Does the due date exist? ‘Initiation is not mandatory’

The term of pregnancy has been calculated since the year 1812 by taking the first day of the last menstrual period: from that moment on you are in week 1 of your pregnancy. Strange actually, because then no fertilization has taken place yet. In addition, this calculation assumes that a cycle lasts 28 days, while for one it can be 21 days and for another 35 days. The ovulation will then be exactly in the middle, but this also differs per person. Is the concept of the due date obsolete?

That could well be the case, say some experts in this field. Ultimately, the baby will come when it comes and the woman’s body is made to indicate this. A due date can also cause quite a bit of unrest, because what if you go over that date? Then you soon have to deal with protocols and ‘what if’ questions from the outside. Your pregnancy will then be negatively affected and that in turn will have negative consequences for your delivery.

Why does a due date cause unrest?

Many pregnant women stick to that specific due date, even though only 3 to 5 percent of women actually give birth on that date. At the end of your pregnancy you are therefore pregnant: the waiting for your little one has begun. When that specific date approaches, you may become restless. When the date goes by, you might be worried because ‘what if it goes wrong’. Stripping is often discussed around forty weeks of pregnancy and the scenarios of being ‘overdue’ are discussed. Terms such as ‘induction’ pass by and women often receive comments such as ‘but after 40 weeks the chance of stillbirth is much higher, isn’t it?’.

You often get the question from your environment whether you have already given birth: this can cause nerves. That is a pity, because these statements result in worry and stress about perhaps nothing at all for the pregnant woman. For example, the chance of stillbirth after 40 weeks is still very low, especially if both baby and mother are healthy. In the latter case, the chance of stillbirth goes from 0.8 in 1000 to 0.88 in 1000 with a pregnancy that goes from 41 to 42 weeks, says obstetrician Margot van Dijk here. In other cases, the chance is still small: from 2 in 1000 to 3-4 in 1000. Stress affects the production of birth hormones and all these negative influences together can lead to the choice for an introduction.

Is an introduction so negative?

You will eventually deliver when you and your baby are ready. Your body is made for this. Of course this is about women who have a healthy pregnancy, are healthy themselves and have a healthy baby in their womb. Inducing means giving birth when your body and your baby are not yet ready. This can have a major impact on both mother and baby.

According to van Dijk, an induction is chosen too quickly: “We are talking about 1 in 3 women being induced. Not all because of overdue: 20 percent of women are 41 weeks pregnant and 2 to 5 percent are 42 weeks.” She also says: “We are very focused on that date; when it passes, women feel deviant, as if something is going horribly wrong. That is not true; 42 weeks of pregnancy is normal, and so is 37 weeks. The body is so genius that it itself indicates that it is ready to give birth, why should we know better and start introducing it? An introduction has a real impact on your delivery and on your baby.”

Disadvantages of an introduction due to protocol:

• more frequent caesarean section
• a request for pain relief more often (which can have negative consequences)
• you have a lot less freedom of movement during your delivery
• a delivery that lasts longer
• greater chance of a negative delivery experience
• greater chance of an intervention such as a cut
• a forced birth that the baby is not yet ready for
• problems with feeding in the baby after birth
• anxiety in the baby
• problems with temperature regulation in the baby

Do we have to get rid of that due date?

According to researcher Anne Marie Jukic, the average time between ovulation (the moment of your ovulation and therefore your fertile period) and birth is 268 days, which is 38 weeks and two days. That is not measured from the first day of your period, so there is quite a difference. The same study found that the length of pregnancies can vary by as much as 37 days. So more than five weeks. That means that giving birth before and after that period is also quite normal. Based on these results, a calculated period would therefore be much more logical and calmer for the pregnant woman than a specific due date.

It also turned out that many other factors influence the length of time a woman is pregnant (and this also varies from person to person):

• your age: older women are generally pregnant longer
• women who were themselves heavier at the time of birth often give birth later
• with a previous longer pregnancy, the chance of a subsequent longer period of gestation is greater
• some embryos take longer to implant in the uterus and therefore stay in the abdomen a little longer
• an early rise in maternal progesterone allows for a longer gestation period

So you see that many factors play a role in the gestation period of a pregnant woman. Van Dijk also advocates a calculated period: “Women should be better informed about the disadvantages of an induction, including those in the long term. We are not machines, the cake is not finished after 41 weeks. I am in favor of setting a delivery month and not a due date. It puts pressure on the kettle and makes women nervous.”

Protocols also cause stress for the pregnant woman

Not only the statements and thoughts of others around the due date can cause unrest. Protocols can also cause stress for the pregnant woman. If you are still pregnant after 41 or 42 weeks, this is called serotien in the medical world. This happens in 5 out of 100 pregnant women. According to the protocol in the Netherlands, you will be transferred to the gynecologist after 42 weeks. Actually, an introduction is always advised at this point. Around this period, problems can arise with the placenta that can work less well. As a result, your baby receives less nutrition or less oxygen and babies defecate more often in the amniotic fluid, which can be harmful.

What many women often don’t know is that an introduction is a choice. Van Dijk says about this: “Care providers also often pretend that it is mandatory, induction at 42 weeks. That’s not it.” The most important thing for pregnant women to know is that they always have a choice. So make sure you are well informed with your healthcare provider so that you do not make hasty decisions that you may regret later. And the due date? “Take that with a grain of salt.”

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