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The Overdue Blues

PULLING OUT ALL THE STOPS

If all else fails and your baby simply refuses to budge, your doctor will likely start talking about inducing labor. But as long as mom and baby are both healthy, overdue mothers-to-be who want to go the natural route shouldn't feel pressured to submit to an induction before 42 weeks, says Richard Schwarz, chairman of the department of obstetrics and gynecology at New York Methodist Hospital. If labor doesn't look imminent at 42 weeks or if the baby shows signs of distress before then, your obstetrician will call in the big guns -- membrane stripping, prostaglandin gel, membrane rupture, and Pitocin.

First, for membrane stripping, the doctor inserts a gloved finger through the cervix and sweeps it over the membranes that connect the amniotic sac to the uterine wall, which causes cramping and the release of natural prostaglandins that may help ripen the cervix and stimulate contractions. Next, she may administer a prostaglandin gel vaginally or use a crochetlike hook to rupture the bag of waters. If contractions don't start within 24 hours of the amniotic sac being broken, the chance of uterine infection increases and Pitocin will be administered. Given intravenously, this synthetic version of the hormone oxytocin is a nearly foolproof method for bringing on labor. But be warned -- some women report that the contractions induced by Pitocin are longer, stronger, and more painful than natural contractions. There may also be a greater chance of uterine rupture and fetal distress when Pitocin is used.

In the end, whatever methods are employed in an effort to bring your slightly tardy infant into the world, there's one important point to remember: Your baby will get here -- and when he does, 40-plus weeks of pregnancy may seem like a breeze in comparison.

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