Post Term Pregnancy

Pregnant woman in hospital bed
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You are excited about your pregnancy and the birth of your new baby!

And now your due date has come and gone. You are eager for your baby to be born, but now you are anxious for labor to begin. And, you are exhausted.

What happens if you go beyond your pregnancy due date?

In order for your pregnancy to be considered a post-term pregnancy, your pregnancy must continue two weeks past your due date. These pregnancies can be associated with problems of the placenta and/ or the baby. Your healthcare provider will do testing to check the status of the placenta and your baby to ensure all is well.

Post-term pregnancies are associated with the following:

  • first pregnancy;
  • personal history of a post due dates pregnancy;
  • maternal obesity;
  • incorrect calculation of your due date;
  • your baby is a boy.

Health care providers calculate your due date to be 40 weeks, or 9 completed months, from the start of your last menstrual period. Any pregnancy that goes beyond 40 weeks is considered a post due dates pregnancy; any pregnancy that goes beyond 41 weeks to 41 weeks and 6 days is considered a late-term pregnancy, and any pregnancy that is at 42 weeks or extends beyond 42 weeks is called a post-term pregnancy. Are there any risks associated with a pregnancy beyond your due date?

Health care providers know that these types of pregnancies can increase the risk of certain delivery complications such as severe vaginal tearing, postpartum bleeding, and infection.

Health care providers also know that pregnancies that go beyond 42 weeks are at increased risk of:

  • having a larger than usual baby at birth (fetal macrosomia) which in and of itself can cause complications with the delivery process including shoulder dystocia and injury to the nerves of the shoulder, arm, and hand of the baby;
  • a decrease in the amount of amniotic fluid surrounding the baby called oligohydramnios, which can lead to compression of the umbilical cord during contractions and may affect the blood flow and oxygen flow to the baby;
  • a condition called post-maturity syndrome, in which the vernix (cheesy coating on the baby) decreases, the lanugo (soft downy hair on the baby) decreases, and meconium staining occurs from the baby having a bowel movement inside the uterus. Meconium can be swallowed in utero by the baby causing problems with breathing when the baby is born.

Health care providers also know that when the placenta becomes too mature, it begins to function less efficiently. Babies that go beyond 41 weeks have a threefold increase in the risk of stillbirth (death of the baby before birth), and babies that go beyond 42 weeks have an even greater risk of stillbirth.

As long as you and your baby are doing well, your health care provider will continue with your prenatal care.

If you are still pregnant more than one week past your due date, your healthcare provider will likely begin testing to assure fetal well being. This testing will likely include fetal heart rate monitoring in the form of a nonstress test. A nonstress test involves placing a fetal monitor on the mother and careful observation of the fetal heart rate usually over a 20-30 minute time period.

Your healthcare provider will likely also perform an ultrasound to monitor the level of amniotic fluid around the baby. This may include a biophysical profile which evaluates fetal breathing movements, muscle tone, and amniotic fluid levels to determine fetal well being.

In certain situations, delivery might be recommended based on the results of these tests.

It is important that you and your health care provider have a continuous dialogue regarding what plans are in place for your pregnancy and delivery especially if your pregnancy continues past your due date.

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