As every Friday comes our new section: Ask the midwife, for which we are going to count on the collaboration of midwife Marina Fernández, who will answer each week to one of the questions that our readers need to raise.
This week we have chosen a question that will surely interest many readers who are pregnant and, especially, if they are at the end of pregnancy: how to calculate the probable date of delivery and when it is necessary to induce why week 42 is approaching, as it is usual that when that date approaches the gynecologist it is necessary to schedule an induction with the idea of preventing a C-section and guaranteeing fetal well-being.
Marina Fernandez She is a midwife, specializing in home birth, a lactation consultant and an expert in complementary therapies.The question we have selected is that of Eloa2, this is:
I would like to know if the fpp is always calculated based on the last rule and if the duration of the menstrual cycles influences the calculation of the same although it seems that they are not taken into account. And also and if it is not too much to ask, how long does Marina consider to be expected, always in a normal pregnancy, after the fpp to cause it. Thank you very much in advance.
This is the answer to Eloa's question that matron Marina Fernández gives us.
"There are many doubts regarding the way to calculate the FPP (probable due date).
The specialists calculate the FPP from the date of the last rule, this date is 40 weeks later. There is a trick to calculate it quickly (it's called Naegele's rule): it's adding 7 days and removing 3 months plus 1 year to your last rule. For example: If your rule was July 5, 2013, the FPP will be April 12, 2014. Some midwives consider whether the woman has irregular cycles or if she tells us a probable date of fertilization, which some women know by various circumstances, but the most reliable way to obtain FPP is by ultrasound of the first trimester.
The ultrasound of the first trimester in week 12, has a series of objectives, among others, to determine the gestational age through the measures of the fetus. In these first weeks we know that exact millimeters grow every day and with this measure the FPP can be calculated with greater precision, because you can know when was the last estimated date by ultrasound, or the date of fertilization on day 14 approximately of your cycle (if we have 28-day cycles) or if it was at another time earlier or later for any other reason. Only the date of fertilization with assisted reproduction techniques is known exactly. For this reason, many times, gynecologists change the FPP after performing this ultrasound.
The first reason to induce labor is prolonged pregnancy. A normal birth is the one that occurs from week 37 to 42. The recommendations of the SEGO (Spanish Society of Gynecology and Obstetrics) are that a few days before reaching 42 weeks the labor is induced. Before deciding on a labor induction, the gynecologist has to ask some questions, such as:
Is the FPP well calculated? Do we know the gestational age of the baby by an ultrasound of the first trimester or are we simply estimating it approximately by the last rule?
According to Dr. Emilio Santos Leal, in his book “Pregnancy and Childbirth everything you need to know,” he says: “In almost all countries, the criterion of inducing labor is followed by turning 41 and a half weeks. The reason is that it has been shown that doing so decreases the probability of having a cesarean section. Possibly this is because with 42 weeks, many babies begin to have significantly harder skull bones. Out of this case, inducing labor implies more (and not less) risk of caesarean section. "
This is the time to negotiate with your gynecologist a few more days before induction if the following conditions exist:
- You feel your baby move every day at least 10 times.
- Your baby is fine on cardiotocographic monitors, which at this point in pregnancy have to be done every few days.
- The placenta feeds your baby perfectly, through oxygen and adequate nutrients that reach through the blood that circulates through the umbilical cord to your little one, observed by means of Doopler in the control ultrasound that is performed at this time.
- Amniotic fluid is in acceptable quantity and condition, also assessed on ultrasound.
One factor that greatly influences the prolongation of pregnancy is stress, often caused by this same reason of not giving birth, by social and hospital pressure, by the desire to have your baby in your arms, to see her face , etc… Try to do pleasant activities, relax, massage, walks, if you have a partner be in a climate of love and tranquility, feel lucky and enjoy the last days of your pregnancy. "
We hope that the response of midwife Marina Fernández be useful and remember, you can continue sending your questions in the comments to this article, so that she can answer one next Friday.
