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You worked until the week of your due date. Your hospital bag is packed. Your have a new haircut and a fresh manicure. Your due date has come and gone. Your mother in law is posting baby-related messages on Facebook every day. You are tired of saying to all the friends and relatives: “No-no, the baby is not here yet”. You are too heavy to move, too uncomfortable to sleep. You cannot plan your social life more than one evening in advance – and you have seen all movies worth seeing in the local cinema. But this baby of yours is not in a rush.
I am speaking from experience here.
10% of women will go over their due date. 40 weeks, 41 weeks, 42 weeks, and still no sign of contractions. What to do? Well, you always have a choice of medical induction (in fact, your midwife or doctor will suggest it stronger and stronger as time goes on). But if you want to avoid it, what else can you do?
My pregnancy was low risk and I was referred to a local birthing centre. The midwives there were really nice, but they never discussed with me the topic of “being overdue”. Their usual response was “oh, it can happen any day now, may be even tonight”. In their world people either came with contractions or disappeared back to the hospital labour ward. So I had rather a harsh landing when the doctor I saw on my 41 weeks + 5 “visit to discuss my options” said “OK, and now we are going to induce you”. It was not what I wanted. What I wanted was a list of actions to try to go into labour naturally. I wish I had it handy on my due date. So I wrote it all down in this blogpost.
Disclaimer: You can try these things once the baby is considered “full term” – from week 37. Always check with your doctor/midwife first in case of any contraindications. There is no scientific evidence that these methods help bring on labour. In most cases, either noone has done a clinical trial on them or the clinical trials have been small and inconclusive.
But it is hard just to sit and wait so you may as well do something that may help and will not hurt.
Acupuncture. Go to an accredited acupuncturist who specializes in pregnancy and women’s health. Ask midwives or mums in your antenatal class. And once you get one good specialist they will recommend others. This is a small world and people tend to work together.
Reflexology (foot massage). Personally, I found it more enjoyable than acupuncture.
These two methods are not cheap (£60-70 per session and you may need a few sessions). Cheaper (or free) alternatives:
Homeopathic medicines, for example, Caulophylum 200C. Ask your pharmacist for the right dosage.
Aromatherapy using clary sage, nutmeg and lavender oil to stimulate contractions (or just clary sage).
Have sex. Semen has prostaglandin which can help ripen the cervix. Medical induction also involves prostaglandin pessary.
Walk up the stairs sideways. It can help the baby head to engage.
And then, I guess, eating pineapple, dates and hot curry (but only if you like them).
According to this clinical trial raspberry leaf tea doesn’t bring on labour, but shortens the second (pushing) stage.
UK NHS recommends induction at 41 weeks + 5 days. If you are in private care your doctor may suggest induction as early as 41 weeks. There are also some medical conditions (like gestational diabetes) where doctors will recommend an earlier induction, say, at 40 weeks. Most people would go for an induction at the recommended time, but often they don’t know that they have a choice. The choice is to “wait and see” and opt for continuous monitoring. I had to come to the hospital every 2 days to get the fetal heart beat monitored. I also requested and got an extra ultrasound scan after 42 weeks (it only took the midwife 10 minutes, confirmed baby’s position and showed us that there was enough amniotic fluid still).
If you are considering not going for medical induction, educate yourself about risks of prolonged gestation. NHS will give you a booklet that talks about the risk of stillbirth increasing from 2-3 per 1000 to 5-6 per 1000. Here is an American article talking about other risks (that I found informative and quite scary).
Here is a good blogpost talking about risks of induction itself: Should I stay or should I go.
Here is a website with stories of women successfully giving natural births past 42 weeks. There are also a lot of positive stories about women having an induction and a good birth experience afterwards. It is easy to find evidence whatever your view is.
In the end, I had to go for a medical induction at 42+4 because my waters started leaking. But then I felt that at least I did everything I could.