Going beyond the term of pregnancy is not without risk for the baby. Monitoring is usually required. Psychological causes, risks, care, triggering… Midwife Céline Hattab Braha and psychologist Nathalie Lancelin Huin answer our questions.
Some pregnant women may exceed their term of pregnancy. In France, it is estimated that there are about 15-20% of women who give birth after term, between 41 weeks of amenorrhea (SA) and 41 SA + 6 days, and 1% beyond 42 SA, according to data from SYNGOF (National Union of Gynecologists and Obstetricians of France). Such a phenomenon is not always without consequences. In some cases, there may be baby health risks. When are we talking about overrun ? What are the causes and risks? What is the support? The midwife Céline Hattab Braha and the psychologist Nathalie Lancelin Huin, specialized in perinatality, shed light on the overcoming of the term in pregnant women.
When do we speak of exceeding the term of pregnancy?
The term of pregnancy being between 37 and 41 SA, “the overrun of the term is therefore beyond 41 SA. In France, according to the recommendations, you can exceed the term of pregnancy by five days“, explains Céline Hattab Braha, midwife.
What are the risks of giving birth after the term of pregnancy?
Exceeding the term may present risks for the baby in utero. “Generally, beyond 41 SA + 5 days, the placenta calcifies and exchanges with the baby are less successful. The risk is therefore the fetal distress. In utero, babies can emit meconium in their stools, which is a sign of fetal distress and increases the risk of infection. At birth, baby may not be well“, explains the caregiver.
“Beyond 41 SA + 5 days, the risk is fetal distress.”
Why do some women go beyond the term of pregnancy?
One or more psychological causes could have an influence on overdue pregnancy.
Can the desire to stay pregnant play a role?
Some women don’t want to stop being pregnant. “Because they haven’t taken advantage of it enough or simply by taking the time to make their pregnancy aware. Other women feel very pregnant, they have a feeling of fullness, serenity and are in no hurry for it to end. “, underlines the psychologist Nathalie Lancelin Huin. For others, getting pregnant was difficult (journey LDCs for example) and they live this experience as a unique moment, which may not be repeated.
The fear of motherhood
We can absolutely not be afraid of pregnancy and fear the postnatal period. “My body managed to give life, but would I be up to it as a mother? Would I be able to understand it, to know when it is hungry, if it is in pain? Motherhood is under social pressure. Preconceived ideas weigh heavily on women’s shoulders… And the end of gestation, with childbirth, concretizes these questions, sometimes to the point of slowing down the process”, says the perinatal expert.
The fear of childbirth
Some women are afraid to give birth to their child. “Childbirth is a very strong symbolic passage, but also a great source of concern for women. Especially since questions of obstetrical violence have been very present in recent years. It is normal to wonder how this moment will turn out. To be afraid of not holding on, of losing footing, of being in too much pain…”, develops the psychologist.
The mother can also simply have fear of being separated from her child. “When you give life to your baby, our personal and family history is replayed, our couple too! And we go from something purely biological with the child who develops in the body of the mother, to a completely different issue that raises new questions“, she adds.
A regular fetal monitoring is set up in case of exceeding the term. “From 41 weeks of amenorrhea, we watch every other day the future mother and her baby, by doing a pregnancy ultrasound and monitoring”, reports the midwife. It is this monitoring that will make it possible to decide whether or not to induction of labor.
“From 41 weeks of amenorrhea, we monitor the future mother and her baby every two days, by doing a pregnancy ultrasound and monitoring”.
Is maternity leave extended if the term is exceeded?
If the delivery takes place after the term, in terms of maternity leave, there are some possible arrangements. “Prenatal leave is extended by as many days of delay” and the “duration of postnatal leave remains unchanged”specifies the Ministry of Economy website. Concretely, if you were due to give birth on January 7, 2023 but the birth took place three days later, on January 10, 2023, your prenatal leave is therefore extended by 3 days, but the duration of your postnatal leave remains the same.
When to induce labor after term?
After the term of pregnancy, a labor induction can be decided by the medical profession if monitoring has shown abnormalities, such as in the fetal heart rate. “In the absence of abnormalities, there is no formal indication to induce labor, as long as the due date is not exceeded by at least 6 days. (…) At 41 WA + 6 days, it is recommended to perform a triggerpossibly preceded by cervical maturation by prostaglandins”, specify the High Authority for Health website.
Thanks to Nathalie Lancelin Huin, psychologist specialized in perinatality and to Céline Hattab Braha, liberal midwife in Paris.