Going Past Your Due Date: Answers to Common Questions

The following is a brochure that I made for my doula course. If you would like copies to share, please let me know :)

Q. How is a due date determined?

A. The modern 40 week due date is based upon Naegele’s rule which assumes that all pregnancies last for about 280 days from the first day of the last menstrual period.

Q. Are due dates accurate?

A. Naegele’s rule assumes that all women have a 28 day cycle and ovulate on day 14, however, this is not true of all women. Some women have significantly shorter or longer cycles. One of the dangers of making this assumption for all women is that if a woman with a longer cycle were to have her baby forced out prematurely based on the LMP (last menstrual period) the baby could have long term consequences from the premature birth.

Q. What about due dates found by ultrasound?

A. When a woman’s LMP is unknown, ultrasounds are often used to find an EDD (estimated due date). Ultrasound scans taken early on in the pregnancy have an EDD accuracy of +/- 4-5 days at 12 weeks gestation, whereas, scans taken past 12 weeks only have an accuracy of +/- 7-10 days.

Q. Are most babies born on their due date?

A. If pregnancies are left to themselves, 50%-80% of them will continue past 40 weeks. Only 5% of babies are born on their due date with 10% arriving after 42 completed weeks.

Q. What are the risks of going past your due date?

A. The greatest concerns for pregnancies continuing past 40 weeks gestation are Postmature Syndrome and an increased risk of stillbirth. Postmature Syndrome is caused by the placenta failing to provide adequate nutrients for the growing baby. Symptoms of Postmature Syndrome range from minor ones such as longer fingernails and toenails to more severe symptoms such as impaired breathing or meconium aspiration. The risk of stillbirth has a slight increase as the pregnancy continues past 40 weeks with a .12% at 40 weeks and .2% at 42 weeks. However, most studies show that up to 25% of these stillbirths are directly related to genetic abnormalities and not to being postdate.

Q. What tests are offered after you pass your due date?

A. Routine tests that are offered by active management caregivers include a Nonstress Test (NST), Amniotic Fluid Index (AFI), and Biophysical Profile (BPP). A Nonstress Test can show if a baby is responding well to stimulus by an increase in the baby’s heart rate during 20 minute intervals. An Amniotic Fluid Index gives a rough estimate of the amount of amniotic fluid. A Biophysical Profile includes both of these tests. Because there are so many variables to their reliability and the fact than none of these tests can predict events such as cord prolapse or placental abruption, there is no data to show that using these types of monitoring improves pregnancy outcomes.

Q. When should you consider induction?

A. When your caregiver will recommend induction will most likely depend on whether or not you have chosen an active or expectant management caregiver. While most active management caregivers routinely induce at 41 weeks, the American College of Obstetricians and Gynecologists do not recommend routine induction in low-risk pregnancies until 42 weeks. Because inductions themselves carry a whole host of risks, most expectant management caregivers, specifically those who follow the Midwives Model of Care, will take a more wait-and-see approach and will avoid induction unless they believe it is indicated. Having a comfortable relationship with your caregiver where you make the decisions, your concerns are addressed, and your questions are answered is the surest way that you can avoid an unnecessary induction.

10 Things I Hate About Me

My friend, Nina, inspired me to be more authentic. So, here goes...

1. I have apeirophobia (an abnormal fear of infinity). I am a Christian and I have peace about where I'm going when I die, but the thought of being anywhere forever makes me panic.

2. I hate it when I lose my temper with my children. Most of the time I am a very laid-back person, so I can't stand that other side of me. I want to be that mother who is sweet and loving with her children 100% of the time.

3. Since I was a teenager, I've struggled with depression and self-injury. God is good and He gives me victory over these things, but I wish it wasn't a struggle.

4. I hate that I'm not naturally thin and althetic. I know that it's my own fault that I'm not in good shape (I hate exercise!) but it makes me jealous when I see people out running and it's obvious they enjoy it.

5. I wish that I enjoyed planning meals and cooking them. At the end of the day, it's so hard for me to motivate myself to go into the kitchen and make magic happen.

6. I wish that I craved the things that are good for me and disliked the bad things.

7. Sometimes I resent the fact that Nathan gets to go to work every day to do a job he loves where he gets to use his brain. So much of being a stay at home mom is emotional and that's hard for my academic side.

8. Angel's birth, or what I more accurately refer to as his "extraction", left me an angry, traumatized, fragile mess. By the grace of God, I'm healing, but it's a slow process.

9. I have issues trusting people. I'm always afraid that they'll hurt me in some way.

10. I wish that I had a "crafty" side. Some women can sew, knit, look at a pile of scraps and egg crates and see possibilities. Yeah, I'm not one of those women...

25 Random Things About Me

1. I love Jesus. He is my everything. Without Him, I am nothing. I believe that with all my heart.

2. I am a birth junkie! I love watching beautiful birth videos and reading birth stories. They make me cry (in a good way). I am close to becoming certified as a birth doula and I am going to pursue midwifery. I know in my heart that is what I'm called to do.

3. I love my husband with all my heart but I hate using the term "married". I don't believe that signing a piece of paper shows that a couple is in a covenant for life.

4. I love horses, especially my sweet Mustang, Mr Manners. I love everything about horses. Training them is so fulfilling. I love riding English, especially hunter/jumper and I want to eventually compete in three day eventing.

5. I really like pizza. I could live on pizza. When there's nothing planned for dinner and my hubby suggests ordering pizza, I'm like "YES! Made my day!"

6. I hate meat in any and all form, but especially fish, or any seafood like crab, lobster, shrimp, and shellfish, etc. I HATE the smell, despise it like the plague! Blech...

7. I have a very wide range of music and TV that I like and my hubby (smart man) lets me have control of the remote and the radio. On his days off, I'll search out my favorite music videos online and make him dance along!

8. I am completely and passionately against routine circumcision, spanking, and vaccinations. I will argue against all three until the cows come home. Then, when the cows are in the barn, fed and watered, I'll argue some more! :)

9. I am an animal lover and I believe that God wants us to treat animals with respect. I have no respect for anyone who intentionally causes unnecessary harm to an animal.

10. I am a mother to seven amazing children. Three are with their Father in Heaven and four are with me here on earth. I love them all.

11. I love being pregnant and giving birth. Babies are God's sweetest creation. Motherhood is the most challenging thing I've ever been called to, but it's helping me to appreciate God's grace and love even more.

12. I am an avid gum chewer. I chew a couple (sometimes more) pieces a day. This is probably not a good thing since I have issues with jaw pain but, in the words of Jack Twist, "I wish I knew how to quit you..."

13. Shoes and lingerie are my favorite articles of clothing and I have quite a collection of both.

14. I've always enjoyed writing and have attempted to write a few books but the perfectionist in me has a hard time seeing them through to completion.

15. I really enjoy shopping. In our family, I am the "spender" and my hubby is the "saver". Together, we have a good balance.

16. I would rather watch a good TV show than a movie or read a good book instead of either. Movies bother me because it's hard to build a relationship with the characters and the plots develop too fast.

17. I enjoy being out in nature but I don't like camping. I've been there, done that for nine weeks straight. I'm so over camping!

18. I traveled all over Europe as a teenager and I want to do it again with my family someday.

19. I hate having my bare feet on the carpet. I think it's disgusting. I wear socks, slippers or flip flops all year round. When I build my dream home, there will not be a stitch of carpet in sight!

20. I detest bees, wasps, hornets, etc. If they are around, I will most likely run away screaming. I don't care if they sense fear, when they are present, my common sense goes out the window.

21. I really dislike chocolate. I have never understood how people can bite into a mushy, bitter chocolate bar. Yuck!

22. I try to live a very "earth conscious" life. I think, as a Christian, I'm supposed to be a good steward of this beautiful planet so I try to reduce, reuse, recycle as much as I can.

23. Eating healthy is important to me. I buy organic as much as I can and I avoid fast food. Ever since I watched Food, Inc. the thought of a Big Mac makes me ill...

24. I love learning how to play instruments. My next goal is to learn to play the cello. I've been searching for a used one at a good price, if you know of any, let me know!

25. I cannot stand getting up in the morning. If I'm up in time to see the sun rise, it makes me depressed cause it means I should be sleeping. Sometimes I'll stay up really late because going to bed means I have to get up in the morning (weird logic, I know)

Positive Parenting

Recently, Nathan and I took an afternoon to sit down and discuss our parenting goals and strategies. It was very good for us to solidify what is acceptable and what is not and how we plan to deal with various situations that will arise. It was a much needed conversation and I'm grateful that we had an opportunity to come to an agreement on parenting matters.

Our goals are to raise healthy, happy children who love Jesus. We want them to have a beautiful childhood and, most importantly, never doubt that they are loved. The fact that we want them to know, without a doubt, that they are loved is so essential to us as parents because, after all, this is what Jesus does for us.

Since we are attachment parents, spanking is not an option for us at all. While I respect the decisions of other parents who seek the best for their own children, spanking goes against everything that we believe as Christians as well as attachment parents. Because we refuse to use this form of discipline (or rather punishment) for our kids, we've had to become more creative and involved with finding other methods.

One thing that we have been working on is how we communicate with our children. We make a point to speak to them at their eye level in ways they can understand. We also want them to repeat back anything that we ask them to do so that we are sure that they heard us and understand what is requested of them. Talking to them in a polite, respectful way is important if they are to feel truly loved.

We also use natural consequences for their negative actions instead of vague punishment. For example, if Angel has been warned not to throw his monster trucks and continues to do so, a natural consequence is to have the monster trucks go away. This teaches him that no one will play with you if you're mean to them. Another example would be if Jazmyn has been told not to run out to the street and she does anyway, she will lose the privilege of playing outside. Natural consequences are consequences that are directly related to the negative action and they make sense. Telling a child not to hit their sibling and then smacking them if they do so would not be a natural consequence and would not make sense.

Something that's been working beautifully with our preschooler, Angel, is his reward board and his tickets. He earns stars on his board when we're home or tickets when we're out for doing what he's asked and behaving himself during the day. When they add up, he gets rewarded for his good behavior. Since we implemented the reward board, we've seen an improvement in his attitude and behavior. One of the reasons why I think it works so well for him is because it gives him a tangible way for him to see that good behavior has good results. Another reason why it's effective is because it focuses on the positive. I don't think parents realize how many "Atta boy's" it takes to make up for just one negative reaction.

We try to make a point to focus on what our kids are doing right instead of waiting for them to mess up and punish them. We want our kids to know that they are loved and accepted even if they make wrong choices. Their wrong choices are never encouraged and they are never ignored but the focus is on them making healthy, positive choices.

Here are some articles and resources that helped us and we totally recommend them!

http://www.askdrsears.com/html/6/T062100.asp

http://www.askdrsears.com/html/6/T060200.asp

http://www.askdrsears.com/html/6/T061000.asp

http://books.google.com/books?id=aKwpLs0S8uEC&dq=How+to+Really+Love+your+Child&printsec=frontcover&source=bn&hl=en&ei=d9LcS7fjA5O-sgOSq6HOBg&sa=X&oi=book_result&ct=result&resnum=4&ved=0CCEQ6AEwAw#v=onepage&q&f=false

Confession

Hi, my name is Jenni and I have a problem with body image. There, I said it. I think it all started when I was about sixteen and I discovered one day (much to my horror) that my butt had grown considerably, complete with stretch marks. Innocent me, I didn't even know such things were possible! I knew there was nothing I could do about it so I tried to shrug it off and not let it bother me. But it was always in the back of my mind and I would wonder if there was something I could have done to prevent it.

I stayed pretty thin and wore the same jeans from high school until I became pregnant with my son. I knew that being pregnant would come with the added bonus of weight gain but I was still shocked when, at one of my last prenatal visits, the scale showed that I was almost 160. I was thinking "I'm only 5' 5"! How did that happen?"

After he was born, the obsession to lose the weight started. I didn't have the time or the money for a gym membership and my husband was working incredibly long hours. I didn't want to go walking or jogging by myself every day so I did the only thing I knew would work. I didn't eat. I would eat something like toast or a bowl or cereal for breakfast and sip coffee all day long until dinner. The coffee made it feel like there was something in my stomach but it did nothing for my lack of energy. My husband became increasingly concerned about how weak I was that he was constantly telling me to eat something. I said I would eat when I lost the weight.

And most of the weight came off by the time I became pregnant with Jazmyn. I was five pounds away from where I wanted to be. Several months into the pregnancy was when I started seeing my midwife and she pressed the issue of eating lots of healthy food for the baby. The thought of gaining a lot of weight terrified me but I tried to push my feelings aside and follow her recommendations.

Jazmyn was born in June so shorts, sun dresses, and swim suits were in season. I started out with a good attitude of "The weight will come off eventually." and "It took nine months to gain this, it's going to take some time to come off". But after having several people ask me how far along I was, and when my baby was due, (sometimes while I was holding my infant!) I became increasingly depressed. I would bounce around from starving myself, trying to exercise, and times of doing nothing and thinking, "What's the point? I'm just going to get pregnant again and gain it all back!"

I was probably twenty pounds away from my ideal weight when I got pregnant with Eden. This time I was determined to eat plenty of nutritious food and grow a healthy baby. I was successful, she weighed nine pounds at birth, but it also came at a cost for me. Who would have thought it was possible to gain so much weight on an almost completely organic diet? Well, it's possible and here I am.

As soon as she was born I started thinking about exercising, cutting back portion sizes, and fitting into my "skinny jeans". Yes, I've still kept some jeans that I haven't worn in almost four years because somehow I think they will serve as motivation. I fantasize about putting on a bikini again and what that will feel like.

It's a daily struggle for me to eat enough for my nursing baby.  I still have days where I'll skip meals, convinced that the hunger pains mean my body is consuming fat. If I miss a day of working out, I'll eat less, chew gum and work out that much harder the next day. When I step on a scale I'm willing the dial to move down with my mind.

This behavior is unfair to myself, is obsessive, and it's a sin. That's why I need Jesus. I need His reminder every day that He loves me just the way I am and that losing weight could not make Him love me more. He reminds me that the women of faith in the Bible have no mention of their weight. Even the Proverbs 31 women is not held to a standard of thin. My body is a temporary shell that won't last but my relationship with Jesus will last forever.

I hate admitting that this is a part of me, but it is and I am thankful for my husband who tells me I'm beautiful every day. I know he believes it and I am learning to believe it for myself. I want to be a good example to other women and my own daughters of what it means to be truly beautiful.

Eden turned two months old three days ago. I made it! I actually survived the first two months with three kids. There were definitely some overwhelming moments, times when all three of the kids would be crying and screaming and all I could do was pray that God would give me just enough grace to get through the rest of the day. And the grace would come because He is so faithful. There were also a lot of beautiful moments. Like seeing Eden smile for the first time. Or watching her when she is first awake in the morning and all she wants to do is kick her legs and coo. Witnessing her eyes light up when she heard Jazmyn say "Don't cry, baby Bear." So many precious moments that go by way to fast.

I was so blessed to have Nathan be able to take two weeks off after Eden was born. I spent most all of it at home with my family, bonding, resting and recuperating. When he went back to work, my friend, Nikki, was over many times to help. She was a Godsend! She fixed lunches, did laundry, played with the kids, and kept me company. She saved my sanity in those early weeks of adjustment.

My parents have faithfully been coming over every Saturday to visit and give me a reprieve while Nathan's still working weekends. It has been so nice to spend time with them and the kids really look forward to it. It is such a blessing to have them living so close to us.

We were able to go up to Pendleton for a few days to visit with my aunt, uncle, and grandparents. My aunt Marie was so hospitable and made us feel right at home. I really enjoyed all of the quality time we got to spend with everyone.

It's amazing how every baby is different. It never ceases to amaze me how something that worked so well to soothe one of my babies does absolutely nothing for the others! Eden is a very sweet, happy baby for the most part, but during her colicy times she gets her point across about how mad she is! Nathan and I have to tag team during dinner on most nights because that is her fussiest time. Thankfully she's been sleeping through the night (other than feedings) since she was born. I'm not sure how I would be able to function if she chose to spend nights doing her colic routine.

Her first bath

Sucking on Mommy's finger

She's Finally Here!

My daughter, Jazmyn, was born ten days after her due date. So, as my due date with Eden approached, I tried to mentally prepare myself for that to happen again by counting down to forty-two weeks. But when the forty-two week mark came and went, it felt very much like stepping off of a ledge. I didn't have anything to count down to anymore and the not-knowing was very unnerving.

I had an appointment with my friend and midwife, Tiffany, a few days after the forty-two week mark and, after checking on me and the baby, she offered to strip my membranes as she had with Jazmyn. I was definitely ready to be done being pregnant, but as long as we were both doing well, I was determined to wait for the baby and my body to decide when they were ready for labor.

On Christmas morning, I woke up early in the morning with a sore throat and just generally felt miserable. I took some supplements, gargled some vinegar, and went back to sleep for a couple more hours. During breakfast around ten, I suddenly got a strong contraction that took me by surprise. After I got several more at about ten minutes apart, I knew that labor had finally started. I was very excited, but I was still feeling sick so I tried to rest as much as I could all day.

My parents, my sister, and her family came over late in the afternoon and we ate dinner and opened presents. Later that evening, my contractions were getting closer together but because I was still feeling so ill, I knew that I wouldn't have the energy to give birth if I didn't get some sleep. So, following my midwife's recommendation, I drank a glass of wine and went to bed.

The wine helped me sleep for a little while, but soon I started getting awakened by strong contractions that were eight minutes apart. By the time morning came, I was exhausted and near tears because I just wanted to sleep! I ate some breakfast and my contractions finally lessened enough for me to sleep for several hours. When I woke up around one in the afternoon, I took a shower and ate some leftovers from Christmas dinner. I was surprised at how much better I felt and knew that I could face labor with renewed energy. My family showed up again to have dinner with us and I informed them that we were about to welcome our baby! They were so excited that they were going to be there for the birth!

We talked, snacked and played a board game while I quietly labored on the birth ball. By four o'clock, my contractions began to demand all of my attention. I retreated to my bedroom and told Nathan to start filling up the birth pool. As we were waiting for it to fill, Nathan cuddled with me and I made a comment about how I was surprised that my water hadn't broken. I mentioned how rare it was for a baby to be born "in the caul" or without a ruptured amniotic sack, but that it was considered very lucky!

An hour went by and my contractions were coming every four minutes and lasting just over a minute. When I informed my Tiffany of this, she told me that she and her assistants would start heading our way. The pool was soon full and I gratefully welcomed the warm embrace of the water.

Nathan had essential oils burning, my Owl City cd (that he had just given me for Christmas) playing, and the video camera set up to record the birth. He also made sure that temperature in the room and the pool was warm and comfortable. I am so blessed to have a husband who knows just what I need
when I'm in labor!

Tiffany, Nikki, and Jenny arrived at about six-thirty. Tiffany checked the baby's heart tones and asked how I was doing and if we needed anything. I said I was so excited and also hungry, so Nikki and Jenny made Nathan and I peanut butter sandwiches. Tiffany read to me out of the fourth Twilight book and we laughed and talked between contractions.

Nathan started to notice that my contractions were getting harder to manage so he joined me in the pool. Being able to hold onto him was very helpful and comforting as I went through transition. My contractions were very strong but they still had several minutes in between so I had a hard time believing that I was nearing the end when I felt my first pushing surge. I felt her head about an inch in and still covered in the sack!

It felt so amazing to feel my pushing surges after laboring for so long! I felt so powerful and in tune with my body as I breathed my baby down. I also knew that I would see my baby within minutes and that was a thrilling thought! After a few more contractions, I could feel the head bulging and starting to crown. Tiffany asked if she could check the heart tones one more time when I was ready and I nodded, deep in concentration. She didn't get a chance to because the next contraction came and I smiled and said, "The head's out!" Sure enough, she was still covered in the amniotic sack. I waited for the next contraction and with a little push she slid out and I pulled her up to my chest! She knew what her lungs were for and started crying right away.

It was such a surreal, beautiful moment. Nathan kissed me and told me how amazing I was, I gushed about how gorgeous the baby girl was that I had just birthed, and Tiffany was crying too hard to speak. My mom and sister came into the room and were so excited to see the brand new baby!

Eden's first picture.

Tiffany holding our new baby! It was so awesome so have her there.

Nathan weighing his brand new baby girl!

Eden Marie was nine pounds, with a head full of dark hair and big, blue eyes. She showed some signs of being post-date but she was as healthy as could be! Her birth was so smooth and easy on me and I feel so very blessed!