You counted down the days to week 40, waiting to finally meet your little one, and your due date came and went. You may be feeling disappointed, frustrated, or anxious. You’re physically uncomfortable and tired, emotionally exhausted from feeling on edge as if any moment could bring labor, and just so ready for baby to be here. Let’s look at week 41 pregnancy and beyond — risks, tests, postmaturity, and (what feels like neverending) waiting.
Estimated reading time: 7 minutes
Updated August 6, 2021
You’ve spent a very long time with a particular date in mind. You’ve been counting toward that due date. And knowing that your baby could come early, you were probably on alert for weeks before your due date. For many moms, the long wait for baby’s arrival can turn excitement and anticipation into frustration.
Remember that a normal, full-term pregnancy is anywhere between 37 and 42 weeks. Your due date is really just a general idea of when baby will come. In fact, only 5% of babies are born on their due date (1). Not only do many births occur after the 40th week, but 7% of pregnancies last 42 weeks or longer (2). It is only in these cases — the ones where a pregnancy reaches 42 weeks — that baby is considered post-term or overdue. You may hear people use the word overdue once they’ve passed their due date. But the reality is that all the way up to 41 weeks, 6 days, your baby is still just full-term.
As you wait, try to relax knowing that baby will be here soon. Continue to take care of yourself. Eat healthy foods and keep drinking plenty of fluids. Eating may be uncomfortable, as the ever-growing baby continues to take up space where digestive organs used to be. Remember that multiple smaller meals throughout the day can combat this.
Try to get some exercise if you can do so without pain. The most comfortable activity at this point may be swimming or spending time in a pool. The water takes the stress off of your joints and achy body, and you don’t have to worry about keeping your balance. Rest and relax as much as you can; baby will be here soon and the demands of labor, delivery, and life with a newborn could lead to fatigue.
The risks associated with carrying a baby beyond the due date are very small, and in fact, these don’t become a concern until after week 42. Still, it’s best to be well-educated in case you do reach the point where your healthcare provider starts talking about things like extra testing or even considering induction.
The main risks associated with a pregnancy that passes 42 weeks are utero-placental insufficiency, decreased amniotic fluid, and postmaturity syndrome.
In pregnancy, the placenta provides respiration and nutrition for baby. But it’s an organ with a limited life — we’re not meant to have a functioning placenta indefinitely. In a post-term pregnancy, the placenta starts to get old and may not function as well as it did earlier in pregnancy. With time, it may fail to provide the respiratory function and essential nutrients baby needs. (2)
As baby grows, there may be a decrease in the amount of amniotic fluid. This drop in fluid levels tends to be much more common after 42 weeks. During pregnancy, the amniotic fluid acts as a cushion for baby inside the womb. Having less of it increases the chances that the umbilical cord could become pinched as baby moves or as the uterus contracts, ultimately decreasing the flow of oxygen to baby (2).
About 20% of post-term babies have postmaturity syndrome, or dysmaturity syndrome (3). This is a group of symptoms resulting from insufficient nutrition from the placenta. It includes: thin, wrinkled, peeling skin; a thin body; long hair and nails; and frequently the passage of meconium (3).
Remember that while these things may sound worrisome, most women who give birth even after 42 weeks deliver healthy babies. The fact that the risks exist just means that your caregiver will watch your baby carefully. If your baby shows any signs of stress, your provider will talk to you about the option of inducing labor.
One of the risks of a post-term pregnancy is that your baby will be larger than average. This makes sense, as he has had more time to grow, and babies do put on a lot of weight in late pregnancy — as much as a half pound a week. Macrosomia doesn’t mean that anything is wrong with your baby, it just means that a vaginal delivery could be more difficult or that you may have an increased chance of a cesarean delivery.
Meconium is the first stool that baby passes, typically within the first few days after birth. Sometimes, baby passes some meconium while still in the uterus, and as baby “practices breathing” by inhaling amniotic fluid, he may inhale meconium. In most cases, there are no complications from meconium aspiration syndrome. However, sometimes baby can get very sick, and it is one of the leading causes of serious illness and death in newborns. (Remember, these cases are rare. It’s important to understand the seriousness of complications, but also to understand that in the vast majority of cases, there are no complications or mild ones.)
Your doctor or midwife will monitor your baby’s health after your due date has passed. He or she may ask you to do kick counts at home. Other tests may be done in the doctor’s office or at the hospital. These include:
During a Nonstress Test, a fetal monitor is attached to your belly. You press a button every time you feel your baby move, and the monitor records the baby’s heartbeat. Heart rate usually goes up with movement, so comparing these things can give your doctor an idea of how baby is doing.
We discussed the biophysical profile test last week at 40 weeks of pregnancy. It is another way of assessing baby’s health. Doctors assign a 0, 1, or 2 rating to each of the following categories:
The NST part of the BPP is done with an external fetal monitor, and the other four tests are done by ultrasound (1).
This is also called a stress test. It helps the doctor see how well the baby will tolerate contractions during labor. A monitor is placed on your abdomen and you receive small amounts of oxytocin through an I.V. to make your uterus contract. (This is not enough to induce labor; just enough to cause some contractions so doctors can see how baby handles them.) Baby’s heartbeat is then monitored for response to the contractions.
As mentioned above, a pregnancy isn’t post-term (or overdue) until it exceeds 42 weeks, or 294 days from the first day of the last menstrual period (1). There’s no need to worry if you are at more than 40 weeks’ gestation. Remember, most babies born even past 42 weeks are healthy; however, it’s rare for a woman who delivers at a hospital birth to have a pregnancy that lasts beyond 42 weeks without labor induction. At 41 weeks, there may be some additional monitoring involved to be sure things look good. But if your baby is healthy and active, you’ll likely just be monitored until labor begins on its own. Once again, it’s all about the waiting!
Kopa Birth’s online childbirth classes allow you to prepare for a natural childbirth from the comfort of your own home, 24/7. Enroll today in our free online childbirth class to learn more about preparing for a natural hospital birth.
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You counted down the days to week 40, waiting to finally meet your little one, and your due date came and went. You may be feeling disappointed, frustrated, or anxious.
