THE MANAGEMENT OF A PREGNANCY THAT IS BEYOND ITS ESTIMATED DUE DATE
Forty completed weeks of pregnancy is your due date. Not everybody has given birth by then. Just as some give birth before their due date, others go beyond their due date. If all the usual measures and tests of pregnancy well being are normal, then going beyond your due date is considered normal and acceptable. Indeed, one in eight "normal pregnancies" go beyond their due date and are not in labor by 14 days beyond the due date.

For how Iong! can a pregnancy be followed safelv?
Most physicians do not like to see a pregnancy go much beyond 14 days past the due date, as long as things are going well as evaluated in the office and you are taking good care of yourself. Some action will be taken when something begins to look different or unusual. This is the time when it is even more important to keep your appointments so that significant changes can be readily identified.

What happens if you have reached 42 weeks "normally" and have yet not delivered?
Your physician will most likely decide to induce your labor. How this is done depends upon your cervix and its readiness for the onset of labor. It may be possible to make your lahor start with a natural hormone called Oxytocin. (pitocin) given in carefully measured amounts. Alternatively, another hormone called Prostaglandin may be used.

How successful are inductions?
Success depends mostly on the condition of your cervix - the opening of your womb. If it is "ripe" or "favorable" the success rate is high.

How does one know the cervix is favorable?
This is done by a vaginal examination that your physician performs starting ahout 40 weeks of pregnancy. The length (thickness or effacement), consistency (softness), direction and dilatation (how open) are the. major determinants of "ripeness" or readiness.

What if vour cervix is not favorable?
In many patients a natural hormone call Prostaglandin (Prostin or a derivative called Cytotec) has been used to improve the condition of the cervix. This medicine comes in a jelly-like form or tablet and is inserted into your vagina while you are resting in a hospital bed.

The sensitivity of the cervix to Prostaglandin is different from person to person. Some require only one or two doses while others may require many doses. The usual time between doses is about 3-5 hours.

Prostin or Cytotec induction is done as a modified outpatient procedure and usually does not require an overnight hospital stay.

If you are a candidate for an induction trial, your physician will give you a tentative date and time for starting the procedure. As this is not an "emergency" procedure it will be begun and continued on a space available basis with due consideration for your safety and comfort. Check by phone for space availability before you come: telephone 784-4267. You may be called one or two days before or after your tentative induction date. Patients scheduled to be induced in the morning must be ready to come to the hospital at 6:00 AM:

Quick results are not implied or guaranteed. Please do not tell your friends and relatives that you are going to have a baby when you are coming in for induction trial. As this is a procedure of uncertain duration, do not expect a baby immediately. Indeed, there are times when you may be sent home at the end of the day.

Please direct further questions to your physician.