41 week pregnancy risks

What to Expect When 41 Weeks Pregnant

Written by WebMD Editorial Contributors

Reviewed by Dan Brennan, MD on March 16, 2021

Reasons for a Late-Term Pregnancy

There are a few different reasons why you might have a late-term pregnancy:

The due date was miscalculated.
You’re pregnant with your first baby.
You’re overweight.
You’re having a boy.
Your previous pregnancies went past 40 weeks.

Challenges of a Late-Term Pregnancy

When you are 41 weeks pregnant, you and your baby may have an increased risk of health problems, including:

Larger than average baby. Because your baby has had more time to grow, it will likely be larger than the average size during childbirth. This increases the risk of your baby's shoulder getting stuck behind your pelvic bone during delivery.

Late-term pregnancies increase the chance you may have to have an operative vaginal delivery or cesarean birth (c-section).

A cesarean delivery is a medical surgery where your doctor cuts through your belly and uterus and gently removes your baby. This procedure can help protect the health of you and your baby, and in some cases, is safer than a vaginal birth.

Postmaturity syndrome. If you go past the 41st week of pregnancy, your baby might start to have dry, peeling skin, overgrown nails, and less fat beneath the skin. There may be green, brown, or yellow staining from stool passed while still in the amniotic sac.

Low amniotic fluid.Amniotic fluid is the protective liquid contained by the amniotic sac that your baby grows inside of during pregnancy. As you have a late-term pregnancy, the amount of amniotic fluid gets gradually less, which can affect your baby's heart rate and compress the umbilical cord during labor.

Physical complications from late delivery. As a mother who is 41 weeks pregnant, when you give birth, you are at greater risk of experiencing severe vaginal tearing, infection, and postpartum bleeding.

Postpartum hemorrhage. If you are experiencing heavy bleeding after you give birth, it could be a postpartum hemorrhage. This is a rare but serious condition where the heavy bleeding from your vagina doesn’t slow or stop. This can cause blurred vision, chills and an overall feeling of weakness like you’re going to faint. If you think you might have a postpartum hemorrhage, call 911 right away.

What to Expect When You’re 41 Weeks Pregnant

If you reach 41 weeks in your pregnancy, your doctor will start to do tests on the baby. The most common tests are a non-stress test and ultrasound. When they’re completing the tests, they are looking at a few things in particular:

To make sure the baby is active and healthy
To check the amniotic fluid levels
To check to see if your baby is having any problems

The goal is to keep both you and your baby safe while ensuring that you can deliver your baby sooner rather than later. This is important because once you reach the 41st week of pregnancy, the risk of complications during childbirth goes up.

How Doctors Induce Labor

If you do not go into labor on your own and it is past your due date, your doctor may recommend inducing labor. They will provide different treatments that will start or move your labor at a faster pace:

Medication. Your doctor may give you a medicine called oxytocin. This can cause you to have contractions to induce labor.

Medicine suppository. Sometimes your doctor will place a round or cone-shaped drug (suppository) into your vagina to help soften the cervix and help start labor.

Breaking your water. Your doctor may break the amniotic sac that your baby has been growing inside of, causing your water to break. This can be helpful in starting labor.

Catheter. To help your cervix to dilate, your doctor may place a tube with an inflatable balloon inside your vagina.

Whether your doctor or midwife recommends hanging in there for a few more days, or tells you it’s time to schedule an induction or c-section, keep good communication and be prepared. You’ll want to make sure you know exactly what to do if you go into labor and have a backup plan in case things change.

When you pass your due date Information | Mount Sinai

Pregnancy complications - post-term; Pregnancy complications - overdue

Most pregnancies last 37 to 42 weeks, but some take longer. If your pregnancy lasts more than 42 weeks, it is called post-term (past due). This happens in a small number of pregnancies.

While there are some risks in a post-term pregnancy, most post-term babies are born healthy. Your health care provider can do special tests to check on the health of your baby. Keeping a close eye on the baby's health will help increase the chance of good outcomes.

Why Does it Happen?

Many women who go past 40 weeks are not really post-term. Their due date was just not calculated correctly. After all, a due date is not exact, but an estimate.

Your due date is estimated based on the first day of your last period, the size of your uterus (womb) early in your pregnancy, and with an ultrasound early in pregnancy. However:

Many women cannot remember the exact day of their last period, which makes it hard to predict a due date.
Not all menstrual cycles are the same length.
Some women do not get an ultrasound early in pregnancy to establish their most accurate due date.

When a pregnancy truly is post-term and goes past 42 weeks, no one knows for sure what causes it to happen.

What are the Risks?

If you have not given birth by 42 weeks, there are greater health risks for you and your baby.

The placenta is the link between you and your baby. As you pass your due date, the placenta may not work as well as before. This could lessen the amount of oxygen and nutrients that the baby gets from you. As a result, the baby:

May not grow as well as before.
May show signs of fetal stress. This means the baby's heart rate does not react normally.
May have a harder time during labor.
Has a higher chance of stillbirth (being born dead). Stillbirth is not common but begins to increase the most after 42 weeks gestation.

What if my Pregnancy Goes Past the Due Date?

Until you reach 41 weeks, your provider may not do anything unless there are problems.

If you reach 41 weeks (1 week overdue), your provider will do tests to check on the baby. These tests include a non-stress test and biophysical profile (ultrasound).

The tests may show that the baby is active and healthy, and the amount of amniotic fluid is normal. If so, your doctor may decide to wait until you go into labor on your own.
These tests can also show that the baby is having problems. You and your provider must decide if labor needs to be induced.

When you reach between 41 and 42 weeks, the health risks to you and your baby become even greater. Your provider will likely want to induce labor. In older women, especially older than 40, it may be recommended to induce labor as early as 39 weeks.

How Will the Doctor Induce Labor?

When you have not gone into labor on your own, your provider will help you start. This may be done by:

Using a medicine called oxytocin. This medicine can cause contractions to start and is given through an IV line.
Placing medicine suppositories inside the vagina. This will help ripen (soften) the cervix and may help labor to start.
Breaking your water (rupturing the membranes which hold amniotic fluid) can be done for some women to help labor start.
Putting a catheter or tube in the cervix to help it begin to dilate slowly.
Some combination of these methods may also be used by your provider.

Will I Need a C-section?

You will only need a C-section if:

Your labor cannot be started by your provider with the techniques described above.
Your baby's heart rate tests show possible fetal distress.
Your labor stops progressing normally once it has started.

Levine LD, Srinivas SK. Induction of labor. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 12.

Thorp JM, Grantz KL. Clinical aspects of normal and abnormal labor. In: Resnick R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 43.

Last reviewed on: 4/19/2022

Reviewed by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

41 weeks of pregnancy - signs of labor and what happens at the forty-first week of pregnancy, discharge

What happens

At the 41st week of pregnancy, the baby is completely ready to meet his mother. All internal organs are formed and functioning. The skeleton continues to develop, hair grows, and the baby's nails are already so long that he may well scratch himself.

The original fluff of lanugo has practically disappeared, as well as the lubricant that covered the body of the fetus at all stages of development. The waxy secret was necessary to protect the skin from the effects of amniotic fluid, and by the 40-41st week of pregnancy, its remnants were preserved only in skin folds, armpits and in the groin area.

The digestive system produces meconium, and the intestines continue to train, making undulating movements. The baby's lungs have accumulated enough surfactant to prevent the alveoli from sticking together on the baby's first exhalation.

But the placenta at 40 - 41 weeks of pregnancy can no longer satisfy all the needs of the child. The process of its aging progresses, and the fetus receives less oxygen and nutrients. At the same time, the expectant mother begins to have headaches, blood pressure rises, limbs swell, and the baby may suffer from hypoxia.

How you feel

Nothing new happens at 41 weeks pregnant. Now the movements are felt less often, since there is practically no free space in the uterus. But still, you need to continue to control their number. If the child does not make itself felt for 3 - 4 hours, he is probably just sleeping. Eat something sweet and lie on your left side for half an hour. If there is no result after a couple of hours, repeat these manipulations again. If even then the baby does not respond, this is an occasion to consult a doctor. Too active or, conversely, rare and weak movements can also indicate a fetal problem, which is most often associated with a lack of oxygen.

At 41 weeks of pregnancy, it is imperative to monitor vaginal discharge: changes in them can tell a lot. For example, the appearance of mucus is a sign of a cork coming out, which can come out gradually or all at once (in this case, you will see a thick whitish or yellowish lump with streaks of blood on the linen). If blood comes from the birth canal, this may be a symptom of placental abruption. And watery discharge appears when amniotic fluid is poured out.

As in the previous periods, at the 41st week of pregnancy, pain in the abdomen is possible. Drawing pains are usually caused by the fact that the fetus has sunk down and presses its head against the pelvic floor. For this reason, pain can occur not only in the abdomen, but also in the lower back, hips, groin and legs.

You need to rest, so if you can’t fall asleep at night, set aside time for sleep during the day - it’s time to gain strength before childbirth.

Risk factors

At the 40th - 41st week of pregnancy, the main danger for the baby is the aging of the placenta. Also at this time, late toxicosis is possible, the main symptoms of which are swelling and increased blood pressure. Therefore, if you feel unwell or notice that the swelling of the body has increased dramatically, contact your doctor immediately - you may need to be hospitalized.

Medical supervision

At the 41st week of pregnancy, the expectant mother needs to visit a gynecologist and undergo standard procedures:

Blood pressure measurement;
Weighing;
Listening to the fetal heartbeat;
Determining the height of the uterus.

And, as always, it is necessary to pass urine and blood for a general analysis. In addition to standard studies, at 41 weeks of pregnancy, they can check the secretion of the mammary glands, study the qualitative composition of amniotic fluid, and determine the presence of lubrication on the baby's skin.

At such a late date, the doctor constantly monitors the condition of the baby and the placenta so as not to miss the moment when the pregnancy becomes delayed.

In addition to the usual examination, at 40 - 41 weeks of pregnancy, the gynecologist may prescribe:

Doppler. With the help of this study, the blood flow of the fetus, blood circulation in the vessels of the uterus, the placenta are assessed, on the basis of which conclusions are drawn about whether the baby receives enough nutrients and oxygen;
Cardiotocography. During this procedure, uterine contractions and the fetal heartbeat are recorded simultaneously. The results of the study will determine the presence or absence of intrauterine hypoxia;
ultrasound. Ultrasound diagnosis at 41 weeks of gestation will help determine the size of the fetus, the amount of amniotic fluid, assess the condition of the placenta and see if it closes the exit from the uterus;
Amnioscopy. This procedure makes it possible to assess the amount and color of amniotic water, the condition of the fetal bladder.

If any abnormalities are found, the doctor may suggest a caesarean section or induction of labor.

Recommendations

At 41 weeks of pregnancy, you should be fully prepared for the upcoming birth and pack a bag to the hospital in advance so as not to be nervous during contractions.

Be sure to take with you:

Passport;
Exchange card;
Medical insurance policy;
Cell phone;
Robe;
Slippers;
One or two packs of sanitary napkins;
A pair of bras.

Pay attention to the advice of your doctor and follow all his instructions. Try not to be nervous. Follow the diet prescribed by the doctor. For a period of 41 weeks of pregnancy, consume as many fruits and dairy products as possible, give up sugar, confectionery, chocolate, flour, fatty and fried foods. It would be useful to take a vitamin complex recommended by a specialist.

If you feel well, you can do simple physical work around the house and, accompanied by relatives, go for walks. Moderate physical activity at 40 - 41 weeks of pregnancy is very useful: it helps reduce feelings of anxiety and can gently stimulate the process of childbirth.

In addition, sex will help speed up the birth of the baby. If there are no contraindications, then doctors only welcome (and even recommend) intimacy at a period of 40-41 weeks of pregnancy.

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PUBLICATIONS

Relevance

Studies show that pregnancies longer than 42 weeks or 294 days are associated with an increased risk of perinatal morbidity and mortality. The World Health Organization and clinical guidelines from various countries recommend induction of labor in women who are more than 42 weeks pregnant.

Although the overall likelihood of good perinatal outcomes between 40 and 42 weeks is high, the risk of poor perinatal outcomes gradually increases after 40 weeks.

Researchers from the Netherlands and Australia compared pregnancy outcomes with induction of labor at 41 weeks versus expectant management up to 42 weeks in women at low risk.

Methods

1801 women with uncomplicated singleton pregnancies were included in the non-inferiority INDEX, an open-label, randomized controlled trial.

900 women were randomized to labor induction at 41 weeks and 901 women to expectant management until 42 weeks. All women were observed in Holland from 2012 to 2016.

The primary endpoint of was a composite of perinatal death and neonatal morbidity (<7 Apgar score at 5 minutes, arterial pH <7. 05, meconium aspiration syndrome, brachial plexus injury, intracerebral bleeding, and hospitalization in neonatal intensive care unit).

secondary endpoints were maternal outcomes and mode of delivery.

The non-inferiority limit was 2%.

Results

Mean gestational age at delivery was 41 weeks + 0 days in the induction group and 41 weeks + 2 days in the expectant management group.

In the induction group, 15 out of 900 women (1.7%) had poor perinatal outcomes, compared with 28 out of 901 women (3.1%) in the expectant management group (absolute risk difference, −1.4% , 95% CI -2.9%-0.0%, P=0.22 for non-inferiority).
11 (1.2%) infants in the induction group and 23 (2.6%) in the second group had <7 Apgar scores at 5 minutes (relative risk, 0.48, 95% CI 0.23- 0.98).
None of the infants in the induction group and 3 (0.3%) in the expectant management group had an Apgar score <4 at 5 minutes.
No neonatal deaths were reported.
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