The MYTH of "40 weeks"

© Spot of Serendipity 
Babies come when they are ready. Did you know that?  They are not “early” or “late”. They are right on time – their own time! It is going to take generations of humans UNlearning the term “40 weeks” to change this perception and thought process. If a woman’s (very) loosely calculated “due” date comes and goes with no signs of labor, the baby is not “late”. S/he is just not ready. Babies come when they are ready.
All functions of Nature operate best when uninterrupted.  Our current Western civilization has gotten exceptionally good at interrupting the biological process of birth. We create “problems” through the over-use of ultrasound. We over-test prenatally. We do not discuss the importance of a woman’s diet during pregnancy. We are almost looking for terrible things to happen during an otherwise very perfect process and one that wishes to ensure the survival of our species. From an evolutionary point of view, if birth was as dangerous and risky as modern medicine has led us to believe, homo sapiens would not have survived – and THRIVED – for as many centuries as we have thus far. And that is a fact. The common response to that fact is “modern medicine has saved many women’s and baby’s lives that would have died hundreds of years ago”. That is also true. What is not true is the perception that you can eliminate risk entirely from birthing. In fact, you cannot eliminate risk entirely from any process, especially driving a car. Yet nobody is fighting over whether we should or should not drive a car.
This week, I am with my family in Texas waiting for a new little niece to grace us with her Earthly presence. The hot humid air coupled with warm summer breezes and the excitement surrounding the anticipation of a new baby reminds me of this very time three years ago….I wrote about this topic then as well. My sister was patiently waiting for my nephew to arrive. It was hot, she was uncomfortable and very ready for his pregnancy to be over. Every day, people would say to her, “you still haven’t had that baby??” Every day, she would feel exhausted and over-whelmed and grumpy with the dramatic antics of our two year old daughters fighting over toys. Every day, she hoped would be THE DAY she would go into labor. She did all the things to try to encourage my nephew to come out. Finally, late one night at close to 42 weeks pregnant, she took a walk around the block with only her dog as company. Her contractions became regular until her water broke and my nephew made his debut just after sunrise on Independence Day. What joy and relief came with his birth; my sister was over-joyed to no longer be pregnant!
© Spot of Serendipity
While most would classify my nephew as “late” in his arrival to Earth, he was right on time, FOR HIM. It was HIS timing and HIS birth and HIS readiness that my sister waited for – and protected – amidst the copious amounts of comments  and questions she received every day from well-intentioned people. People who aren’t used to the fact, or aware, that “40 weeks” is a total estimate of gestational length in humans.
Back in March and April, I was supporting a doula client and friend who had prodromal labor for WEEKS. She was over it. She was tired and uncomfortable and really ready to hold her third baby girl. We had talked and joked about how “fast” we anticipated her third labor and delivery to go. Her second baby came in a hurry so we made the false assumption that her third would do the same, if not arrive even faster! For weeks, we kept thinking “this is it!” each time her contractions would start up again. They would go on for hours and hours at a consistent rate and we would cross our fingers that her baby would arrive that evening. And then the contractions would stop. Over and over she labored off and on for weeks. Weeks! People made the same comments to her that my sister received….”where is that baby?!” or “I can’t believe you haven’t had that baby yet!” or even “that baby is stubborn!”. But is the baby stubborn? Or she just not ready yet? We don’t know why labor stops and starts (and prodromal labor is the worst) but we DO know that allowing a baby to initiate labor and not interrupt the physiological process of birth is BEST for mothers and babies unless medically indicated otherwise. And we were so very thankful that her care provider is aware of this as well and offered her zero pressure to electively induce her labor or do anything other than WAIT. Why is this not standard practice for all care providers in maternity care?
© Spot of Serendipity

Where did the magical “40 weeks” come from? An obstetrician named Franz Naegele in the 19th century developed a mathematical formula to “calculate” a woman’s “due date”. He started with the first day of a woman’s last menstrual cycle and added seven days. He then subtracted three months and came up with a “due date” which he determined to be 266 days from conception to birth. BUT….this rule ASSUMES

  •        all women have the exact same amount of days in their cycle (they do not)
  •        all women ovulate on the same day of their cycle (they do not)
  •        every pregnancy is the exact same for an individual woman (they are not)
  •        all women’s bodies function exactly the same regardless of age, health, diet, ethnicity, race, geographic location, etc (they do not)

SO, as you can see, this formula is HIGHLY inaccurate yet we are basing every. single. thing. related to pregnancy and birth on this one estimated GUESS at when babies might possibly be born. Everything from when you are scheduled for prenatal appointments and testing to when modern medicine would attempt to schedule elective (read: unnecessary) inductions and Cesareans. You’ve heard every pregnant woman you’ve ever known say “I’m __________ weeks pregnant today!” But is she? Maybe her “due” date is off by a few days, a week, maybe two weeks! Maybe we have no idea what we are talking about and there is no way to calculate when babies arrive. Maybe we don’t needto calculate when babies might arrive. We spend a lot of time and energy and anxiety worrying about “due” dates and they are not even accurate. And the fact of the matter is, babies come out. Whether we measure and worry or not, they still come out of the mother’s uterus when they are finished incubating.
Does anyone else find the emphasis placed on Naegele’s rule to be ridiculous? Absurd? Or possibly detrimental? Misleading? Possibly causing worry that would otherwise not be there? A healthy first-time mother who has encountered zero complications during her pregnancy is suddenly going to lose her belief in her own ability to birth her baby, an otherwise instinctually normal belief that most women possess. Every mother, of course, wants a healthy baby and birth – she will do anything to ensure that happens, even fully believe her care provider when she is told she must induce her labor otherwise her baby’s life is at risk. The majority of the time that is completely not true!
© Spot of Serendipity
The significance that is placed on “40 weeks” is causing a lot of complications during pregnancy and birth in America. It directly contributes to the substantial increase in elective (unnecessary) inductions and “emergency” Cesareans we have seen in this country in the last two decades alone. Unnecessary inductions lead to an increase in premature babies that would otherwise have been born ready to function without having to spend time in the NICU. It is a common cause for unwarranted concern in the last weeks of pregnancy. It is the source for a lot of needless worry and fear. And most women have no idea how completely inaccurate their “due” date is… ludicrous the idea of “40 weeks” truly is. Truthfully, a woman’s ethnicity/race and geographic location has a much higher impact on how long she will carry her baby before giving birth than her conception date.
What can we do? The best thing we can do is educate one another. Ask questions. Research Naegele’s Rule and how erroneous it is. Women that are knowledgeable about their cycle length and day of ovulation have an advantage in feeling confident about their baby’s arrival time rather than relying on their care provider to arbitrarily come up with a “due” date based off of an incorrect mathematical formula. We can easily change our language….consciously deciding to remove the words “early” and “late” from our vocabulary when describing the timing of a baby’s birth. Change the words we use when speaking about pregnancy and birth, when describing how “far along” women are in their pregnancy.
© Spot of Serendipity
Babies come out when they are ready. We cannot predict when babies will be born any more than we can predict when babies will be conceived. Attempting to manage and control this process when not medically indicated is detrimental to women and their baby’s birth and only causing more concern and worry. Let’s change our perception and our words to reflect this knowledge.

Forty weeks, schmorty weeks!

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