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Expert Q&A:
Is there a safe way to get labor started at 40 weeks?

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Elaine Zwelling
Answered by Elaine Zwelling R.N., Ph.D., L.C.C.E., F.A.C.C.E.
Elaine Zwelling, R.N., Ph.D., has been involved in maternal-newborn health care for 40 years. She has a bachelor's degree in nursing from Capital University and a master's degree in nursing and a Ph.D. in Family Relations and Human Development from Ohio State University. Dr. Zwelling brings to the Pampers Parenting Network her experience of helping expectant parents enjoy their pregnancy, plan and create a positive birth experience, and learn about parenting their newborn baby. She is certified by Lamaze International as a childbirth educator, is a Fellow in the American College of Childbirth Educators, and has taught childbirth classes for 25 years. Dr. Zwelling was the director and faculty for the Lamaze International Childbirth Educator Certification Program of Florida; in that role she prepared many nurses to become childbirth educators.

Dr. Zwelling was a Professor of Maternal-Newborn Nursing for 23 years at both Capital University and Ohio State University in Columbus, Ohio. At these institutions she taught undergraduate and graduate students and conducted research. For eight years she was a Senior Consultant with Phillips &; Fenwick, a women's health consulting firm in Santa Cruz, California, specializing in helping hospitals implement family-centered maternity care. Currently Dr. Zwelling is a Perinatal Nurse Consultant with the Hill-Rom Company. In this position, she provides comprehensive support and consultation to hospital maternity units to create quality care environments equipped with the appropriate equipment for labor and birth and provides clinical education for nursing staff.

Dr. Zwelling is the co-author of a maternal-newborn nursing textbook, Maternal-Newborn Nursing: Theory and Practice, and has published many professional journal articles related to maternal-newborn health care, family-centered maternity care, and childbirth education. Dr. Zwelling is a recognized speaker at professional conferences and teaches continuing education seminars for childbirth educators and perinatal nurses throughout the country.

Dr. Zwelling resides in Sarasota, Florida, and has a grown son, lovely daughter-in-law, and two grandchildren.

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Question


Is there a safe way to get labor started at 40 weeks?

Answer


Although you're 40 weeks' gestation and apparently have not had signs of labor beginning, there should be no immediate need to induce your labor unless there is a medical problem or concern (for example, gestational diabetes, or signs of distress in your baby). The "normal" range for labor to begin is between 38 and 42 weeks' gestation. I would ask your physician why he or she wants to induce you. If you and your baby are both fine, I'd suggest waiting a little longer for Mother Nature to get things going naturally.

Induced labors are often more difficult to deal with, requiring you to need medication or an epidural anesthetic much earlier in your labor than if the induction drug Pitocin was not being used. When anesthesia is given early in labor, you're confined to bed, there is the possibility that labor will not progress as well, and a Cesarean delivery may be the result. It's also not wise to have an induction before your cervix has begun to show signs of readiness for labor, such as ripening (softening), effacement (thinning), and beginning dilation. Staying active and walking each day won't necessarily start your labor, but are good for your general well-being. Old-fashioned remedies that our grandmothers used to start labor, such as castor oil or enemas, are not usually effective, either.

If labor has not begun by 42 weeks' gestation, discuss induction with your physician. After that time induction may be wise, because the placenta begins to show signs of aging beyond 42 weeks, and the baby needs to be born. So take a deep breath, be patient, and within another week or so your body will probably decide it's time for labor to begin.

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Member comments
Past My Due Date
I am 40wks and 5 days past my due date i am 1cm dilated and 60% effaced. My dr. has set up an ultras..

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