Close-up on weathered gray sundial in the Hatley Castle Gardens, Victoria, British Columbia (Miranda Hernandez)
Sundial in Hatley Castle gardens, Victoria, British Columbia (Miranda Hernandez)

Going Overdue in Pregnancy; a Case Study

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Going overdue in pregnancy is common. The average first-time mom goes into labor naturally at 41 weeks, 1 day. Following the publication of the results of the ARRIVE study, there has been talk recently about recommended induction at 39 weeks. Some are cautiously for this proposal. Some are not. This is one case study about a patient who refused — me.

I have always been drawn to the natural community, and so when I was pregnant with my first child, I wanted to do all the “traditional” natural things — I interviewed doulas at 6 weeks. I saw the providers paid for by my insurance, but I also did concurrent care with midwives. I signed up for childbirth classes under the Bradley method, and I planned for how I believed things should be.

I have always been drawn to the natural community, and so when I was pregnant with my first child, I wanted to do all the "traditional" natural things: doula, midwife, Bradley Method...This is what I forgot...
(Miranda Hernandez)

At exactly 35 years old, I was considered advanced maternal age, and my insurance-covered providers recommended induction at 39 weeks. My midwives told me this wasn’t necessary, and that “babies come when they’re ready.”

I heard this from other people too. I even read somewhere that labor is stimulated when the baby releases an enzyme indicating lung development is complete. It seemed to make sense. And so when I told my insurance-covered providers that I didn’t want an induction, I genuinely thought I was doing what was right for both my child and me.

Although I wanted minimal interventions, I was not opposed to non-invasive testing. I did the screening for gestational diabetes and GBS, and passed both. My midwives also tested my urine at each visit. And starting in my 36th week of pregnancy, I began regular appointments for non-stress testing. None of these tests revealed any problems. My son always even seemed to “perform” for the non-stress tests, and always passed with flying colors. And I guess I lived under the assumption that if anything was wrong, my providers would see it.

They didn’t see. My son died on the morning of my 41st week of pregnancy, and nobody had suspected a thing.

So here is my dilemma — how do I make sense of these things I used to believe? How do I acknowledge the beauty of doing things naturally, and simultaneously accept that nature isn’t perfect? That some bodies aren’t built to labor without modern medicine? That some pregnancies don’t end in a healthy living child?

Here is my dilemma -- how do I make sense of these things I used to believe? How do I acknowledge the beauty of doing things naturally, and simultaneously accept that nature isn't perfect? That some bodies aren't built to labor without modern medicine? That some pregnancies don’t end in a healthy living child?
(Miranda Hernandez)

How do I make peace with the fact that even with the most careful monitoring and yards of positivity, nothing in life is guaranteed?

The title of this post indicates this is a case study. I am telling you my story, but I understand I can’t make choices for any others. What I do want to do is share information. Because before my son died, I thought stillbirth was something that happened in 1 out of one million pregnancies. And if I had known the true numeric risk, I would have done have done things differently.

These are the things I wish I had known before I allowed my pregnancy to go overdue:

  • 1 in 160 pregnancies will end in the death of the child at or after 20 weeks of pregnancy.
  • Not every body is capable of carrying a pregnancy to term or afterwards. Sometimes our bodies fail, and sometimes they fail without warning.
  • The risk of stillbirth rises for every day a pregnancy proceeds past 39 weeks.
  • You can do all of the recommended testing, and communicate everything you’re feeling to your provider, and still never be 100% certain everything is okay.
  • When the nurse rushes out of your exam room and then you see the doctor’s lips move and you don’t hear the words but instead you feel them in your bones, you will regret everything. But by then it will be too late.

My son died almost 3 years ago. And I have only recently developed the strength to talk about how to prevent this for others who were led to believe the same as me. I have only recently developed the motivation to write this article, and to share my story.

And yes, I know so many women who have gone one week, or two weeks, or even longer past their due date, and their children are perfectly fine. I am not refuting that. Stillbirth “only” happens in 1 out of 160 pregnancies. And because it is relatively uncommon, you will hear many positive stories from those who have gone overdue. You will likely hear 159 stories for every 1 like mine. But while 1 in 160 seems like a small number, when you put it into context, its impact is immeasurable. I will live the rest of my life without my firstborn child.

I know so many women who have gone one week, or two weeks, or even longer past their due date, and their children are perfectly fine. I am not refuting that. Stillbirth "only" happens in 1 out of 160 pregnancies. And because it is relatively uncommon, you will hear many positive stories from those who have gone overdue. You will likely hear 159 stories for every 1 like mine. And while 1 in 160 seems like a small number, when you put it into context, its impact is immeasurable.
(Miranda Hernandez)

So please be cognizant when talking to someone who is or is about to be overdue. Because you can’t know for certain that everything is going to be fine. And yes, while my story is only one possible outcome, it is still worth considering. Because knowing this information could have saved my child’s life. And it might save your child too.

Related Posts:

Miranda’s Story: Problems in my Pregnancy?
Miranda’s Story: 29 June 2017
Pregnancy Blog: 8 Factors to Consider Before You Go Overdue in Pregnancy
Miranda’s Blog: Survivor’s Bias
Pregnancy Blog: Stillbirth & Statistics; What Does it Mean to be “Rare”?

Downloadable graphics:

Evidence-based information in support of safe and informed pregnancy. NOT medical advice—please discuss questions with your medical provider.
Return to Resources for Expecting Parents

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