My Provider Said: We don’t allow patients to go past 41 weeks…
All included links are from Evidence Based Birth
More and more women are being encouraged to induce at 39 weeks, due to a study that came out in 2018 called ARRIVE, which suggested better birth outcomes in babies. So don’t be surprised if your provider asks you if you’re interested in elective induction before your due date.
It’s also good to know that a review of data indicates that 50% of first-time mothers give birth by 40 weeks and 5 days, and 75% give birth by 41 and 2 days. A due date is based on the assumption that every woman has an uber-regular, 28 day menstrual cycle, and that they ovulate exactly on the 14th day of that cycle—which for many of us, doesn’t apply. A due date is a calculated guess.
If your care provider told you that their practice “doesn’t allow” patients to go past 41 weeks, know that all this means is they will pressure you for induction, and will often scare you with stillborn rhetoric. It doesn’t mean they won’t see you anymore or kick you out of their practice. By law, they cannot refuse care.
Here are the recommended guidelines from American College of Obsterics Gynecology, Association of Ontario Midwives, and National Institute for Health and Care Excellence:
As a pregnancy approaches 41 weeks (late-term), most professional guidelines begin to recommend that providers have discussions with patients about the benefits and risks of inducing labor versus expectant management (ACOG 2014, reaffirmed 2024; AOM 2021; Delaney & Roggensack 2017; NICE 2021). They also begin to recommend increased fetal monitoring if expectant management is chosen at 41 weeks and beyond. The recommendations for pregnancy at 42 weeks trend towards recommending induction if labor has not yet started on its own. If expectant management is chosen at 42 weeks and later in pregnancy, regular fetal monitoring is encouraged.
Full article here: Evidence on: Inducing at 41 Weeks or Later
Always make sure you read the limitations section of the studies being reviewed. Many studies out there have planty of limitations, but are often and unfortunately the best research we have available. I find the Evidence Based Birth website to be very thorough, and they usually have a podcast associated with their articles so you get the benefit of scientists explaining the data to you in ways that make sense.