Whether or not you’ll be induced depends on your own health, the status of your cervix and the baby’s well-being as determined by a non-invasive procedure called fetal non-stress testing. The conditions inside your uterus after your due date may also stress the baby during labor and vaginal delivery. As a result, Warshak says, “Even if your cervix is at 8 centimeters and labor is progressing, we’ll do a C-section if the baby is not tolerating labor well.”
The midwife philosophy Midwives tend to wait a little longer than OB-GYNs do. “In our practice, we wait until 42 weeks for women to go into labor naturally,” says Joanne Hasman, C.N.M., a certified nurse-midwife at Special Beginnings Birth and Women’s Center in Arnold, Md. “If they don’t by then, we schedule an induction at our hospital. We also try natural methods and refer women for acupuncture, reflexology or reiki.”
At 40 to 41 weeks, if your cervix is dilated at least 2 centimeters, the midwives in Hasman’s practice perform what’s called a “cervical sweep,” using a finger to separate the cervix from the amniotic sac. This can sometimes kick-start labor. “If the woman is really ready [to go into labor], I’ll see her back here in 24 to 36 hours,” Hasman says.
The C-section question
An ongoing concern has been whether induction, as opposed to what’s known as expectant management (waiting for labor to start spontaneously while monitoring the mother’s and baby’s well-being), might lead to a higher risk for emergency Cesarean section, and studies have been conflicting. But a new Danish study of more than 230,000 women found that inducing labor from week 39 to week 41 is not connected with higher C-section rates compared with waiting for labor to begin spontaneously or inducing labor later.
Playing the waiting game
Backaches, heartburn, hemorrhoids—at 40 weeks all you want to do is hold your baby in your arms. Here are a few tips to help you cope:
■ MAKE GOOD USE OF YOUR EXTRA TIME Sleep. Finish the nursery. Stock your larder with ready-made meals. Address birth announcements and thank-you notes.
■ CREATE A BLOG OR VOICEMAIL MESSAGE Keep family and friends up-to-date with a daily blog entry, such as: “Just visited the doc, who said everything’s fine.” Record a new voicemail with an upbeat message: “No, baby’s not here yet. Thankfully, we’re all healthy. Keep checking this message for daily updates!”
■ SHUN DIY LABOR STARTERS “There are no home remedies that reliably and safely initiate labor,” says maternal-fetal medicine specialist Carri R. Warshak, M.D. “If there were, we’d use them in the hospital.” Castor oil can make you sick and dehydrated. Spicy foods can give you heartburn. And, she says, no good studies back the claims that sex or exercise can trigger labor.