Why I don’t do due dates – one woman’s perspective

One woman's induction in hospital.

A first time birthing woman I know has been managing the fear others are feeling around her upcoming birth by choosing to present some facts for those who haven’t yet found out that obstetrics is mostly antiquated nonsense. I found her thoughts and perspective interesting given my own perspective as a writer and birth attendant and observer of hundreds of women nearing birth time over the last few years.

Her admirable summary, which has footnotes for those who like them, is written clearly, concisely and with ownership over her political views around birth.

Some other information to peruse while you ponder the notion of “postdates”* is here and here. Thanks for sharing, I’m sure many women will find your thoughts helpful as they too manage the obstetrically-induced fear that piles up at the end of pregnancy.

Why I don’t do due dates

I’ve been asked a few times lately what my actual due date is. I by no means wish for this explanation to be a personal affront to anyone, and hope that this is taken as my perspective rather than a personal comment or judgement.

An Estimated Due Date is just that – an estimated date calculated on the basis of a woman’s last menstrual period (if known), conception date (if known), or ultrasound scan (increasingly inaccurate as pregnancy progresses)(1). Due to practices of risk management via routine induction in many hospitals, an Estimated Due Date has become more like an expiry date for a pregnant woman. Just as we all have different menstrual cycles, breast sizes, preferences for salty or sweet foods, etc, we all have differing gestation as well.

A healthy term pregnancy is considered by the World Health Organisation to be anywhere between 37 and 42 weeks gestation. In the absence of any indicators of ill health or complications, it is my firm belief that a woman should be able to gestate for the length of time required for spontaneous labour to occur. Fewer than 5% of babies are born on their actual ‘estimated due date’(2). So telling people this date, really just gives them (a) a one in 20 shot of knowing when your baby will be born and (b) the ability to calculate back the day upon which, 38 weeks earlier, you had sex. It’s a “probability, not a deadline”(3).

My stance is a political one as well. Most hospitals prescribe routine induction at 40 weeks +10 days(4). This arbitrary calculation creates a lot of anxiety for women who know that they will be induced if they go past this date. It disempowers the pregnant woman, putting her in the hands of risk managers rather than care providers. With no other evidence and significantly poorer outcomes of subsequent intervention, many women are forced into induction at 40+10 (usually after days of effort on their own behalf, using ‘natural’ induction methods such as acupuncture, essential oils, sex, castor oil, etc, to ‘bring labour on’ before their body and baby are ready). This creates unnecessary anxiety and risks for the woman and her baby, with the ‘cascade of intervention’ a real danger.(5)

Recently, a friend of mine gestated to 42 weeks. Unfortunately, many of her Facebook friends knew her Estimated Due Date. What ensued, on behalf of people that would normally fulfil a supportive, anticipatory, excited role in my friend’s life, became external pressure, ‘concerns’ for my friend, and constant badgering. My friend made an innocent comment in her status update about knitting, only for the response to be something about pushing! This cheerleading in a public forum is not helpful to a woman who certainly feels the measure of passing time and its concomitant anticipation more acutely than all around her.

In short, I am very excited for the birth of my wee babe, as I am sure you are. I absolutely appreciate your interest and anticipatory excitement. However, I can’t reliably predict when my baby will be born. I will be delighted to share the news with you when it is, though.

(1) http://www.bellybelly.com.au/articles/pregnancy/due-date-calculator
(2) American Congress of Obstetricians and Gynaecologists: http://www.acog.org/publications/patient_education/bp069.cfm
(3) Henci Goer: When is that baby due? http://www.ivillage.com/when-baby-due/6-a-129259
(4) http://www.kemh.health.wa.gov.au/development/manuals/O&G_guidelines/sectionb/2/5177.pdf
(5) Childbirth Connection: The Cascade of Intervention in Childbirth http://www.childbirthconnection.org/article.asp?ck=10182

* There’s no such thing as postdates, it’s all prebaby.