First things first. Just because your baby didn't show up yesterday doesn't mean you're overdue — yet. If you're still pregnant next week, we'll talk again. All it means for now is that your baby didn't get the memo about your due date — which was only an estimate anyway.
Even if you become officially "overdue," as you will be next week, if there's still no action, your baby won't be considered "post-term" until after week 42.
Now that that's cleared up, here's some more good news. The vast majority of overdue babies are delivered safely. But — and there's always a but, isn't there? — the longer the baby stays inside, the greater the risk of potential complications, such as a deterioration of the placenta, a decrease in the amount of amniotic fluid or the baby becoming too large to be delivered vaginally.
That's why your practitioner is wisely planning to keep a close eye on your health and that of your baby once you pass the 40-week mark. She will do that by using any of these common tests:
- Kick counts: You've likely been counting those kicks twice a day since 28 weeks, and your practitioner will encourage you to continue keeping count. If you haven't counted 10 movements by the end of an hour, have some juice or a snack, take a little walk, even jiggle your tummy, then lie down, relax and continue counting. If two hours go by without 10 movements, call your practitioner.
- Nonstress test: You'll be hooked up to a fetal monitor, the same kind that's used during labor, to measure the baby's heart rate and response to movement. A nonstress test is able to detect if there is any fetal distress.
- Biophysical profile: This is the fun part: You get to have more ultrasounds done and get an overall picture of how things are looking. During the ultrasound, your baby is evaluated for fetal breathing, movement, fetal tone and amniotic fluid level. The profile also involves placing two belts around your belly to monitor your baby's fetal heart rate and the frequency of uterine contractions with sensors.
- Amniotic fluid index: This modified biophysical profile measures the quantity of amniotic fluid using an ultrasound.
- Contraction stress test: This test, done in a hospital, evaluates how the baby responds to the stress of uterine contractions, which are usually induced with Pitocin or nipple stimulation. If the baby responds fine to the contractions, it's usually an indication that the conditions in the uterus are still favorable — and baby hasn't worn out his welcome.
Most of the time, overdue babies pass these tests with flying colors — which means they can continue to stay put until they're good and ready to make their debuts. Rarely, the nonstress test results can be labeled "nonreactive" or "non-reassuring" — which really isn't as unreassuring as it sounds.
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Since these tests yield plenty of false positives, a non-reassuring result doesn't definitely diagnose distress, but it will mean that your practitioner will continue to test your baby, and if it turns out that there's any indication of fetal distress, will induce your labor. Even without fetal distress, your practitioner may choose to induce at 41 weeks.
Here's hoping your baby hurries up!
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