Pregnancy Week 40: What To Do If Your Baby Is Late

Reaching 40 weeks can bring excitement, tiredness and uncertainty, especially when labour has not started. A due date is an estimate rather than a deadline, and many healthy babies arrive several days before or after it. Pregnancy dating can also be affected by irregular cycles, late ovulation or uncertainty about the date of the last menstrual period.

At this stage, your maternity team may discuss continued waiting, extra monitoring or induction of labour. The safest choice depends on your health, your baby’s wellbeing, the accuracy of your dates, the condition of the cervix and your preferences. A pregnancy at 40 weeks is not automatically overdue, but it is a useful time to make a clear plan for the days ahead.

In Australia, care may be provided through a public hospital, private obstetric practice, birth centre or midwifery program. Arrangements differ between metropolitan services in Sydney, Melbourne, Brisbane or Perth and smaller regional hospitals, where transfer or travel planning can matter. Contact your midwife, obstetrician or maternity assessment unit if you are unsure what your local service recommends.

Understanding The Due Date And Late Pregnancy

The estimated due date usually represents 40 weeks from the first day of the last menstrual period. Only a small proportion of babies are born on that exact day. Ultrasound dating, particularly an early scan, may provide a more reliable estimate when menstrual dates are uncertain. Your clinician will use the best available information rather than relying on the calendar alone.

A baby born between 37 weeks and 38 weeks and six days is generally described as early term, while 39 weeks to 40 weeks and six days is full term. From 41 weeks, a pregnancy is often called late term, and from 42 weeks it is post-term. These categories help guide discussions, but they do not predict exactly when spontaneous labour will begin.

As pregnancy continues, the placenta may gradually become less efficient, and the amount of amniotic fluid can change. The risk of complications remains low for many people but increases as gestation advances, which is why providers commonly review the pregnancy more closely after 40 weeks. Reduced fetal movement, bleeding, fluid leakage, severe headache, vision changes or significant abdominal pain require prompt medical advice at any stage.

Monitoring When Labour Has Not Started

Expectant management means waiting for labour while checking that you and your baby remain well. Monitoring may include blood pressure, urine testing, an assessment of fetal movement, measurement of the uterus and a discussion about symptoms. Depending on your circumstances and local policy, the team may offer an ultrasound to assess amniotic fluid or cardiotocography, commonly called a CTG, to record the baby’s heart rate.

Monitoring cannot guarantee that every problem will be detected early, so your awareness of normal movement remains important. Babies do not have less need to move because there is less room. If movement is reduced, absent or noticeably different from your baby’s usual pattern, do not wait for the next appointment. Call your maternity unit immediately and follow its instructions rather than relying on a home Doppler.

Before leaving an appointment, ask when the next review will occur and what would trigger a change in the plan. People living outside a major city may need to arrange transport, accommodation near a hospital or a route for urgent transfer. In hot Australian weather, regular fluids, shade and rest can make daily activity more comfortable, but heat exhaustion, fainting or persistent vomiting should be assessed medically.

Induction Options And How They Work

Induction of labour is a planned process used to start contractions before labour begins naturally. It may be recommended for a pregnancy that reaches 41 weeks, or earlier when there are concerns such as high blood pressure, diabetes, fetal growth problems, ruptured membranes without contractions or signs that the placenta is not functioning well. Timing varies according to individual risk and hospital policy.

The first step may be a membrane sweep, in which a clinician separates the membranes from the cervix during an internal examination. This can release local hormones and may make spontaneous labour more likely, although it can cause cramping or light bleeding and does not always work. It should be offered with an explanation and your consent.

If the cervix is not ready, cervical ripening may be recommended. Options include a prostaglandin pessary, gel or controlled-release insert, or a mechanical balloon catheter. A balloon can reduce the chance of excessive uterine contractions associated with some medicines, although it may be uncomfortable. Once the cervix is favourable, the waters may be broken artificially and an intravenous oxytocin infusion may be used to establish regular contractions.

Induction can take many hours and sometimes more than a day, particularly with a first baby. Continuous monitoring may be advised during oxytocin use or when there are specific risk factors. Pain relief choices usually include breathing techniques, movement where safe, nitrous oxide, injections and an epidural. Ask whether your hospital permits eating and drinking during each stage, since policies can change once active induction or anaesthesia begins.

Deciding Whether To Wait Or Induce

The decision should be shared between you and your maternity team. Ask how certain the due date is, what your personal risks are, how the baby will be monitored, when induction would be recommended and what happens if the first method does not work. You can ask for time to consider the information, involve a support person and discuss alternatives, unless there is an urgent safety concern.

Australian maternity care is guided by informed consent principles. A clinician should explain the expected benefits, possible harms and reasonable alternatives before a non-emergency procedure. You can accept, decline or ask to postpone an intervention after receiving suitable information. State and territory services may use different forms and local protocols, so the exact pathway can vary between a public hospital in Adelaide and a private hospital in Sydney.

Useful questions to discuss at the next appointment include:

• What is the reason for recommending induction now?
• How will my cervix be assessed, and which method is most suitable?
• How long can we safely wait if monitoring remains reassuring?
• What pain relief, movement and birth-position options will be available?
• What happens if cervical ripening or oxytocin does not start labour?
• When should I call the hospital rather than wait for my appointment?

A planned induction can provide reassurance and may reduce risks associated with prolonged pregnancy, but it can also mean more examinations, monitoring and time in hospital. It may affect access to a birth-centre setting or a water birth, depending on the reason for induction and the hospital’s rules. Discuss your priorities early so the plan reflects both safety and your preferences.

Preparing For The Birth And Knowing When To Call

Practical preparation can reduce stress while you wait. Keep your phone charged, pack any required documents and medications, confirm the hospital entrance used after hours and arrange care for older children or pets. If you are travelling from a rural area, check fuel, accommodation and transport plans. Public hospitals usually provide a list of what to bring, while private hospitals may have different admission procedures.

Gentle activity such as walking may help you stay comfortable, but there is no dependable home method that guarantees labour. Sex, nipple stimulation, herbal products, castor oil and high-dose supplements can be unsafe in some pregnancies or interact with medicines. Do not use an herbal remedy to bring on labour without asking your midwife or doctor. Advice found in online pregnancy resources should be checked against guidance from your own maternity team.

Seek urgent advice for vaginal bleeding, suspected waters breaking, regular painful contractions, severe or persistent abdominal pain, fever, severe headache, visual disturbances, sudden swelling or reduced fetal movement. Call emergency services on 000 if you are seriously unwell, have heavy bleeding, have trouble breathing, lose consciousness or believe the baby is about to be born and you cannot safely reach hospital.

Keep a written record of your plan, including the maternity unit’s phone number and the date of your next review. If you need to send non-urgent administrative information to a health publisher or service, use its email contact rather than sharing private medical details in a public comment. For personal symptoms, your maternity provider is the appropriate source of care.

If induction is advised, remember that the purpose is to support a safe birth, not to make your body meet an artificial deadline. Some inductions progress quickly, while others require patience or a change in method. Stay informed, report changes in movement or symptoms promptly and use your support people to help you rest, eat according to hospital advice and remain comfortable while the next step unfolds.