Saturday, May 10, 2008

Forced Due Dates

As I wait for this baby to make its appearance, sometime soon, I start to ponder the concept of due dates. Typically a due date is determined by one's doctor. The expectant woman informs her OB/GYN of her LMP (last monthly period) from there the doctor uses a scientific formula to calculate a date.
One of the most common misconceptions about pregnancy is that it lasts nine months. In reality, the average pregnancy is 266 days or 38 weeks from conception. Doctors typically date a pregnancy in weeks to gain a more accurate and specific age of the pregnancy. A doctor predicts a due date by counting back three months from the first day of the last menstrual period (LMP), then adding one year and seven days. Pregnancies are broken up into trimesters: 0-12 weeks make up the first trimester, 13-24 weeks are the second trimester and 25-40 weeks constitute the third trimester"
There is a problem with this practice. Premature births are on the rise and has increased significantly according to the March of Dimes.

WHITE PLAINS, N.Y., FEB. 3, 2004 – The number of babies born prematurely (prior to 37 weeks gestation) reached a record high of 480,812 in 2002, according to a new government report.  Nationwide, the rate of premature births jumped 13% between 1992 and 2002, with seven states showing increases of 30 percent or more. 
"This is alarming news," says Dr. Jennifer L. Howse, president of the March of Dimes. "Premature birth is now the most common, serious and costly infant health problem facing our nation.  Last year annual hospitalization of these infants cost $13.6 billion.  As a nation we must address this growing crisis in infant health and make it a priority."

March of Dimes
There are numerous reasons why women go into preterm labor, but with the rise in cesarean rates, and induction of labor, I cannot help but wonder if premature babies are created at the hands of doctors. With these correlating statistics, I'm almost positive that is the case.

What Are Due Dates?
While many doctors will admit that NO ONE knows exactly what triggers the start of labor, many doctors are inclined to "label" a woman "overdue" when she hasn't delivered according to their calculations and commence with an induction of labor that precedes the start of various interventions. If there has been no scientific explanation of what starts labor, and the babe that rests in the womb seems, for all intents and purposes, healthy and well, WHY are so many doctors inclined to induce labor? Could this be part of the rise in premature babies????

How can doctors be confident in the due dates they select for women? Especially when the doctor, and in most cases, the mothers, do not know when a baby is conceived. The duration of gestation lasts for 38 weeks from the date of conception. Since there is no accurate knowledge of conception, the typical gestation duration was modified to 40 weeks. Now, if a woman reaches the end of her "40-week" gestation without results, shouldn't  the doctor assume that his/her calculations were off  and wait for an additional two or three weeks (for late arriving babies)? Yet many doctors will insist upon their "correct" calculation of due dates and induce labor accordingly, even though the baby is thriving and well in the womb.


My Story
I have experienced a miscalculated due date by a doctor, fortunately, it had a very positive outcome. When I was expecting my second son, my midwife referred me to a doctor for an ultrasound. At the time of the ultrasound, I was seven months pregnant. The doctor took his "measurements" and announced that I was in fact due July 20th as opposed to August 15th (MY calculated due date) According to his calculations I was due to give birth in a month NOT two. The unfortunate thing in this situation was that I let this doctor doubt what I knew and understood of my cycle. It was the start of the LONGEST (but right-on-time) pregnancy I've ever experienced!!! Two weeks after the doctor's supposed due date, I knew he was horribly wrong and that I had at least another two weeks to go. While I was physically healthy, the battle I fought that last month was an emotional and spiritual one. There is no doubt in my mind,and the mind of other professionals that if I was that doctor's patient, and inclined to passivity towards my personal responsibility, my beautiful, healthy son would have been born ONE WHOLE MONTH early, you see... he was born AUGUST 20th. Five days after my calculated due date, one month after the doctor's calculated due date.

As eye-opening as that whole experience was I cannot completely lay fault at doctors inaccurate due date calculations. Too many of us women are inclined to passivity towards our responsibility to understand how our bodies work for ourselves. Too many of us mothers are lacking in self-confidence in our own bodies in what they are or not capable of. It may be easier for most of us not to make an effort to learn how we work and take personal responsibility and accountability, after all if something goes wrong they can easily lay blame at the hands of doctors, but I ask you are you willing to accept the consequences of the luxury of ignorance? It can be truly devastating because the consequences extend to the beautiful soul that lives within your womb.

Natural Family Planning
I learned how to determine when I ovulate, by the Natural Family Planning Method. Before you shut down this post, hear me out. While many women do not like the inconvenience of NFP. I propose ALL women should at least read or understand for herself HOW it works regardless of your choice of contraception. From it you will learn HOW a woman's body works, I'm not talking about what you learned in your junior high sex ed class, but deeper information that tells you how a woman's reproduction cycle functions. For example did you know that a 28-day cycle is NOT a typical cycle for every woman? Not only do they NOT teach that in Jr. High, but most doctors rely on a 28-day cycle for their due date determination. A woman's cycle can last anywhere from 26 to 40 days. You may not be interested in NFP. but it is clear that the information provided impacts every woman who desires to have a successful pregnancy. While I believe it is difficult for a woman who is taking birth control with hormones to apply NFP (because BC affects hormones that display specific symptoms necessary to determine ovulation/menses), I still believe it's necessary for simple information's sake, after all, KNOWLEDGE IS POWER.

Author's Note:
I highly recommend "Taking Charge of Your Fertility" by Toni Weschler, MPH

Recommended Reads
Role of Probiotics in Pregnancy, Childbirth and Breastfeeding








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