before meals. Limit intake of fruit juice and refined white flour, sugary products, and refined vegetable oils or partially hydrogenated fat. Aside from being unhealthy and fattening, the refined sugars and starches grow big babies that are harder to push out.

Make sure to eat plenty of dates and pineapples - some swear by them to encourage labor. I am not convinced, but no harm trying.

Prepare Your Mind

Prepare for a deeply positive childbirth experience. It is very important to enter labor and birth with positive feelings, trusting your body and the whole birth process.

It is helpful to write a positive birth vision, what you wish your labor and birth to be like from start to finish, and include the role and involvement of all persons who will be there.

This is something you and your partner can think about and write together. You may write as little or as much as you like, but enjoy thinking about this special time in your life. 

There are a number of methods to help you get ready for the amazing experience to come:

• Childbirth classes

• Hypnosis for birth in adjunct 

• Gentle, Prenatal and Restorative Yoga 

• Breathwork, meditation, and progressive muscle relaxation techniques (yoga nidra)

• Watching positive birth movies

• Listening to inspiring podcasts and birth summits

• Books. Some of my favorites are:

  • Mindful Birthing by Nancy Bardacke

  • Orgasmic Birth by Elizabeth Davis and Debbie Pascale Bonaro

  • Ina May’s Guide to Childbirth by Ina May Gaskin 

  • Baby Catcher by Peggy Vincent 

  • Natural Birth Secrets by me, Anne Margolis! 

Accept and express feelings that might be holding you back, such as anxiety or fear about childbirth or becoming a mother, uncertainty about your changing role as a person or relationship with loved ones, and hesitation about giving up the special attention you’ve enjoyed while being pregnant. Do not hesitate to talk with a close friend, family member, childbirth educator, or therapist, as labor and birth is heavily influenced by your emotions. Often, simply sharing and releasing ambivalent or troubling feelings does wonders to help you open up, let go and give birth. When that does not help, try releasing it from your body with breathwork.

Practice the following thoughts daily while doing slow deep breathing in a quiet meditative space: 

Spend some time saying goodbye to your pregnancy and inviting your baby to come out. Tell yourself that you and your baby are ready for labor and birth to occur. Imagine your uterus contracting. Visualize your cervix softening and opening, and picture your baby descending through the birth canal so you can cradle your beautiful newborn child in your arms. Affirm that you will surrender, let yourself be relaxed and open so that your body will do what it was perfectly designed to do - give birth to a new human being.  

HERBAL SUPPORT

Most of the supplements and herbal remedies I recommend are available on my customized online holistic apothecary. Find the best supplements that have gone through my thorough screening process there. Look in the category for labor stimulation support or search them individually. My online dispensary is a convenient way for you to purchase my hand-picked, professional-grade, whole food supplements and other natural health products. Ordering is simple, and the products will be shipped directly to your home or work within a few days.

Drink fresh infused Red Raspberry leaf tea regularly. Among its many benefits, it encourages more effective uterine activity and thus an easier birth. It is optimal to make your own by adding a generous handful of the dried herb to 1 quart of water. Let it soak in a glass canning jar for approximately one hour, then strain. You can add honey, fresh mint leaves and/or lemon juice to taste and drink several times per day.

Dr. Christopher’s Birth Prep herbal formulation is designed to cause an increase in toning contractions in late pregnancy and prepare your body for labor and birth. It can be taken during the last 6 weeks of pregnancy under supervision by your provider. The recommended cycle is 1 capsule per day at week 34-36, 2 capsules per day at week 37, 2 capsules twice per day at week 38 onward, until you have your baby.

Make your own wonderful late pregnancy herbal tonic, to be used 37 weeks onward. Combine 1 dropperful each of red raspberry leaf, partridge berry, blue vervain and cramp bark with ¼ dropperful each of wild yam and motherwort in a separate tincture bottle and shake to mix well. Take 1/2 dropperful of the mixture a few times daily. You can double the dose in the last week before your due date. Other reputable herbal brands include Gaia, Wish Garden, Herb Pharm and Eclectic Institute.

You can take Evening Primrose oil capsules, 500 mg daily, as early as 36 weeks to help ripen the cervix. 

At 38 weeks gestation, start inserting 6-8 caps of Evening Primrose oil deep inside your vagina behind the cervix every 8-12 hours if:

• This is your first baby OR

• You have a history of post-term pregnancies

At 41 weeks gestation, start inserting Evening Primrose at the dose above if:

• Your cervix is still not ready for labor as measured by internal exam AND 

• Your bag of waters is intact

You should have a ripe cervix within a few days. At 41 weeks, you can also increase the oral 500 mg dose to three times daily. 

GET IN THE MOOD

As long as your bag of waters is still intact and you do not have a history of premature labor, engage in frequent sexual intercourse, especially after 36 weeks. Semen contains prostaglandins which can help ripen the cervix for labor, and reaching climax can bring on uterine contractions that may stimulate labor if the cervix is ripe and the baby is ready. The same energy that gets baby in, gets baby out, so turn up the sensual and make lots of love.

GET MOVING

Likewise, if you do not have a history of preterm labor, engage in regular moderate exercise like brisk walking, cycling, dancing, swimming or low impact aerobics for at least 30 minutes 5 days per week. As you get closer to term, moving around while upright uses gravity to help get the baby in an optimal position for birth, as well as press on the cervix and cause it to ripen and stimulate contractions.

As women get closer to the term, it is common to feel an increased frequency, length and intensity of Braxton Hicks contractions as the uterine muscle warms up for labor. These contractions are felt as occasional lower abdominal menstrual-like cramping in early pregnancy. But, as you get closer to term, you can actually feel your uterus ball up and harden, often from the top on downward before it softens again. They are usually brief, painless and irregular without pattern, increase with activity and resolve with rest. 

If you do not feel such uterine activity beginning at 39 weeks, you can do nipple stimulation every 10 minutes for an hour 3 times per day to stimulate contractions. To do this, roll the end of your nipple between your fingers and compress and pull slightly as a suckling baby would do. Alternately, you can, or use a breast pump, which will come in handy postpartum. 

Natural Ways to Bring on Labor

Only use the below methodologies if you have reached or passed your due date and you have discussed options with your practitioner.

Increase nipple stimulation to every five minutes for 2 hours, 4-5 times per day. It may take several hours, but with a little persistence, this can get labor going. Nipple stimulation causes release of your body’s own oxytocin, the hormone that ripens the cervix and stimulates uterine contractions. Don’t stop until labor is progressing on its own.

Take homeopathic Cimicifuga 30c, 4-5 pellets, alternating with Caulophyllum 30c, 4-5 pellets every hour for 12 hours. Repeat for two days. This gently stimulates your cervix to ripen and labor contractions to begin.

Massage your uterus with Castor oil until you get a contraction, and then repeat every 5 minutes until a labor pattern is established on its own.

If all else fails, you can try drinking Castor oil. This induces labor by stimulating your bowels, so be prepared for the possibility of diarrhea. Take 2 ounces of Castor oil in orange juice every hour for a total of 3 times. Two ounces of vodka, brandy or bourbon can be added to this mixture to loosen you up psychologically if needed. After each drink, go for a walk around your house (staying close to a bathroom!) and then take a hot shower, letting the water flow onto your nipples and persistently massage your belly with some of the Castor oil.

If still no labor, there are other things we can recommend like an enema, gently stretching your cervix open and stripping your membranes (separating the membranes from their attachment to the lower uterine wall), or as a last resort, breaking your water and/or medication if your baby needs to be born without delay.

If you need more personal guidance, schedule a consultation with me. I am happy to help!