What to do when the pregnancy is past the due date and still not labor?

The article was professionally consulted by Specialist Doctor I Tran Thi Phuong Loan - Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Phu Quoc International General Hospital.

Pregnancy past the due date but still not labor is a case where a pregnant woman is pregnant for more than 40 weeks and still has no signs of giving birth. Pregnancy beyond the due date can greatly affect the health of the fetus as well as the pregnant mother.

The due date is the date the doctor predicts that the baby will be born, determined based on the first day of the woman's last menstrual cycle.
The average gestation period is 280 days or 40 weeks, calculated from the first day of a woman's last menstrual cycle. When pregnancy lasts from 41 to 42 weeks (1 week after the due date), it is called late pregnancy. A pregnancy that lasts more than 42 weeks from the first day of the last menstrual period is called an overdue pregnancy.
Pregnancy beyond the date of labor will have a risk of affecting the health of both the mother and the fetus. However, this problem usually only occurs in a small number of pregnancies past the due date.
Some of the risks associated with pregnancy beyond the due date include:
Stillbirth. The baby is too big. Excessive pregnancy. There is stool in the fetal lungs, causing the baby to experience severe breathing difficulties after birth. The reduced amount of amniotic fluid puts pressure on the umbilical cord and limits the oxygen supply to the fetus. Pregnancy beyond the due date increases the likelihood that a woman will need support if she gives birth naturally or has to have a cesarean section. In addition, the risk of infection and postpartum bleeding is also higher when the pregnancy is past the due date.

When a woman is less than 1 week past her due date, she does not need to be tested. By the time the fetus is 41 weeks old, the doctor will recommend the pregnant woman to take a test to check the pregnancy status.

Monitoring tests when the fetus is past due date include:
Monitor to monitor fetal response: Use a monitor to monitor the fetal response, to help check the health status of the fetus past the due date, sometimes combined with ultrasound. Non-stress test: measures the fetal heart rate over a period of time usually 20 minutes. Results were recorded as reactive (good outcome) or no response (bad outcome). Bad results do not mean that the fetus is not healthy, it is necessary to perform other new tests to accurately diagnose the condition of the fetus past the due date. Biophysical test: is a test panel related to fetal heart rate monitoring as well as fetal ultrasound. This test determines the current health status of the fetus based on heart rate, breathing, movement, muscle tone. CST test: monitor fetal heart response to uterine contractions. The doctor will inject the hormone oxytocin into the mother's body through an intravenous line to cause uterine contractions like when giving birth. The test results help the doctor know how healthy the baby is when uterine contractions appear at birth.

When a pregnant woman is past her due date and still has not gone into labor, the doctor considers choosing the following methods to induce labor:
Amniotic fluid removal: The doctor wears gloves and uses his finger to separate the amniotic membrane from the uterine wall. Breaking the amniotic sac: making a small hole in the amniotic sac to break the amniotic fluid, thereby inducing labor. Oxytocin: a drug that helps induce labor contractions, given intravenously into a pregnant woman's arm. Dosage can be increased gradually over time but must be carefully monitored. Prostaglandin analogues: these drugs are placed intravaginally to ripen the cervix. Cervical dilation: Your doctor places a catheter with a very small balloon attached to the end of your cervix. Water is then pumped into the balloon until it stretches, which causes pressure to help open the cervix and initiate labor. These methods of induction can pose some risks to the mother and baby such as: changes in fetal heart rate, too strong uterine contractions, infection, ineffective induction of labor, etc. When the fetus is past the due date but still has not gone into labor, pregnant women should soon visit medical facilities to be diagnosed by experienced obstetricians and given appropriate interventions. Accordingly, in order for the labor to take place smoothly and safely, the mother needs to be well psychologically prepared and equipped with knowledge on a number of issues such as methods of pain relief during childbirth, how to push and breathe during childbirth. usually properly, taking care of the perineal stitches, as well as taking care of children in the perinatal period,...
For first-time mothers, it is inevitable that there are shortcomings, not much experience in the matter. maternity care as well as postnatal care. Understanding the process of carrying a painful labor and wishing to relieve the pain of childbirth, Vinmec offers a comprehensive Maternity program with a complete "painless delivery" service during and after birth.
The biggest obsession of women who have a caesarean section is the pain after giving birth because the anesthetic has worn off. Every movement, even the smallest, makes the incision painful.
When giving birth by cesarean at Vinmec, women will be able to relieve pain after surgery by using an anesthetic of the lumbar squamous muscle under ultrasound guidance. This is an anesthetic method that helps prevent pain signals from being transmitted to the brain, making the mother feel no pain, helping the mother relax, recover, take care of the baby and fully enjoy it. motherhood joy.
In addition, Vinmec also applies the technique of nerve anesthesia to help relieve pain in the perineum and lower abdomen, whether it is a natural birth or a cesarean section, this method also supports the mother to "go through labor" in the easiest way. .
After birth, the baby will be cared for in a sterile room before being returned to the mother. Pregnant women will rest in a high-class hospital room, designed according to international hotel standards, 1 mother 1 room with full facilities and modern equipment. Mothers will be consulted by nutritionists on how to feed the baby before being discharged from the hospital. Postpartum follow-up with both mother and baby with leading Obstetricians and Paediatricians.
For detailed information, please contact the hospitals and clinics of Vinmec health system nationwide.