Royal Baby Watch: A delivery fit for a … king?

The royal baby watch has reached a fever pitch as Kate Middleton’s reported July 13th due date has come and gone – and still we know nothing more about the future heir to the throne. So while the world holds their collective breath in anticipation, as a doctor who deals in this sort of thing, I have some predictions to make.

First, I think it’s going to be a boy.  There’s no science behind that – but from my personal experience, most post-term babies turn out to be boys.

Second, if she doesn’t deliver this week on her own, she will most likely be induced by the weekend.  Her pregnancy is now entering a period where obstetricians have to be on the alert to make sure that the baby is thriving normally.

Ninety-five percent of all normal pregnancies deliver before 42 weeks. However, once a pregnancy hits the due date – which is 40 weeks of gestation – doctors become a little anxious about making sure that the infant is receiving adequate nutrition and oxygenation.

The placenta typically begins to age after 37 weeks in a normal pregnancy. And remember, the placenta is the filter that provides all the oxygen to a child during pregnancy. So once a pregnancy approaches 40 weeks, close attention is paid to fetal  movement, amniotic fluid index and the size of the baby.

The most common reason for going past your due date is miscalculation. In other words, there could be a discrepancy of plus or minus seven days in terms of the possible date of conception. Nowadays, most doctors calculate the due date after performing an ultrasound early in the pregnancy, which is able to more specifically predict an accurate due date. And there is no doubt that babies born after 42 weeks do have an increased risk of post-birth complications.

So what might Kate’s doctors be planning?

Well, I’m sure they’re giving Kate a few more days to see if she goes into labor on her own. However, by this weekend, they may be considering induction. Induction of labor could always lead to an unexpected C-section, but sometimes, that’s the tradeoff that must  be made – especially if there is a concern that delivery is taking too long.

There are tests that I’m sure the doctors are using to monitor the well-being of the baby while still in the womb. These include a non-stress test, which monitors the fetal heart rate and looks for accelerations or excitement. Or they could be using biophysical profiles – an ultrasound which looks at fetal movement and amniotic fluid volume.

In either case, here’s my prediction: Delivery on the 20th or the 21st, with a beautiful baby boy waiting in the wings to become king.

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