I was rotating doctors when one doctor recommended that I be induced at 39 weeks, based on the ARRIVE study. I looked into it, and spoke to a different doctor at my next appointment who thought that was pointless since my pregnancy has been healthy. The ARRIVE study that is changing the thinking on the risks of c-section following early induction most conclusively showed that participating in a study on c-section rates reduced c-section rates. The c-section rate in the study was 18-21% compared to a national average that is around 32%.

I’m putting more faith in my doctor evaluating the health of MY pregnancy instead of a study of women in their mid-twenties. And I like to talk to my doctor about the absolute risk instead of worrying about extrapolated relative risk differences between a 24yo and a 40+yo.

Talk to your doctor. Headlines love to talk about relative risk because it sounds more dramatic than an increase in absolute risk that may or may not be statistically significant or apply to the circumstances of your pregnancy.

“‘Think like a fetus.’ If a fetus knew that the literature says there’s no benefit for staying in past 39 weeks, and potential risks increase after 39 weeks, wouldn’t the fetus want to be delivered at 39 weeks?

Multiple studies from the United Kingdom and the United States showed that infant mortality risk increases after 39 weeks. Stillbirth rates are at their lowest at 39 weeks and increase significantly after that. The reason is unknown.”

https://annualmeeting.acog.org/news/support-for-elective-iol-at-39-weeks-growing/

Nothing good happens after 39 weeks. Stillbirth rates go up, preeclampsia rates go up, the baby gains a lot more weight and can be harder to deliver vaginally, the placenta can start to break down, amniotic fluid levels can decrease, etc.

I would push for an induction date, stat OP. There is zero benefit to waiting until 42 weeks.

My conservative OB practice wanted to induce me at 39 weeks (healthy/uncomplicated 4th pregnancy @35 years old). I had gone into labor with my previous pregnancies a few days after my due date. I declined the 39 week induction recommendation and they didn’t push back, just asked for NST and fluid check at 40 weeks and induction by 41 weeks. Baby looked great at the NST @ 40+1 and I went into labor at 40+5 (no signs of labor 40+4). My induction had been scheduled for 41+1 and as the OBs predicted, I delivered before then.

I was induced at 41+4. My OB wanted to do it a few days earlier, at 41 weeks even, but the hospital where I delivered didn't have beds available; I had to wait for them to call me to come in.

I'm 32, FTM, and did not experience any complications during the pregnancy, fwiw.

I just had a long conversation about this with my midwife to set expectations for my current pregnancy (approaching due date; last was induced at 41+5). My takeaway is that there is minor evidence of increased risk of still birth post-39 weeks for 35 yrs plus. (I’m also 37). Her view is that it’s a very personal decision re weighing of risks, but for an otherwise healthy pregnancy, and under 40, she doesn’t think that risk outweighs the risk of c-section resulting from induction. I haven’t decided what I want to do if I go more than a few days past 40. But their practice is open to inducing at my request after 39 weeks. (And FWIW, my induction last time was a fine experience). Hope your baby comes on his or her own quickly and easily.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The biggest risk in going past 40 weeks is that the placenta can calcify and stop providing nutrients to your baby. You might not know this has happened until it's too late. I'm sorry, I'm not trying to freak you out - it was a long road for DW and me to have our two and we unfortunately weighed risks like this constantly until the babies were both here.

I hear you on this but it's so hard to get statistically valid info on risks while controlling for level of care. I've seen statistics about increasing risks,etc, but none that involve verification of a healthy placenta via ultrasound at 40 weeks, 41 weeks, etc. Or maybe I just haven't find those?

PP here - I think that's part of the problem. You can't determine if it's happened until you go into labor and give birth - and that's when it can be too late. The reason I mention this is because we have a few friends (in online groups for at risk pregnancies - women with immune issues specifically) who had this problem. It was something that wasn't diagnosed/determined until baby was born.

My wife's MFM told us that the idea that C-section correlating to high induction rates isn't accurate. If you trust your OB and hospital in which you're delivering, I think you can feel confident about induction and not being forced into a C section unless it's absolutely necessary.

I see, thanks. Helpful (and scary) information. I was induced with my first after my water broke with no contractions. Dd was in distress with pitocin but I was able to avoid a c section. I am not averse to induction or c section if needed, it's just a struggle to figure out if I have any "real" reason to overrule my doctor's protocol. Until now I never would have said I had any doubts in her judgement.

OP that PP is completely full of crap. It sounds like you just need to ask your OB why she's making this call. I'm sure she has a good reason she probably just glossed over it. I wouldn't doubt her judgment now, especially without talking to her and getting more info.

I wouldn't say the pp is full of crap, but I do recognize that anecdotes from a high risk Facebook group is not the statistically valid study I was looking for. I still do trust my ob which is why I'm keeping my appt for Monday when I'll be 41+2, but it is a nagging concern that there are so many women who aren't allowed to go past 41 (or even 40).

There is no scientific basis for the placenta calcification theory. Most stillbirths are from genetic defects or just unknown. There is such a thing as pathological placenta calcification that can be life-threatening to pre-term fetuses - extremely rare and not your situation as you are full term.

I'm allowed to go to 42 weeks. My first was born at 41+3 naturally.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The biggest risk in going past 40 weeks is that the placenta can calcify and stop providing nutrients to your baby. You might not know this has happened until it's too late. I'm sorry, I'm not trying to freak you out - it was a long road for DW and me to have our two and we unfortunately weighed risks like this constantly until the babies were both here.

I hear you on this but it's so hard to get statistically valid info on risks while controlling for level of care. I've seen statistics about increasing risks,etc, but none that involve verification of a healthy placenta via ultrasound at 40 weeks, 41 weeks, etc. Or maybe I just haven't find those?

PP here - I think that's part of the problem. You can't determine if it's happened until you go into labor and give birth - and that's when it can be too late. The reason I mention this is because we have a few friends (in online groups for at risk pregnancies - women with immune issues specifically) who had this problem. It was something that wasn't diagnosed/determined until baby was born.

My wife's MFM told us that the idea that C-section correlating to high induction rates isn't accurate. If you trust your OB and hospital in which you're delivering, I think you can feel confident about induction and not being forced into a C section unless it's absolutely necessary.

I see, thanks. Helpful (and scary) information. I was induced with my first after my water broke with no contractions. Dd was in distress with pitocin but I was able to avoid a c section. I am not averse to induction or c section if needed, it's just a struggle to figure out if I have any "real" reason to overrule my doctor's protocol. Until now I never would have said I had any doubts in her judgement.

OP that PP is completely full of crap. It sounds like you just need to ask your OB why she's making this call. I'm sure she has a good reason she probably just glossed over it. I wouldn't doubt her judgment now, especially without talking to her and getting more info.

I wouldn't say the pp is full of crap, but I do recognize that anecdotes from a high risk Facebook group is not the statistically valid study I was looking for. I still do trust my ob which is why I'm keeping my appt for Monday when I'll be 41+2, but it is a nagging concern that there are so many women who aren't allowed to go past 41 (or even 40).

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The biggest risk in going past 40 weeks is that the placenta can calcify and stop providing nutrients to your baby. You might not know this has happened until it's too late. I'm sorry, I'm not trying to freak you out - it was a long road for DW and me to have our two and we unfortunately weighed risks like this constantly until the babies were both here.

I hear you on this but it's so hard to get statistically valid info on risks while controlling for level of care. I've seen statistics about increasing risks,etc, but none that involve verification of a healthy placenta via ultrasound at 40 weeks, 41 weeks, etc. Or maybe I just haven't find those?

PP here - I think that's part of the problem. You can't determine if it's happened until you go into labor and give birth - and that's when it can be too late. The reason I mention this is because we have a few friends (in online groups for at risk pregnancies - women with immune issues specifically) who had this problem. It was something that wasn't diagnosed/determined until baby was born.

My wife's MFM told us that the idea that C-section correlating to high induction rates isn't accurate. If you trust your OB and hospital in which you're delivering, I think you can feel confident about induction and not being forced into a C section unless it's absolutely necessary.

I see, thanks. Helpful (and scary) information. I was induced with my first after my water broke with no contractions. Dd was in distress with pitocin but I was able to avoid a c section. I am not averse to induction or c section if needed, it's just a struggle to figure out if I have any "real" reason to overrule my doctor's protocol. Until now I never would have said I had any doubts in her judgement.

OP that PP is completely full of crap. It sounds like you just need to ask your OB why she's making this call. I'm sure she has a good reason she probably just glossed over it. I wouldn't doubt her judgment now, especially without talking to her and getting more info.

I was induced once, and had one C. I recommend a C much more than being induced. Good luck.

Anonymous wrote:The biggest risk in going past 40 weeks is that the placenta can calcify and stop providing nutrients to your baby. You might not know this has happened until it's too late. I'm sorry, I'm not trying to freak you out - it was a long road for DW and me to have our two and we unfortunately weighed risks like this constantly until the babies were both here.

This is a load of rubbish. Where did you get this pseudo science?? There is zero evidence to support this theory.

OP, the risk of stillbirth for you being under 40 and assuming your pregnancy is healthy and you yourself are in good health with no conditions is incredibly low.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The biggest risk in going past 40 weeks is that the placenta can calcify and stop providing nutrients to your baby. You might not know this has happened until it's too late. I'm sorry, I'm not trying to freak you out - it was a long road for DW and me to have our two and we unfortunately weighed risks like this constantly until the babies were both here.

I hear you on this but it's so hard to get statistically valid info on risks while controlling for level of care. I've seen statistics about increasing risks,etc, but none that involve verification of a healthy placenta via ultrasound at 40 weeks, 41 weeks, etc. Or maybe I just haven't find those?

PP here - I think that's part of the problem. You can't determine if it's happened until you go into labor and give birth - and that's when it can be too late. The reason I mention this is because we have a few friends (in online groups for at risk pregnancies - women with immune issues specifically) who had this problem. It was something that wasn't diagnosed/determined until baby was born.

My wife's MFM told us that the idea that C-section correlating to high induction rates isn't accurate. If you trust your OB and hospital in which you're delivering, I think you can feel confident about induction and not being forced into a C section unless it's absolutely necessary.

I see, thanks. Helpful (and scary) information. I was induced with my first after my water broke with no contractions. Dd was in distress with pitocin but I was able to avoid a c section. I am not averse to induction or c section if needed, it's just a struggle to figure out if I have any "real" reason to overrule my doctor's protocol. Until now I never would have said I had any doubts in her judgement.

Anonymous wrote:

Anonymous wrote:The biggest risk in going past 40 weeks is that the placenta can calcify and stop providing nutrients to your baby. You might not know this has happened until it's too late. I'm sorry, I'm not trying to freak you out - it was a long road for DW and me to have our two and we unfortunately weighed risks like this constantly until the babies were both here.

I hear you on this but it's so hard to get statistically valid info on risks while controlling for level of care. I've seen statistics about increasing risks,etc, but none that involve verification of a healthy placenta via ultrasound at 40 weeks, 41 weeks, etc. Or maybe I just haven't find those?

PP here - I think that's part of the problem. You can't determine if it's happened until you go into labor and give birth - and that's when it can be too late. The reason I mention this is because we have a few friends (in online groups for at risk pregnancies - women with immune issues specifically) who had this problem. It was something that wasn't diagnosed/determined until baby was born.

My wife's MFM told us that the idea that C-section correlating to high induction rates isn't accurate. If you trust your OB and hospital in which you're delivering, I think you can feel confident about induction and not being forced into a C section unless it's absolutely necessary.

Anonymous wrote:The biggest risk in going past 40 weeks is that the placenta can calcify and stop providing nutrients to your baby. You might not know this has happened until it's too late. I'm sorry, I'm not trying to freak you out - it was a long road for DW and me to have our two and we unfortunately weighed risks like this constantly until the babies were both here.

I hear you on this but it's so hard to get statistically valid info on risks while controlling for level of care. I've seen statistics about increasing risks,etc, but none that involve verification of a healthy placenta via ultrasound at 40 weeks, 41 weeks, etc. Or maybe I just haven't find those?

The biggest risk in going past 40 weeks is that the placenta can calcify and stop providing nutrients to your baby. You might not know this has happened until it's too late. I'm sorry, I'm not trying to freak you out - it was a long road for DW and me to have our two and we unfortunately weighed risks like this constantly until the babies were both here.