All eyes are on the royal family as the world watches with bated breath for the arrival of the next Prince or Princess of Cambridge. According to media reports, Duchess Catherine’s due date was estimated to be around mid-July with some reports speculating the actual date as July 13. Others claim July 19. Because of this projected due date, some now consider the princess to be “overdue.”
UPDATE: The Duchess of Cambridge is now in labor as of this morning and could have possibly already delivered, according to the latest media reports.
Given this speculation, we thought it would be a good time to discuss the topic of due dates, induced labors and what it means to be “overdue.” As a pregnant woman myself who was five-days overdue with my first child, this topic is of particular interest to me.
I asked Robert Watson, M.D., an obstetrician and gynecologist and medical director of the Paul and Judy Andrews Women’s Hospital at Baylor All Saints Medical Center at Fort Worth, to shed some light on this topic by answering a few of my questions.
Q: What causes a baby to be overdue?
“No one really knows. Babies come at their own time. Actually, just as many babies are born before their due dates as they are after their due dates. We have no way of knowing when the baby will actually arrive. In fact, the due date is really just an average. A pregnancy lasts for 40 weeks which is actually nine and a half months, not the nine month calculation that we are so accustomed to,” explains Dr. Watson. “We calculate a pregnancy’s due date based on the first day of a woman’s last menstrual cycle so technically she is two weeks pregnant before conception occurs.”
Q: Is there any harm in a baby being overdue?
“It depends. Research has shown that the optimal time to deliver a baby is between 39 and 41 weeks of pregnancy. A pregnancy lasts for about 40 weeks so if Duchess Catherine was due July 13, for example, she is now 8 days overdue which would make her 41 weeks pregnant. If she was estimated to be due on July 19, she is only three days past her due date,” says Dr. Watson. “Studies have shown that the longer a baby stays in the womb past their due date, the higher the chance of complications. The mother’s age and health also has a lot to do with this risk.”
Q: Do you think the Duchess’ physicians will have to induce labor?
“I can’t say for sure because I’m not her physician, but what I can tell you is that most physicians will induce labor around the 41-week mark. We usually don’t like a pregnancy go past 41 weeks these days. Often this decision is influenced by how “ready” the cervix is for labor,” says Dr. Watson. “In any regard, most physicians will ‘monitor’ the baby very closely with sonograms to ensure fetal well-being as the mother progresses beyond her due date.”
Q: How do physicians induce labor?
“We typically use a synthetic version of a natural hormone called oxytocin, or Pitocin® as it is commonly known. If the cervix is not ready for labor, we often will use different agents to prime the cervix and get it ready for labor,” explains Dr. Watson.
Q: Is it true that most first-born babies typically arrive after their due dates?
“Not necessarily. I have heard that theory, but there isn’t a lot of data to support it. It’s mostly anecdotal evidence.”
Q: Is it true that most inductions ultimately result in a cesarean section?
“Again, this is not necessarily true. Here at Baylor, our policy is that we do not induce labor prior to 39 weeks on an elective basis. Actually, it’s best not to have an elective induction at all unless the cervix, which is the lower narrow portion of the uterus, is ready to deliver,” says Dr. Watson. “We monitor and check the condition of the cervix as a woman gets closer to her due date. We are checking to see if the cervix has effaced, or thinned out, and if it has started to dilate. A c-section is major surgery so it is a little more risky than a natural delivery. However, it is necessary in some cases to ensure the health of the mother and baby if a natural delivery has complications.”
Q: Is it true that the size of the baby can be a factor in inducing labor?
“Absolutely. The size of the baby is a key component in the decision making process of whether to induce or not. Today, with better nutrition and better prenatal care, we are seeing much larger babies than were typically seen just a few decades ago. This often presents a challenge to both the obstetrician and the mother,” says Dr. Watson. “Regardless if Will and Kate’s baby is overdue or right on time, we can rest assured they are in good hands.”
Are you anxiously awaiting the birth of the royal baby? Have you placed any bets on the arrival date or name?