A methodological problem in individual studies and systematic reviews is that critical outcomes such as perinatal mortality and hypoxic ischemic encephalopathy are rare. An HTA meta-analysis including 17 RCTs ( n = 7223 women), and recently published systematic reviews including 31 RCTs and 157 RCTs showed a lower perinatal mortality rate in the induction group, fewer cases of MAS and either no difference or a lower risk of Caesarean section after induction, compared to spontaneous labour. However, most randomised controlled trials (RCTs) comparing induction with awaiting the spontaneous onset of labour, with or without foetal surveillance, are small and of poor methodological quality. ĭue to the increased risk associated with PTP, a solution would be to suggest induction of labour before the pregnancy becomes post term. Maternal complications in PTP are puerperal infections, postpartum bleeding, disproportion, labour dystocia, emergency Caesarean section and cervical lacerations. Furthermore, developmental delay, increased rates of obesity and early markers of metabolic syndrome have also been reported in post term children. Such complications increase the risk of foetal mortality, meconium aspiration syndrome (MAS), umbilical cord complications, asphyxia, pneumonia, sepsis, convulsions, shoulder dystocia, traumatic injuries, peripheral nerve damage and neonatal encephalopathy. Previous research has focused on the prevalence and risk of perinatal complications in PTP. The reported PTP prevalence in Sweden was 6.9% in 2013. PTP prevalence varies between 0.4% in Austria and 8.1% in Denmark. <37 GW, interventions, induction of labour, availability of routine ultrasound pregnancy dating, the number of primiparous women in the population and pregnancy surveillance routines. Factors that influence prevalence are population characteristics such as maternal age, rate of preterm birth e.g. The prevalence of PTP is approximately 5-10% but varies between countries. Risk factors include primiparity, advanced maternal age, maternal obesity, heredity, previous PTP and a male foetus.
Some identified causes are foetal anencephaly, foetal adrenal hypoplasia or insufficiency and placental sulphates deficiency. Studies analysing the risks and management of PTP also include pregnancies from ≥41 GW, i.e., late term pregnancy. However, there is no consensus on this definition. The World Health Organisation (WHO) has defined post term pregnancy (PTP) as lasting 294 days or longer, i.e., gestational week (GW) 42 + 0 days, from the first day of the last menstrual period. In addition, they should be asked how they experience waiting for the birth in order to create a sense of trust and confidence in the process. It is vital that women are seen and acknowledged by midwives at the antenatal clinics. An understanding of the importance of different information sources, such as family and friends, is necessary. Conclusionsīeing in limbo represents a contradictory state related to time and process of giving birth, when women need to be listened to by healthcare professionals. In this state of limbo, the women became more easily influenced by people around them, while in turn influencing others. Previously, they had trusted the body’s ability to give birth, but this trust diminished after GW 41 + 0. Lack of information led to searches in social media.
Health care professionals focused solely on the due date, while the women felt neither seen nor acknowledged. The women experienced difficulty due to not being in complete control, while at the same time finding it a beneficial experience. Negative feelings dominated and increased over time. The contradictory aspect was the notion that time passed both slowly and quickly. Exceeding the estimated date of childbirth implied a period of up to 2 weeks that was not expected. The essence of women’s experiences of a pregnancy at GW ≥ 41 was described as being in limbo, a void characterised by contradictions related to time, giving birth and the condition. Data were analysed with a phenomenological reflective lifeworld approach. Interviews were conducted at the antenatal clinic or in the woman’s home, depending on her preference. Individual in-depth interviews were conducted from August 2013 to September 2014 with 10 healthy women with an expected normal pregnancy at GW 41 + 1-6 days in Gothenburg, Sweden. The study has a lifeworld research approach. Therefore, the aim of this study was to describe women’s lived experiences of a pregnancy ≥41 GW. However, qualitative interview studies concerning women’s experiences of PTP are lacking. Many studies focusing on the prevalence, risks and management of PTP include pregnancies ≥41 gestational weeks (GW).
PTP is defined as a pregnancy ≥294 days, but the definition is arbitrary. Globally, the prevalence of post term pregnancy (PTP) is about 5-10%, but the rate varies considerably between and within countries.
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