Risk of stillbirth increases after 41 weeks of pregnancy, study suggests

[Photo: Getty]
[Photo: Getty]

Inducing labour for women whose pregnancy continues to 41 weeks could help lower the number who experience stillbirth, new research has suggested.

Currently the NHS states that induction should be offered to all women who don’t go into labour naturally by 42 weeks.

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“Induction is offered to all women who don't go into labour naturally by 42 weeks, as there's a higher risk of stillbirth or problems for the baby if you go over 42 weeks pregnant,” the site explains.

But, following the results of latest research scientists in Sweden suggest it could be reduced to 41 weeks to help lower the risk of pregnancy complications and baby loss.

The call follows a trial of 2,760 women with an uncomplicated, single pregnancy who were admitted to 14 Swedish hospitals between 2016 and 2018.

The participants were assigned to two groups: approximately half were induced at 41 weeks, while they others had to wait.

Among those who waited there were six stillbirths, compared with none in those induced.

READ MORE: Gripping a comb during labour could help ease the pain of childbirth

Babies in the induction group were also about a third less likely to be admitted to NICU than those in the expectant management group.

Originally the researchers planned to include more than 10,000 women but their advisory board stopped the experiment early because they believed the findings to be too important.

The study, published in the BMJ, suggested that it is safer for the baby for labour to be induced at 41 weeks and that there were no adverse side-effects such as increased rates of caesarean section.

But the researchers also said that overall risk of perinatal death after 41 weeks was low, pointing out that the study was limited due to differences in local practices for induction and difficulty knowing the exact cause of the stillbirths.

Writing in a linked editorial, Professor Sara Kenyon, professor of evidence based maternity care at the University of Birmingham, and colleagues said: “Choice is important within maternity care, and clear information about available options should be accessible to all pregnant women, enabling them to make fully informed and timely decisions.”

Prof Alexander Heazell, spokesperson for the Royal College of Obstetricians and Gynaecologists and clinical director of Tommy’s Research Centre on Stillbirth, told Guardian pregnancies that reach or pass 41 weeks are usually safe and straightforward but there was a small increased risk of stillbirth.

“We are saddened by reports of babies who died during a research trial in Sweden. The loss of a baby is a devastating tragedy for parents, to the wider family, and the healthcare professionals involved,” he said.

“Current UK guidance recommends that induction of labour should be offered to women with uncomplicated pregnancies who go beyond 41 weeks to avoid the risks of prolonged pregnancy, including stillbirth. We support the continual review of clinical guidelines as new evidence emerges to ensure best practice.

“A woman’s individual needs and preferences should always be taken into account and they must have the opportunity to make informed decisions in partnership with their healthcare professionals.”

READ MORE: Model who didn't realise she was pregnant gives birth on bathroom floor

According to research, only about one in 25 (4%) of babies are born on their exact due date, with around one in five babies born at 41 weeks or after. 

Yahoo UK chatted to the birth experts to bring you some suggestions for bringing on labour.

Eat your way into the delivery room

“Red raspberry leaf tea can be taken from 32 weeks pregnant and is available from health food shops or some supermarkets,” explains My Expert Midwife co-founder and midwife, Lesley Gilchrist.

“It will not start your labour off, but it does strengthen your uterus and make the muscle more effective once labour has begun.”

Gilchrist says there is also some evidence to suggest that eating six dates a day from 36 weeks pregnant can shorten your labour slightly and, for some women, start labour a bit sooner.

Nipple stimulation

No, not in that way! “The hormone oxytocin (which produces contractions) is also produced when breastfeeding, therefore hand expressing from 36/37 weeks can encourage its production,” explains Gilchrist.

“Any milk that you may collect from hand expressing can be stored in the freezer and used after your baby is born.”

Rachel Fitz-Desorgher, baby expert at The Baby Show and author of Your Baby Skin to Skin suggests stimulating nipples for 1 hour, 3 times a day for 3 days. “Then take a break for a day or two and then repeat. It really causes strong contractions but don't let that stop you as this shows your hormones are going up,” she adds.

Pre-birth exercise

We’re not suggesting you drop and give 50 burpees right before birth, but exercise can help to maintain a good level of fitness for labour. “It also encourages the production of feel-good hormones called endorphins,” explains Gilchrist.

“Walking, especially using the stairs in later pregnancy, can encourage your baby's head to engage into your pelvis. Swimming and yoga can also be good at promoting relaxation,” she adds.

Acupuncture and acupressure 

According to Gilchrist these treatments can help to stimulate the production of oxytocin, as well as help relieve aches and pains, and promote relaxation. “Seek a trained professional to perform acupuncture and to teach you acupressure in your pregnancy,” she suggests.

Sex

You’ve heard the rumours, but turns out there’s some science behind it. “Having penetrative and non-penetrative sex can stimulate oxytocin, while semen contains prostaglandins, which can help to soften the cervix, making it ready for when labour starts,” explains Gilchrist.

Laugh your way into labour

“Do or watch something that makes you laugh, such as a comedy or a feel-good film,” suggests Gilchrist. “Remember, relaxation will promote oxytocin and increasing your levels of oxytocin will make labour more likely to start.”

Fitz-Desorgher agrees that relaxation is also a good idea. “High adrenaline can stop you going into labour. So a nice warm bath, a good movie and a massage (that nipple stimulation again!),” she says. “Start after 37 weeks.”

If all else fails ask your midwife about her doing a stretch and sweep to help things get going.

“Nothing will work if you're simply not ready,” says Fitz-Desorgher.

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