WHEN IS BABY COMING!

I have a lot of respect for fathers who have walked the pregnancy journey with their partners. These men spend 40 weeks of extreme unpredictability, riding on an adrenaline high that threatens to drop the ball at any time.

The 40-week journey is not for the faint hearted. From the excitement of finding out about the baby, multiple pregnancy test kits lined up in the bathroom, to the nerve-wracking first trimester with its attendant morning sickness, bloating, acne and poor appetite.

For many moms, the second trimester brings remarkable relief. They settle into pregnancy and life may seem almost normal. For the petite women, the pregnancy may not even be obvious and they may not even require a wardrobe change just yet. They are energetic and are able to go about their business with a lot of ease.

Nevertheless, the third trimester usually crowns it all. The moms are excited. It is a period of shopping for cute baby clothes, baby bottles, bassinettes and cots. It is when one is obviously pregnant and accorded VIP treatment. It is a period of no queueing, everyone tripping over their feet to be of help. The joke goes that it is the period when one can never fail an exam, however tough.

This is when the baby shower spirit takes over and theme colours, wish lists of baby items are made and the most fabulous cakes are baked. Women get together and dish out the most astounding snippets of advice on motherhood. The fathers find themselves on the receiving end of food cravings. Overnight, they must become miracle workers to contain the overwhelming palates.

But it does have its downside. The fatigue, breathlessness, joint pains and waddling gait creep in. The feet begin to swell and the shoes must be a size or two bigger. It is a period when sleep is not comfortable however tired one is. It is impossible to find a comfortable sleeping position. She has taken over ownership of all the pillows in the house.

At this point, the mom’s tune changes and she develops a new urge. An urge to have the baby out of her womb. She is tired of waiting to meet her baby. She is fed up with the pins and needles in her feet at the end of the day and in her fingers in the morning when she wakes up. She is out of clothes that fit and cannot imagine buying new bras as she has outgrown the last purchased batch in just a month.

She has ticked all the calendars around her; on her desk in the office, on the fridge, on her phone. She has packed her baby bag and rechecked it for the umpteenth time. It rides with her in the car to work and back home every evening. She has her obstetrician on speed dial and her cabbie has had to do the drive from her house to the hospital in high traffic to reassure her that in the absence of her spouse, she will make it in good time.

The D-Day seems to float further away despite the clock steadily ticking in the right direction. When mommy hits breaking point, she starts to negotiate with her baby to put her out of her misery and just show up already. She nags her doctor at every visit to compromise and bring the baby out just a little earlier. She is at her wits end.

So why do we dig in our heels as doctors and stick to the famous estimated date of delivery (EDD)? This date is 40 weeks from the date of the last period prior to conception. The American College of Obstetricians and Gynaecologists (ACOG)Committee opinion no. 579 in 2013 clearly defined delivery period in relation to the EDD.

A baby delivered in the period ranging between 37 weeks 0 days to 38 weeks 6days is an early term baby. The ones born at 39 weeks 0 days to 40 weeks 6days is the full term baby. Those who ‘refuse’ to be born at term move into a different phase, with 41 weeks 0 days to 41 weeks 6days being late term, and those beyond 42 weeks being post-term.

The early term babies, despite being regarded as term, do carry a relative risk of complications of prematurity, especially with respiration, as compared to their term counterparts. This is the reason why there is a lot of reluctance to deliver them unless there is a clear medical reason to. After all, why deny them an extra week or two of weight gain and extra nutrient storage?

The full term period is the time when approximately 70% of babies are born. This is when most mothers will spontaneously go into labour. When the babies are planned for delivery by caesarian section, it is usually scheduled at 39 weeks 0 days.

Beyond 41 weeks 0 days, the little one has outstayed their welcome in the womb and they are handed an eviction notice. This is when induction of labour is done to help the little one come out.

Once the pregnancy reaches term, the placenta has completed its normal lifespan. It starts to age and its capacity to provide for the baby starts to wane. This is the reason the baby requires to be delivered when the placenta can still support the baby through the rigorous process of labour.

When complications arise and babies must be delivered before term, every effort is made to buy at least a day to help mature the lungs. The mom is given steroid injections to help with this process. Labour may be delayed or arrested with the help of medications to buy a precious few hours. This intervention may draw the line between survival of the little one to have a fighting chance, and an infant mortality.

For this reason, as bourgeois as it may seem to moms who want to decide their baby’s birthday to suit their lifestyle, it is well worth noting that no amount of technology in a newborn unit can rival the womb in nurturing the baby to maturity. As my wise professor always said, the best incubator is always the uterus!