With Meghan Markle's reported due date coming and going this past Sunday, plenty of people were convinced that Baby Sussex had already arrived in secret — but since palace sources just toldVanity Fair that "there's no royal baby yet," it's possible that the baby is overdue. And while we don't know for sure it that's the case, it's a fairly common possibility, especially since this is the Duchess of Sussex's first baby.
"It’s more common that you go further in your gestational age with your first baby than subsequent pregnancies," says Meera Garcia, MD, chief of obstetrics & gynecology at NewYork-Presbyterian Hudson Valley Hospital and assistant professor of obstetrics & gynecology at Columbia University Vagelos College of Physicians & Surgeons. "It’s almost like the body is learning how to go from pregnancy to delivery, and that learning process makes it so that first-time moms tend to deliver later, compared to moms who are having their second or third baby."
When that happens, however, there are potential health risks — as well as benefits — involved. Dr. Garcia calls it a "crissing and crossing" of benefits and risks: "As the baby gets to 39 weeks, 40 weeks, we know that there’s a higher percentage of lung maturity."
"The other side is, if you go well past the due date, the placenta starts to get old," she says. "It’s almost like it has an expiration date, and as the placenta starts to get older, it doesn’t provide the nutrition and oxygen to the baby that it should. There’s this fine line between making sure the baby is ready to be delivered, and making sure the baby doesn’t get so big that you need to do a c-section."
Because of this issue, doctors and hospitals may induce birth if someone is still pregnant past their due date. Dr. Garcia says that this is a conversation that is usually begun when the person gets close to said date, so that they're aware of the possibility.
"In a textbook answer, you could go up to two weeks past your due date," she says. "But in practice, we try to set up a[n induction] date that’s convenient to the patient after 40 weeks and three days."
But royal fans probably know it's been reported that Meghan is considering a home birth, and that she has consulted a doula (a birth coach) — in which case, things may look a little different. Although the American College of Obstetricians and Gynecologists (ACOG) believes that hospitals and accredited birth centers are the safest settings for birth, they also hedge that "each woman has the right to make a medically informed decision about delivery," as long as they work with licensed midwives who can assist with birth.
According to the Office of National Statistics, about 2.1% of people in the U.K. gave birth at home in 2017. That number is lower in the U.S. — ACOG estimates that about 0.9% of births per year in the U.S. occur at home.
Domino Kirke, co-founder of Carriage House Birth, a collective of birth and postpartum doulas, says that inducing labor is less of a thing with home births as opposed to hospital births. Kirke, who has coached clients through home births, and has gone through a homebirth herself wherein she was two weeks over her due date, says, "Due dates are only estimated, so we never really know — there are a lot of moving parts with them. There’s a lot more space to give the family the time the body might need to go into labor."
Kirke adds that when she works with pregnant clients who are past due, a lot of it involves soothing stressed parents-to-be who are frustrated or anxious that the baby hasn't been born yet.
So what does she usually say to help them through that frustration?
"I would remind them that the baby’s not ready," she says. "Just try to enjoy those final moments of it being just the two of you. A watched pot never boils, and this is the last time for about ten years that you’re going to be able to sleep in, watch movies, and go on long walks. You’ll walk away with a healthy child, and it’s going to be non-stop for a long time."
It's Meghan's decision (and business) as to whether she's gone with a home delivery or a hospital one, but in any case, it sounds like it's a good thing that she's apparently already just going with the flow through the final stages of pregnancy.