During the final weeks of pregnancy, you might feel nervous as you approach your due date and especially if you go past it. For first-time birthing parents, however, it’s really important to remember that your due date is an estimate. In fact, research shows that about half of first-time parents birth their babies by 40 weeks and 5 days, while 75 percent of first-time parents deliver by 41 weeks and 2 days.

As a licensed birth center in Florida, we abide by state regulations set forth by the Agency for Health Care Administration. Therefore, at Magnolia, we are permitted by law to have patients in our care until 42 weeks, which is two weeks past your due date.

If your due date comes and goes, we continue to monitor your health and your baby’s well-being. Since going past your due date is common, you should take time to learn what happens in this scenario. We’re going to cover the basics of going past your due date, so keep reading!

Can I Still Receive Birth Center Care If I Go Past My Due Date?

Yes! Around 39 weeks, our Miami midwives will begin discussing some safe, natural induction methods and when it’s appropriate to start using them. These include exercise, nipple stimulation, acupuncture and acupressure, chiropractic care, sex, red raspberry leaf tea, and castor oil.

Once you’ve reached your due date, we will set up appointments for you to go for a nonstress test and biophysical profile. These non-invasive screenings ensure you, your baby, and the placenta are still healthy. As long as that’s the case, you are allowed to proceed up to 42 weeks. You may be wondering, “If I’m past my due date, how can I go into labor?” You can keep trying natural induction methods at home.

Our medical director, Dr. Mark Spence, works in conjunction with us to evaluate our clients. If you get close to the 42-week mark, we are required to consult with him, and we will begin talking with you about hospital induction at that time. It’s worth noting that it’s very uncommon for clients to get to 42 weeks and end up needing to go into the hospital.

To provide context and contrast, most Miami OBs have a conversation about inductions with patients around 38-39 weeks. The majority of obstetric practices don’t allow their patients to go past their due date and certainly not beyond 41 weeks. We practice evidence-based care at Magnolia, and that’s why we individualize your care, support post-date screening, and work with Dr. Spence to determine whether induction is the safest choice.

What Tests Are Common After I Go Past My Due Date?

Now, you’re probably wondering, “What is a biophysical profile?” and “What does a nonstress test involve?” Here’s what you need to know about these screenings, which may occur once or twice per week, and what they mean for you and your baby.

Nonstress Test

A nonstress test (NST) is a noninvasive screening that monitors the baby’s health. The name is appropriate because a nonstress test does not put stress on the baby, but it checks to see if the fetus is reacting normally to stimulation and is getting adequate oxygen.

When you have an NST, a care team member will apply a fetal monitor belt to your belly. You’ll recline in a chair and keep track of the movements your baby makes for 20-40 minutes. Some fetal monitors require you to press a button each time your baby moves.

“Providers often suggest this method when the cervix is not “favorable,” meaning it’s less than three centimeters dilated ...”

The NST results are categorized as reactive or nonreactive. Reactive means the baby’s heart rate and movements fall within the normal range, and nonreactive indicates the baby’s heart rate and movement patterns didn’t meet the minimum qualifications. If nonreactive sounds scary, try not to worry. That term is not a definite sign of a problem. Usually, the next step is to repeat the NST for another 40 minutes, but further testing might also be appropriate.

Biophysical Profile

A biophysical profile (BPP) is an assessment of fetal well-being that involves an ultrasound examination and a nonstress test. Combining these two screenings gives a more accurate evaluation of your baby’s health by examining the following five markers.

• Breathing: How the baby's chest moves during practice breaths in the amniotic fluid

• Heart rate: How many times the baby’s heart beats per minute

• Movement: How often the baby moves over a certain amount of time

• Tone: How well the baby can extend and flex limbs, like arms and legs

• Amniotic fluid index (AFI): How much amniotic fluid is in the womb

The provider will assign a score of 0-2 to each of the five areas and then add the numbers together. A score between 8-10 is considered reassuring, while a 6 or 7 could indicate repeat testing or delivery. Scoring 4 or less typically means additional testing or immediate delivery.

How Does Induction Work If I Go Past My Due Date?

If you get to 42 weeks, we will work with Dr. Spence to schedule a hospital induction, most likely at North Shore Medical Center, where he works most often. The following are common methods for medical labor induction when you’ve gone past your due date. Sometimes, just one technique is enough to put you into active labor. Other times, multiple steps might be what’s needed to have a vaginal birth.

Artificial Rupture of Membranes

Also known as breaking your water, this is when a provider uses what’s called an amnihook to make a hole in the amniotic sac. The amniotic fluid will then begin leaking, and the goal is that contractions will begin after the bag is ruptured. One of the downsides of this method is that, once the water is broken, most hospitals require you to birth your baby within a certain amount of time.

Foley Bulb

This is a procedure where a healthcare provider inserts a catheter into the vagina and through the cervix. Using a syringe, the bulb is filled with water, causing it to inflate and put pressure on the cervix. The cervix responds by dilating, or opening, and this action releases hormones that tell the uterus to contract. When the cervix dilates to about 3-4 centimeters, the Foley bulb falls out on its own. The catheter can also be removed by a healthcare team member if the cervix does not react as expected.

Suppositories

Providers often suggest this method when the cervix is not “favorable,” meaning it’s less than three centimeters dilated, hard, posterior, not effaced, barely effaced, or some combination of these characteristics. There are different medications that can be used as suppositories, and the goal is for them to open the cervix. Remember — when the cervix dilates, the uterus usually gets the hint to start contracting. There is evidence showing this is a more likely scenario in a post-date pregnancy, or one that goes past 40 weeks.

Pitocin

An artificial version of the hormone oxytocin, Pitocin causes uterine contractions. This medication is typically used in conjunction with one of the other methods listed above. Hospital team members administer Pitocin through an IV line and will monitor how your body accepts it. They will generally increase the amount of the medication every 10-30 minutes until they see a consistent contraction pattern.

Takeaways on Going Past Your Due Date

As you get closer to your due date, it’s natural to have a wide range of emotions, like excitement or worry — or both. If you go past your due date, our Miami midwives still want you to have the intervention-free, out-of-hospital birth you desire. We’ll do everything we can to help you achieve it, all while monitoring your health and your baby’s well-being.

To find out if Magnolia’s prenatal care and birth services are right for you, schedule a free consultation!