Chapter 6: Due Dates or Guess Dates

One of my clients was told she was overdue and was becoming increasingly nervous, but unless a baby is conceived by artificial or in vitro fertilization, or the couple chart basal body temperatures and see ovulation occur, it is almost impossible to predict the exact date of conception and then calculate the due date.

We are actually changing the term from “due date” to “guess date.” In the past, doctors have induced babies rather routinely that were still not showing any intention of coming out in their forty-first week. They were worried about things that might happen when babies are truly overdue and their placentas are no longer working at 100% capacity, but babies who “cook” until forty-two weeks are more often than not perfectly healthy and do very well. Babies are mature and viable, as we say, after thirty-seven weeks, though they do even better if they arrive during their fortieth week. So, without knowing a true guess date, babies have been induced far too early due to miscalculations and it becomes apparent that they are even premature, not at all overdue. The medical community is taking a new look at induction at this time, with good reason.

Jeannie called me the day after she reached her forty-week guess date. That morning she had seen her doctor, who had insisted that they go ahead with an induction the following day and possibly a scheduled C-section. Her doctor cited the reason was that the baby “appears rather large.” Jeannie had given birth to two other children but the doctor was worried about a host of “risk factors” surrounding post-date babies. Jeannie’s first baby had been born by C-section, though baby number two was a successful VBAC (Vaginal Birth After Cesarean) at only twenty-eight weeks. Another baby, a beautiful little girl, was born in 2010 but was also very premature and did not survive.

When she called, Jeannie was crying, understandably upset with all that the obstetrician had laid out for them the next morning. She had gone home and told her husband and asked him what they should do. Lonnie’s answer was, “Call Stephanie. She’ll know what to do.” So she was on the phone asking for advice and much-needed support.

It is important to explain that as a doula I do not make decisions for anyone. I don’t tell them which is the best of all the options they are offered, but I will help them explore the possibilities and give them as much information as I have or call someone else if I don’t know. She asked if there was anything they could do to encourage labor and avoid being induced.

I told her that they could have sex, for one. It has worked for some moms. The thought is that the male hormones assist with “turning on” labor, and that orgasm simulates blood flow and the uterus often follows suit. Sex can be quite comfortable if your partner is behind you while you are lying on your side. Being on top of him may not feel quite as good if the baby is well engaged low in the pelvis. Foreplay alone is another option. Nipple stimulation (also with help from a willing partner or available toddler who is still nursing) often works. Rolling your nipples manually or using a breast pump has also been suggested. It has been long thought that being “turned on” is what got the baby in there in the first place and that there is a place for it here, too.

Some women have tried the notorious castor oil cocktail, which works by stimulating the bowel and in turn, if irritated enough, triggers a response by the uterus, and thus labor. Some practices do not advocate this method at all. A mom-to-be could become quite ill and not go into labor anyway. Riding a bike or taking a drive on a long dirt road has supposedly worked on occasion, too.

“Stripping the membranes” is when a midwife or doctor separates the cervix from the bag of water by sweeping a finger around the baby’s head just inside the cervix. It also tips off the hormones that labor should soon follow but that can only be done if the cervix is dilated one to two centimeters already.

An Amish friend of mine told me her method when I was “overdue”: “You get in your buggy and go visit a friend and that will start labor, rather than sitting at home hoping.” I guess lifting three or four little kids up into a buggy, riding along bumpy back roads and then lifting the kiddies back down at the friend’s house, with all the snacks and coats and all, and hauling myself up and down on the buckboard would have worked for me.

Instead of suggesting a buggy ride, I said to Jeannie, “You should take some quiet time and connect with your baby. Tell her it seems to be time and you don’t want a C-section or any drugs, for that matter, so maybe you two can work out some kind of a deal.” She agreed and thanked me and promised to call the next day.

The phone rang at midnight. Jeannie and her family had spent a quiet day at home together, took a nap, and then went to a barbeque at a friend’s house. Just as they finished eating, Wham! The contractions started on their own. She was euphoric, but told me they were going to head right to the hospital because she didn’t think there was time to go home and pick up her baby bag first.

The nurse was checking Jeannie when I got to the hospital. Six centimeters already! We gave high fives all around.

Then she told me one of the strangest stories I had ever heard. While they were settling down for their nap earlier in the day, she was talking to her baby, connecting as she fell asleep like I had suggested. She had a dream, describing it as “totally real.” In the dream she was talking to her baby, whom they were planning to call Camilla, and the baby was telling her, “Well, actually, I’m not coming out unless you agree to name me Veronica. No way!”

So, in Jeannie’s words, “I said, ‘Okay, anything you want. You got it,’” and the dream ended. They told their other kids about it and all agreed that Veronica it would be, though they had never given that name a thought.

Then Veronica’s older sister said, “It should be Veronica Jordan. I am sure.” Jeannie and Lonnie looked at each other and decided that their kids seemed to know a whole lot more about it than they did, so Veronica Jordan it would be.

About half an hour after the nurse checked her, Jeannie said she was feeling a bit “pushy.” The nurse checked again and she was ten centimeters. The nurse ran out, crashing into another nurse coming into the room and both raced to get the room set up with a warmer, instrument tray, and all the other paraphernalia that is part of a hospital birth these days.

I helped Jeannie focus on breathing and get into a comfortable squat on the bed while Dad picked up all the coats, the birth ball, and clothes strewn around us. In the rush, someone asked if the doctor had been called. She hadn’t, until just then. Jeannie and I just grinned at each other. Another doctor was on the floor and quickly gowned up and stood at the end of the bed, hands ready to catch. As the little head crowned, Jeannie’s doctor rushed into the room, and the other doctor stepped aside so she could catch the rest of Veronica Jordan as she slid out. It was all and more than we could have wished for.

An interesting aside is that another baby girl was born to a family down the block from Veronica’s house about the same time. They did not know the family but found out later that they named their baby Camilla.

 

Veronica Jordan.

 

 

 

“Women’s strongest feelings [in terms of their birthings], positive and negative, focus on the way they were treated by their caregivers.”

~Annie Kennedy & Penny Simkin