Postterm Pregnancy: When Your Pregnancy Goes Past Your Due Date

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You have been waiting for nine months to hold your baby in your arms, and your due date has come and gone. Now what?

The average length of pregnancy is 280 days, or 40 weeks. This countdown starts from the first day of your last menstrual period. A pregnancy that lasts 41 weeks up to 42 weeks is called late term. A pregnancy that lasts longer than 42 weeks is called postterm.

The causes of a postterm pregnancy are unknown, but factors that may increase your chances include if you:

  • Are carrying your first baby
  • Are having a boy
  • Had a previous postterm pregnancy
  • Are obese

Concerns About a Postterm Pregnancy

Most women who have postterm pregnancies deliver healthy babies with no complications. But the risk for certain problems goes up slightly during a postterm pregnancy. These problems include:

  • Macrosomia, or delivering a large baby (over 9 pounds)
  • Meconium from your baby’s bowels getting into his or her lungs, which can cause breathing problems
  • Decreased amniotic fluid, which can cause the umbilical cord to pinch and reduce the flow of oxygen to your baby

Testing During a Postterm Pregnancy

Once you reach 41 weeks, your doctor may want to do some testing to make sure your baby is not showing any signs of distress. These tests include

  • Electronic fetal monitoring: Your doctor will place two belts around your abdomen to hold sensors. The sensors measure your baby’s heart rate and the frequency of your uterine contractions.
  • Nonstress test: This test measures your baby’s heart rate for a specific amount of time, usually 20 minutes. The results are given as reactive (reassuring) or nonreactive (nonreassuring). If you get a nonreactive result, that doesn’t mean your baby isn’t healthy, but your doctor will want to do more tests.
  • Biophysical profile: This test involves monitoring your baby’s heart rate in addition to doing an ultrasound. The goal is to check your baby’s heart rate, breathing, movement, and muscle tone. Your doctor will also assess the amount of amniotic fluid surrounding your baby.
  • Contraction stress test: Your doctor will monitor how your baby’s heart rate changes when your uterus contracts. To make your uterus contract mildly, your doctor may give you the drug oxytocin as an IV in your arm. The results of this test could be categorized as reassuring (all is fine), nonreassuring (more tests are needed), equivocal (the results are not clear) or unsatisfactory (there weren’t enough contractions to provide a good result).

If any of these tests reveal your baby is showing signs of distress, your doctor may want to induce labor.

Inducing Labor

There are several different ways your doctor may attempt to move your labor along during a postterm pregnancy:

  • Stripping the amniotic membranes – Your doctor sweeps a gloved finger over the thin membranes that connect the amniotic sac to the wall of your uterus, which can stimulate the release of hormones to start labor.
  • Rupturing the amniotic sac – Your doctor makes a small hole in the amniotic sac to release the fluid
  • Oxytocin – This drug causes your uterus to contract. Your doctor will likely start you on a low dose and gradually increase it if necessary. You will be carefully monitored to make sure your contractions don’t come on too strong too suddenly.
  • Prostaglandin analogs – Your doctor may place medications in your vagina to soften your cervix and get it ready for labor.
  • Cervical ripening balloon – Your doctor may place a small balloon-like device in your cervix to dilate it and help start labor.

If inducing fails to start labor, your doctor may try again or may determine that a cesarean delivery is the best option for you and your baby.


Once you go over 41 weeks of pregnancy, your doctor will closely monitor your baby’s health and watch for any postterm pregnancy problems. If you have any questions about what will happen once you go past your due date, don’t hesitate to ask your doctor.

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