Bump Watch: What To Do If You Go Overdue!

One of the topics we covered on our antenatal retreat with expert midwife Nikki Khan is what to do if your pregnancy goes past 40 weeks.

This is particularly relevant for me at the moment as I await the late arrival of friends’ and family members’ babies.

A full term of pregnancy is actually anything between 38 and 42 weeks though our due date is always in the 40th week. It is therefore not unreasonable that people get frustrated if the day comes and goes and there is no baby to be found.

The due date that we are given is only an estimate worked out by our dates or from a dating scan. In reality just five percent of babies are born on their actual due date. As long as all is well with you and the baby you will be left for nature to take its course but will be closely monitored.

As you approach the 41 to 42 week mark, your midwife or doctor may decide to start the process of inducing labour. This involves kick-starting labour through intervention or with drugs.

The first step would be to try a membrane sweep. The midwife or doctor will try to separate the membranes around your baby from your cervix. This encourages the release of the hormones that help to trigger labour. If the sweep is successful labour usually starts within 48 hours.

Nikki Khan Top Tip
A clenched fist under each buttock can make internal examinations easier and less painful. Also gives midwfie easier access for sweep or trying to break waters while maximising comfort for the mummy to be in an awkward uncomfortable procedure. A tens machine can also be used to ease examinations and sweeps.

If a sweep is not successful then you will be offered gel or pessaries to medically stimulate the cervix.

Once the cervix begins to soften then a midwife might try to break your waters to bring labour on.

There is no guarantees with any of these procedures and it may be that a caesarean section becomes the best and safest course of action available for you and your baby.

Before things get that far though there are certain things that you can do if you do go overdue.

Things People Try

Raspberry leaf tea can kick start labour and should only be drunk from week 37 to avoid a premature birth.

It is thought that a hot curry will induce labour but what it actually does is cause diarrhoea which in turn sparks uterine contractions. It has to be a very hot curry!

It is also claimed that having sexual intercourse will bring on labour. In fact for this method to have even a slight chance of working you would need to have sex about 8 times to get the right amount of hormone from the sperm to stimulate the cervix and bring on a birth.

Gentle exercise and walking may help to bring on labour as being upright and moving around may encourage the baby to move down in the pelvis. This would also help you to relax which could help your body prepare for labour.

You can also have acupuncture to start contractions and labour.

Other ideas for what to do if you are overdue can be found in the book My Pregnancy. It is a great read and full of ideas for trying to get your baby out. It also goes on to give good advice on what to during the birth and once your baby is here. Definitely worth a look if you still have some time.

The ideas I have stated here were shared as part of the Nikki Khan Antenatal Weekend that we went on this weekend. It was fabulous and I learned so much that I know is going to help me through this pregnancy, labour and birth. You can find out more about the antenatal weekend here and I will be writing a full review of the weekend here at Edspire over the next couple of days.

I will also be writing a review of the book My Pregnancy which we were given as part of a very generous goody bag on the course.

Did you go overdue? What did you do? What tips would you give me to share with my patiently waiting friends?

Bump Watch: Writing a Birth Plan

This week I have started thinking about the kind of labour and birth I want to have. I was thinking about it so much last night that I barely slept a wink.

I looked at the NHS Online Birth Plan but there was too much I did not know to complete it fully. I needed a site that would guide me better through my options. Having never attended antenatal classes or expereinced a third timester the best childbirth education I have had so far is my hazy memories of giving birth to Esther and William and watching One Born Every Minute!

Today I have been looking at birth plan information at www.babycentre.co.uk and I have found this to be much more detailed.

They advise naming your birth partner as point one of your birth plan. My birth partner will be my husband, David. I cannot imagine going through something so important and so intimate with anybody else. If labour is long and David needs a break then I would be happy for Michele, my best friend, to come and keep me company for a while in the early stages. If she is available and willing. I haven’t asked her yet!

I would want David to be with me through any and all procedures. We have no secrets and he has already seen things and done things for me that no husband ever should. I want him with me every step of the way.

The next thing to think about is positions for labour. In an ideal world I would like to remain active. I would like to be able to move around as I know that if I am lying down I will focus more on the pain. I like the idea of being up on all fours when I cannot be moving around. But I guess what will be will be. I delivered Esther and William in theatre, on my back. If this was my first pregnancy and everything was straightforward I would have loved a water birth, but for me that is not meant to be.

My first choice for pain relief will be gas and air as I had with Esther and William. I would like to try and give birth using only this if at all possible. If not then I would like to use whatever pain relief is least harmful to the baby and at this point I have no idea what that is. From what I have read it seems all drugs pass through the placenta to some degree. I am looking forward to learning more about my options with the NCT.

After the birth David is not fussed about cutting the cord when I ask him now but I would like him to be given the option at the time as he may feel differently then. We are 99% certain that Matilda is a girl, should that turn out not to be the case then I would like David to be the one to tell me. I would like our daughter (or son!) to be delivered straight onto my tummy and I want to breastfeed them if I can.

So that is my birth plan so far. I bet the reality will be nothing like the birth I imagine but I hopefully have a few weeks yet to enjoy the dream, or experience the nightmare.

My main question that I cannot find an answer to is will labour me so much more painful at full term than at 27 weeks? That is what I really want to know.

Bump Watch: 23 Weeks

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Thank You William Harvey! You Saved Our Lives!

2nd January 2010

Name someone who deserves more credit than they get. And for bonus points, how to change things so they get more

This is an easy one!  The staff at William Harvey Hospital in Ashford, Kent.  Particularly a midwife named Fiona and the whole NICU/SCBU team, each and everyone of them provide care above and beyond their call of duty.  And I thank them all from the bottom of my heart.

On the 10th July 2010 I was rushed into the William Harvey Hospital.  I was almost 26 weeks pregnant and feared the worst.  I was losing my babies.  We were taken straight to the Labour Ward where it was discovered very quickly that actually the babies were fine, the problem was with me.  I was given steroid injections to mature the babies’ lungs just in case I did go into labour, but that wasn’t to be.  Not yet.  It took 2 days of agonising pain and absolute fear for my fiance before I was operated on for a twisted bowel.  Before this stage he was sure that we were going to lose the babies and there were times when we thought that I might die.  I wanted to die rather than have anything happen to our babies.

The surgeon miraculously cut me from just below my chest bone to just below my belly button without disturbing the twins.  It took me 10 long days in hospital  and a blood transfusion to begin to recover from the op.  I was nil by mouth and then had to drink yoghurt drinks before being reintroduced to solids.  My whole body was swollen from pregnancy and water retention.  I was on oxygen and in and out of consciousness.  I was a mess!  I stayed two days in ITU before being kept on the labour ward for 8 days where my care was overseen by Fiona.  She was amazing, really looking after not only me but my fiance too.  Everyone who cared for us was wonderful and steered us through a very rough sea.  After 12 long days I was allowed to go home.  Everyone wished us well and said they would see us again in 13 weeks for the babies to be born.  72 hours later we were back and this time I was in preterm labour and I was terrified.  Once again Fiona was there, this time to welcome our children in to the world.  It was so fitting that she should be there to welcome Esther and William.

I went home from hospital just hours after the birth but at 27 weeks gestation it was without my babies.  For 59 long days and nights they were cared for by the fabulous doctors and nurses in NICU/SCBU.  This expert team cared for our babies and also looked after me as I adjusted to life as not just a mum, but a mum of twins and extremely premature twins at that.  You can read about them in this blog and understand what a fabulous job they do for very little recognition or thanks.

Thank you to everyone at William Harvey Hospital, Ashford, Kent.  Thank you for helping my family get such a fantastic start and for supporting us, giving the babies time to grow bigger and stronger before we brought them home.  Thank you x