The risks of pregnancy after the 42-week mark
Crossing the 42-week line is a post-term risks, posing added risks to the mom and baby
In my career as a Houston, Texas medical malpractice lawyer, I have handled many cases involving poor prenatal, labor, delivery, and birth care in a doctor’s office or hospital.
As a father of four children, I know that one of the first things that soon-to-be parents ask about is the due date for their new baby. Typically, the OB/GYN doctor or health care provider provides an estimated due date on the first prenatal visit, after confirming pregnancy.
A due date provides and important reference point for both parents and the OB/GYN or healthcare provider who will be managing the labor and delivery of the baby.
During quality prenatal care, the OB/GYN will compare the baby’s growth and development to expected milestones and growth charts. When the due date passes and the baby has not been born, a good OB/GYN or birthing provider (such as a midwife) takes note and makes plans to preserve the health of the baby and the mother.
I remember our Texas Medical Center-based maternal fetal medicine specialist (MFM or perinatologist) in our family’s pregnancies saying that he would not allow the pregnancy to continue beyond 42 weeks gestation, meaning that he would definitely deliver the baby at that time. His plan is consistent with medical studies, literature, and other birthing experts, which have found that there is nothing to be alarmed about if a baby is not born by up to two weeks after the due date.
A pregnancy lasting between 41 weeks and 41 weeks, 6 days is called a late-term pregnancy. Beyond the 42 week mark, though, is a bright and concerning line, and delivery in this timeframe is referred to a post-term pregnancy.
Recently, a new mother called by office to tell us about her concerns she had about her labor and delivery care by a Cypress, Texas area OB/GYN and hospital. When she went to the hospital to be induced with Pitocin, she was at 42 weeks gestation, so it was a post-term delivery situation.
She had some complications during the labor and delivery process, including being overmedicated with the epidural anesthesia. The anesthesia and other healthcare providers recommended converting to a C-Section delivery.
The mom’s OB/GYN was part of a practice group. Her OB/GYN had left town for vacation, without telling her. According to the mother, when her OB/GYN received a call with the recommendation for C-Section, she declined and said to continue the mother in labor.
The baby was eventually delivered naturally (vaginally) the same day, but during the birthing process the baby’s shoulder was in a bad position and required extra manipulation. The mother experienced some bad tears during the delivery and the baby’s shoulder was injured. Time will tell if the baby has permanent neurological injures.
Risks of post-term pregnancies (42 weeks and beyond)
Experts and medical studies reflect that there are serious risks to allowing a pregnancy to continue beyond the 42-week line, including:
· Macrosomia: The baby can be too large for a safe vaginal delivery, increasing the odds of both a C-section and getting a shoulder stuck behind the baby’s pelvic bone during delivery. The latter condition is caused shoulder dystocia and can cause permanent neurological injuries.
· Oligohydramnios: This is a condition where there can be low amniotic fluid, which can impair the baby’s heart rate and compress the umbilical cord during contractions. This presents and increase risk of brain injury to the baby because of an insufficient oxygen supply.
· Post-maturity syndrome: This can present with a number of issues, including lanugo (downy hair) and meconium staining of the baby’s skin (by a bowel movement by the baby before delivery).
· Severe vaginal tears for the mother during delivery.
· Maternal infection.
· Bleeding of the mother after the baby is delivered (post-partum bleeding).
We are here to help
Sadly, the new mother I talked about above, and her baby, experienced many of the expected complications from a post-term pregnancy that was mismanaged by her OB/GYN. If you or someone you care for has suffered these types of injuries, call the experienced medical malpractice, birth, baby, and brain injury lawyers at Painter Law Firm, in Houston, Texas, at 281-580-8800, for a free consultation about your potential case.
Robert Painter is a medical malpractice and wrongful death attorney at Painter Law Firm PLLC, in Houston, Texas. He represents patients and family members in medical negligence lawsuits against hospitals, doctors, surgeons, OB/GYNs, and other healthcare providers. In 2017, H Texas magazine named him one of Houston’s top lawyers.
Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.
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