Reply to Kaiser will only let you go ONE week past due date??

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Reply to "Kaiser will only let you go ONE week past due date??"

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[quote=Anonymous]I was with Kaiser last year and discussed this with my OB. She indicated that it was her preference to have patients go no later than 41 weeks, but would be open to going to 42 weeks with monitoring. I also asked her about whether being part of a managed care organization constrained/dictated her practice and she said no, that each doc retains a lot of discretion. (Except she did tell me they do not do breeches, a Kaiser policy).

Most OBs these days have a strong preference for 41 weeks being the endpoint to prevent stillbirth and meconium aspiration syndrome. The most recent literature indicates that allowing women to go past 41 weeks before inducing does not reduce the C-section rate (there is a lot to parse in that simple statement, but that's how the studies have come out). Therefore, they see no benefit to going past 41 weeks,  just additional risks to them and to the baby. I think that OBs honestly see pregnancies that go past the due date as pathological because statistically the best outcomes are in the 39 week range. This is just part of their training -- they see things in terms of risk of *this* baby dying and that is really all they care about. A woman's future reproductive life is just not on their radar screen.

Having said all that, with a family history of longer pregnancies and being a FTM, I think your sister would be well served to push back and ensure that she is at least allowed to go to 42 weeks, particularly if she plans on more than one child. If she is monitored every day and the baby starts to decline, they will catch it. (More common would be a false positive where they find a reason to induce on the ultrasound that really wasn't anything of concern). Because Kaiser is both provider and insurer, they cannot drop her, so she should feel secure in making her preference known. My sense is that it is not unheard of to go to 42 weeks even though it is not OBs' preference so hopefully they will work with her.  [/quote]

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