There's a myth, or rather a mindset, being perpetuated heavily in our birth culture, that you have to "do" things to make labor happen. That it won't just happen on its own.
Women say things like, "I never went into labor on my own, so at 41 weeks I was induced."
"Baby's head wasn't engaged by 39 weeks, so doctor induced me."
"I have ZERO signs of labor! What can I do to make my body do what it's supposed to?" (said at 38 weeks).
The mindset is a belief that if we don't DO something, or if our bodies aren't matching the expectation and experience of ourselves, our doctors, our mother-in-laws or other family, or that one blog we read, then it's "broken", "not working", and "needs to be fixed".
Here's the truth.
Your body is WORKING PERFECTLY if you're dilated to one centimeter at 41 weeks pregnant.
This happened with my firstborn. I was dilated to one centimeter until FOUR HOURS BEFORE HE WAS BORN. FOUR HOURS - that's how fast my body changed!
Your body is WORKING PERFECTLY if you are dilated to a four or five towards full term and still aren't in labor.
A woman I know was dilated to a SIX with her third baby for SEVERAL WEEKS before labor started.
Your body is WORKING PERFECTLY if you have contractions on again, off again, painful and regular, every day or every other day for a couple weeks with very little change in dilation or outward progression.
Often times this is called "prodromal labor" or "false labor". Baby's position, your body's alignment and readiness, the hormone receptors in your body, your stress levels, your nutrition, etc. can ALL play a part in the incredible dance of labor.
I get it. You're exhausted. You're excited. You've waited nearly nine months for this baby to come, and you are READY, dang it. As someone who has personally waited as long as 42 weeks + 3 days for one of her babies to choose her birthday, I GET IT.
But so does your midwife when they say WAIT. And often accompanied with that WAIT is the much-needed, rarely-honored advice to REST.
Why is it so important to rest? Why SHOULDN'T we bounce on the ball, drink castor oil, try that herbal remedy and this farmwives' tale, eat pineapple and spicy food until our tongues and tummies burn?
Well, mostly because all of those suggestions done together will exhaust your body and give you bad digestion or even diarrhea. So if you are successful in starting labor, you'll be so worn out you may not be able to run the final marathon!
This mindset was largely brought about by the induction-happy medical culture we're surrounded by. I had someone almost every day asking when I would be induced as I passed 40 weeks, then 41, then 42 with my third baby. I simply responded "Nobody will induce my baby unless there's a medical complication." We kept monitoring, I felt her kicks, and I was satisfied with waiting as long as my baby was healthy. What the medical community doesn't quite understand is the importance of waiting. Induction can cause so many maternal and infant complications, complications that aren't recognized or given proper weight because of the "authority" given to medical intervention. If you "had" to be induced, after all, then any complication you have was NECESSARY, right?
Not so. The number one reason for induction is going post-dates, and the "danger" of waiting is based on a VERY tiny number - less than 1 in 1000 babies die due to post-dates complications at 40 weeks. The number only goes up a fraction for those that go to 41 and 42 weeks. Yet, to avoid that 0.1% statistic, 60-80% (depending on your hospital and care provider) of pregnancies are induced, forced into labor based on an arbitrary, averaged time-line. (See evidence-based articles with studies and results HERE and HERE)
That doesn't even take into account the idea that women have different gestational lengths. My friend has been pregnant the same time as me with all three past babies - and each time has had a labor that naturally starts at 36-38 weeks, and results in a healthy newborn baby. In contrast, all of mine have naturally gone past 41 weeks, the last one past 42, and I also have healthy newborn babies. Want more experiences and evidence? Head over to the Facebook Group "10 Month Mamas" and read about the women there who go all the way to 43, 44, even 45 weeks - NATURALLY. WITH EVERY BABY. And have healthy, normal-sized babies. We don't all have the same length of period, same fertility cycle, OR same pregnancy length, regardless of what doctors tell us.
Our mindset has been skewed by this culture of medical intervention. We believe that pregnancy should only last 39, maybe 40 weeks, and we think "What's one more week? What's a few more days? Why can't I see my baby now and be done with this whole pregnancy thing?"
The difference might be your body ACTUALLY being ready, preventing a cascade of interventions that harm you or your baby long-term, even might prevent a c-section.
The difference might be your baby's lungs being more ready to breath on their own, preventing time in the NICU that is stressful for you, your baby, and your family.
The difference might be your baby gaining another POUND OR MORE of healthy, needed weight.
(Ultrasounds are notoriously off when estimating weight - many women might be told they're having an 8, 9, 10 lb baby, and yet they are induced and have a 6 pounder who has to spend time in the NICU. These stories are everywhere. ACOG (see below) doesn't agree with the use of ultrasounds at the end of pregnancy.)
ACOG (the Americal Congress of Obstetricians and Gynecologists), states the following about what "full term" means:
Increasingly, research has shown that neonatal outcomes, especially respiratory morbidity, vary depending on the timing of delivery within this 5-week gestational age range. To address this lack of uniformity, the label “term” [has been] replaced with the designations early term (37 weeks through 38 weeks), full term (39 weeks through 40 weeks), late term (41 weeks through 41 weeks), and postterm (42 weeks and beyond) to more accurately describe deliveries occurring at or beyond 37 0/7 weeks of gestation.
Basically, this evidence reveals that women CAN give birth any time in at least a 5 week period (commonly recognized between 37-42 weeks), but that doesn't mean YOU should. Some women have healthy babies sooner. Others need to wait longer. But neither a doctor, an ultrasound, or you can really determine when your baby should be born. So unless there's a major medical indication (fetal distress, lack of growth, significant maternal medical problem), JUST SAY NO to medical induction!
What about the growing culture of "self-induction"? Same problems, except this exacerbates the "need for induction" mindset even further. Because if you try EVERYTHING and nothing works, then what? So many women take on mistaken beliefs of "body failure" and lose empowerment, confidence, and trust in their own intuition when they try to force it when their bodies simply aren't ready.
So the best thing you can do when you get to 37 weeks and you're "ready to pop"?
When you really, seriously think about labor as a marathon, you might start to understand. I love these suggestions from a website I found online:
This article was inspired by a doula client I heard about, and several posts on a Facebook community group I follow. For several days she had irregular, hard contractions every 15-30 minutes or so. She bounced, she walked, and really worked herself up trying to get labor going. She finally decided to go to the hospital for an epidural, and when they checked her (still contracting every 15-30 minutes), she was at a SIX. She had been in labor the whole time, just very long and drawn out in an atypical pattern.
Now, in the end she had a pretty good experience. A full day of labor on pitocin and epidural, which her body fortunately responded to, and a healthy baby was born.
I simply relate her experience to show how getting her mindset all worked up about "not being in labor" and "trying to get it started", really worked against her, and led her to completely change her out-of-hospital, natural birth plan.
In reality, there was nothing to "start", she just needed to rest and have confidence and patience for how her body labored. There is value in the rest that's being prescribed.
But what if your doctor is pushing induction? What if they even set a date?
You have a few choices.
You can be induced. That's fine. Many women choose this, and many women have healthy babies. There are consequences to induction, but if you're prepared you might be able to prevent many of them (start by hiring a doula!).
You can show your doctor the articles mentioned above about the safety of going post-dates (past 40 weeks) and have your induction date moved to after 42 weeks.
You can request to be monitored with NST (non-stress tests) every few days.
You can also "forget" to show up for your scheduled induction, which may be an option if you are very against induction and your doctor isn't supportive (this is NOT medical advice to miss your induction - simply an option to consider for you to make a wise decision based on your individual circumstance).
If you're planning a home or birth center birth and going past 42 weeks will "risk" you out of your midwives' care, here are some considerations:
Have an OB on back up that YOU have chosen who supports your plans for an un-medicated birth. You don't have to see them during pregnancy, but visiting a couple times to build a relationship is recommended.
Self-induction methods you read about online aren't always safe, even if they're natural. Ask your midwife before using castor oil, black or blue cohosh, or any other herb or supplement.
Self-induction methods are typically mere "catalysts" for labor beginning. That means if your body isn't ready, having sex five times or eating that crazy "labor inducing" food simply won't work.
Self-induction is still induction, and you might bump baby out a little soon. Are you prepared for that?
And remember: Just because you transfer care doesn't mean you have to have an induction. Even after 42 weeks, if you feel comfortable and confident continuing your pregnancy, request NSTs every few days, be firm in your decision, and don't go into the hospital until you're in labor!
There's a different "right answer" for every woman. Do your research on the safety of different induction methods (breaking water, stripping membranes, pitocin, cervadil, cervix softeners/ripeners, etc), find your support, and trust that you have the ability to make the BEST decisions for you and your baby.
Here's to your happy, healthy pregnancy, birth, and postpartum recovery!
Wife. Mother of three. Doula. Lover of cats, books, and chocolate. Filled with hope for humanity and joy with every new baby!