Predicting delivery date

34 weeks on Thursday, and things still look good.  I’ve passed two more BPPs, and this baby continues to move and grow.  (As does my belly/ass.)

At my appointment today, I asked my doctor if there were any predictions for due dates based on how I look/my previous baby’s birth date.  She said not really, and that “all bets are off” after 36 weeks.

I’m sure many parents anxiously awaiting the birth of a new baby ask themselves, “when is this going to happen?!?”  And, of course, there’s usually not a definitive answer (unless you’re having a scheduled C-section).

There are many criticisms of the current calculation of “due date”—most importantly that it tends to be 1-4 days too early.   (And we specifically believe my due date is 3-4 days too early because (1) we know I ovulate late generally, (2) we know when we likely, um… got pregnant…, and (3) this guy was measuring 3 days late from the very, very beginning when all fetuses should be basically the same size.)

https://expectingscience.com/2014/09/29/your-due-date-is-wrong-so-when-is-labor-really-most-likely/

But, there are always odds, and these odds take into account the fact that “due date” appears to be early/off because they rely on real-life women!  So I decided to figure out what my odds are of having a baby, and specifically base them off of events coming up in my life….

Event	Chances of delivering by that date*/**	Chances of delivering on that day*
Early April baby “sprinkle”	2.5% / 0.3%	0.3%
Mid-April doula prenatal appt.	5% / 1.9%	0.6%
Early May important meeting	32% / 23%	2.4%
May 10 “due date”	48% / 42%	3%
May 13 suspected due date	57% / 53%	3%
Mid-May friend’s wedding	76% / 70%	3%

*Run using https://datayze.com/labor-probability-calculator.php (based on studies)

**Run using https://spacefem.com/pregnant/charts/duedate1.php (based on 13661 responses, 10368 occurring spontaneously)

I’m not clear why these two predictors are a little off from one another—it might just be in the populations they use.  (Note that they are close, though, especially as the due date gets closer.)

As I’ve previously mentioned, depending on how things are going my doctors might want to pressure me into inducing at 40 weeks, although at least one has indicated if things look good they should let me go to 41 weeks.  So it’s super unlikely I’ll go much past my mid-May due date, meaning there is virtually no chance I will still be pregnant for my friend’s wedding 2 weeks later.  (That being said, if I do go a little late I probably won’t be able to make the wedding.)

Something else I’ve been wondering—will this baby likely come earlier than his brother (born at 40w1d)?  Interestingly, the answer appears to be no—second time moms and first time moms tend to deliver at roughly the same pace:

https://spacefem.com/pregnant/charts/duedate6.php

In fact, I’ve read the best predictor of when you’re going to deliver your second child is when you delivered your first child.

(Although this post suggests second or later mothers may deliver a few days earlier than first time mothers: https://expectingscience.com/2014/09/29/your-due-date-is-wrong-so-when-is-labor-really-most-likely/)

In any case, I delivered my first kiddo at 40w1d, so I’m likely delivering around the same time (maybe a few days earlier) this time around.  Which means I should be able to just make my very important meeting, which is scheduled for 6 days before my due date.  Good to know!!

Natural induction

32 weeks!!!  I had my BPP on Tuesday.  All is good.  Baby is moving all around, and the ultrasound again took like 5 minutes.  I also had my blood re-checked.  Platelets are still low, but don’t appear to be dropping very fast.  So that’s good.

I also did some research on natural induction, because I don’t want to be medically induced if I go past 40 (or 41) weeks.

This article suggests that medical induction of labor increased from 9.5% in 1990 to 23.2% in 2011:

http://europepmc.org/articles/pmc3868990

It also notes that medical induction is associated with lower birth weight and increased odds of C-section.  It considered non-medical methods of induction, suggesting evidence is “sparse,” but “mixed” for sex, “tentatively positive” for nipple stimulation, and “ineffective” for castor oil (and potentially harmful).  The study really focuses on who attempts natural induction (and natural pain management) versus considering what actually works.  (No surprise, women who use doulas are much more likely to avoid medical reliance on either one.)

This article goes through induction methods—both “natural” and medical—and considers their effectiveness and potential negative outcomes. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3224350/

As it related to “natural” methods (castor oil, acupuncture, breast stimulation, sex, “homeopathic” methods, and hypnotic relaxation), the study appeared to conclude that more research was needed.  Acupuncture appeared to decrease the need for other forms of induction, as did breast stimulation.  Castor oil, sex, and hypnotic relaxation did not appear to help, but women using castor oil had increased side effects (nausea).  The article did not consider walking, eating dates, eating black licorice, or using evening primrose oil, other methods old wives swear by.

(This website suggests that drinking red raspberry tea, eating greasy food, or eating pineapple don’t help, and that eating spicy food or using black and blue cohosh may be harmful: http://www.birthbeyondbias.com/birthbeyondbias/2014/4/21/ways-to-naturally-induce-labor)

This is a crazy article—it suggest that rates of autism might be increased in children whose mothers were induced.  https://jamanetwork.com/journals/jamapediatrics/article-abstract/1725449  Whaaa?  I can’t imagine why that would be, unless there’s some association that they did not control for (like older mothers are more likely to be induced / more likely to have children with autism.)

My first (and second) biophysical profile

A week ago I hit 30 weeks.  And I also had my first biophysical profile.  Well, half of it at least.  I had an ultrasound that looked for a variety of things over an up-to 30 minute examination: 30 seconds of breathing, 3 big movements, 3 little movements, and a fluid measurement.

It was quite possibly the most stressful ultrasound I’ve ever had. 

I went in expecting nothing but good news—this baby has been super active, and I had no reason to think that they would find something abnormal at 30 weeks that somehow was missed in all of my other ultrasounds.  But then the ultrasound started and the tech said NOTHING.  NOT A WORD.  And in my experience, silence during an ultrasound is a bad thing.  So I started freaking out.  “Is everything okay?!”  I asked.  She was like, “I don’t see anything yet, I’m just getting started.”  But I scanned the screen and was sure I saw a heartbeat.  So I calmed down.  For a minute.  Still silence.  I started getting nervous again.  “Any concerns?”  She was super unfriendly, “I have to count and I need silence to concentrate.”  So I just sat there, fretting and stressing, until she was like, “and we’re done.” 

Jeez!  Talk about bad bedside manner.  So I passed, I guess.  She didn’t say anything about the exam.  The only thing I managed to get was baby’s heartrate—142bpm.

My husband is worried that the ultrasound is going to do some harm to the baby, but the doctors do not seem concerned.  From what I’ve read, though, it’s not clear that BPP actually has any value.  My doctor said that if you have a normal BPP, the chances of not having a stillbirth in the next week are 99.9%.  (Based on what I’ve read, that might be the same risk without a BPP.)  

At least one article suggests that “There was no difference between the groups in the number of babies that died, nor in the number of babies who had low Apgar scores [between high-risk pregnancies that do a BPP and those that do not]. However, although the number of women involved was small, the BPP was associated with a significant increase in induction and caesarean section. However, the data are insufficient to reach a conclusion about the benefit or otherwise of the BPP as a test of fetal wellbeing.”

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0010436/#!po=4.54545

Apparently I should end up with a “score,” but she didn’t say anything:

https://en.wikipedia.org/wiki/Biophysical_profile

I had another one yesterday, and it went much better.  Partly because I knew what to expect, and partly because baby was going totally bananas before the appointment event started.  He kept it up and the whole thing literally took three minutes—he kicked the probe off of my stomach at one point.  

I asked about the score this time, and she said that if I don’t get 8/8 they go on to do additional monitoring.

After the appointment, I met with one of the doctors.  She was great.  She told me not to stress about my weight, noting I was “lean” before I got pregnant, that my blood pressure is really good, and saying if I exercise every day that’s great.  Baby’s heartrate was in the 130s, exactly where it should be.

I’m 31 weeks in 1 day.  It’s hard to believe!