#370 | 43-Week Pregnancy: Jessica and Aaron Researched, Prayed, and Waited

In today's episode, we sat with Ontario couple Jessica and Aaron, who share the birth story of their first child. Jessica's pregnancy included several key decision points, including whether to accept RhoGAM and how to approach care and manage the expectations of their loved ones as they moved well past their due date -- nearly 3 weeks past!

They describe how they evaluated risk, navigated recommendations, and remained aligned as a couple under increasing pressure, while working with a midwifery team that respected informed consent.

This episode examines how risk is framed in pregnancy, how provider–patient dynamics influence decision-making, and what it looks like to stay grounded in your choices through the final weeks of a post-term pregnancy.

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Transcript

I'm Cynthia Overgard, birth educator, advocate for informed consent, and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Show. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

I'm Jessica, and I'm Aaron, and we're here to tell the birth story of our daughter. So we found out that we were pregnant in June of 2025 and we had a very great, smooth pregnancy. I didn't have any of the normal things that some women go through. I had a little bit of nausea, some exhaustion, but other than that, I really didn't have anything. We signed up for midwifery care in our area. We had our basic appointments every two weeks. We had our first ultrasound, and everything was good there. And then we had 20 week anatomy scan, and everything was good there as well. We did not find out that we were having a little girl until she was born, and we got blood taken, and that's when we found out that I was O negative for the first time. So then Aaron also had to get his blood taken, and he's A positive. So that's where our journey started, of what does the RhoGAM shot mean? And that is how Aaron found you guys.

So yeah, I looked up on Google if there's any articles or anything about people that were against the RhoGAM shot or had not taken it and had healthy babies and good pregnancy and all that. Jess and I both had a very tumultuous time during COVID, standing our ground against various mandates.

Wow. And you're in Canada. That's very intense. Canada was very, very unyielding. It's changed a lot in recent years, your country over there.

Yes, it has. It has, and it's sad in a lot of ways, because we remember when we were growing up, Canada was quite a bit different, and it has changed radically over the last decade or so. I think Jess is fine with me saying this. We went to the convoy that made Canada on the map recently.

Guys, that's just a whole other episode. I knew that it would be a minority position to reject the RhoGAM shot.

And we didn't know much about it. Our provider, which wasn't our midwifery care, it was a family doctor, basically just said you're going to get this shot at 28 weeks because of your conflicting blood types. And we were like, well, what is the shot? And oh, well, it's just routine. Well, that's not good enough for us.

The way that he phrased it was like, well, we're just going to do this and you're going to get the shot. And I looked at Jess thinking, man, I don't think we're just going to get the shot without looking into this. And so yeah, I stumbled upon your guys' website. It was like, Down to Birth. This sounds down to earth. It sounds really awesome. So I listened to an episode with Dr. Sarah Wickham. And over time, we became more educated about RhoGAM and the risks of Jessica's blood type conflicting with the baby's blood type did not outweigh what we thought the risk could be from the shot, and we knew that we had to take a leap of faith. As we got close to that 28 week mark, it was a conversation that we would be having, and even with family members, we were having these conversations. It's like, you're feeling healthy, baby is kicking, baby's moving. Why would we just put something into your body? It seems like everything is going great right now. So we're not going to do that.

Not to let me jump in for a minute. Trisha, will you please explain to the audience about this situation? RhoGAM, positive father, negative blood type mother, what everyone's talking about.

So the concern is that when you have conflicting Rh status, one positive, one negative, the mother being negative, that when this first pregnancy happens, everything is fine. It's not generally a risk to the first baby. It's subsequent pregnancies. So when there's a mixing of the blood at the time of birth, which happens, your body could mount an immune response to attack future babies.

And may I jump in, Trisha, that's if this baby, number one ends up being positive with the mother being negative, right? If the baby ends up being negative, it would not be an issue. Of course, we don't know until the baby is born, which is part of the whole difficulty in this decision.

Okay, go ahead. So Aaron, why don't you share with us a little bit about the research you did and what you found and what helped you come to this decision.

I wish I had the exact numbers in my mind right now, but I remember when we were looking into it, the percentage of our child having some sort of defect or life threatening issue was very, very low. And then even if Jessica became sensitized, the percentage went up only, it was only like one to two percent, that the chances of our kid getting a life threatening illness or needing medical care didn't rise drastically. But the way that it was phrased to us was that you're putting your child at risk and it's very dangerous. And we just didn't think that it seemed as threatening as they were saying.

Did they not make clear that the risk is to a second potential baby in your lives?

Our midwives did talk about future pregnancies for that, but even with that, we, because I forget the statistics too that Dr. Sarah Wickham has in her book, but even then it doesn't seem like it raises that much if you get sensitized, because at that time the provider, our family doctor, was just kind of telling us how it is. We definitely took informed consent, knowing that I could be sensitized and that could hurt other pregnancies. But we wanted to trust that the consequences of our decision, we weighed the pros and cons of that, and we weighed that with because the RhoGAM shot is made up of hundreds, potentially thousands, of plasma of other people that I would be taking during pregnancy. And because we were so firm on the COVID stance and those mandates, and we don't know whose blood would be going into my body, we were just thinking that risk to that baby doesn't outweigh what we believe are the risks from that shot. So that was also a big part of our decision.

Yeah, we did an episode with Dr. Sara Wickham, not particularly on this, but then we did one on women who both accepted and declined RhoGAM. And for women who did decline the COVID vaccine, because we did just mass vaccinate millions and millions of people, there's just so many questions. They're still coming out with the effects of that at this point, that actually did play a role into more women declining. So once you made that decision, why don't you tell us what happened after that, leading into your birth.

So yes, we made a decision which we were really at peace with, and then everything was going pretty okay. And then I actually reached out to you guys, because I was measuring small, so we got a third ultrasound, which we know now that we didn't really need on the other side of birth. And then we got to our 39 week appointment, and induction was already getting spoken about. That's kind of the standard for, I don't know if that's standard in the States, but standard here. Once you get to 39 weeks, they want to talk about induction, including our midwives, but more for informed consent and all that good stuff. But we declined to be induced at 40 weeks on my due date because I was like, this doesn't seem right, I don't feel like I'm ready, and I don't want to push it. Again, we've listened to a ton of your guys' episodes on the decision making around Pitocin. And you know that's not even FDA approved unless it's for medical reasons. But for us, healthy baby, healthy heart rate, great blood pressure, I was doing great. So it just didn't make sense. So we just kept declining Pitocin. And then we did give our midwives a little bit of a run for their money, because we kept declining, and we finally scheduled an induction at 43 weeks, just to give them an answer, because we were like, we kind of just need this off our back.

That is amazing. Are you feeling stressed at that point about your baby's well being, or did you still feel perfectly fine that I just want to await spontaneous labor and I'm really making this choice to appease the midwives?

Yeah, definitely was just making the choice to appease midwives and family, just to give them a date. But I knew that I felt okay, and I knew that the baby was okay. Doing those constant checks, doing the kick checks, it's like there's nothing wrong with the baby. We did do non stress tests to check the heart rate as well for consistency, and everything was perfectly fine. I just knew that my body wasn't ready. So then we scheduled it. We did do a couple of the membrane sweeps, just to kind of help get everything kind of kicking off, I guess. And then we did all the other natural stuff, all the spicy food, Miles Circuit. And at our last appointment with our midwives was the day before I went into labor, and she said that your cervix is very favorable. And she said, I can't believe, based on how your cervix feels, that you're a first time mom. It seems like you've already had kids based on how your cervix is feeling. And that was just a testament of, okay, my body's actually finally getting ready to birth this baby.

It's just interesting because since they're pushing women at 39 weeks to start inducing, she probably doesn't feel a ton of ready, ripe cervixes, especially for first time moms who are more likely to go into labor, on average around 41 weeks. So yeah, it misleads them into what women feel like right before labor.

And just imagine how unready your baby would have been at 39 weeks, four weeks early.

Yeah. And we were also wondering, if you don't mind, if we were also wondering about Jessica's due date, because she seemed to be measuring small. But then once we got like two weeks ahead of that, and she seemed to get up to a very healthy size, it seemed like the baby was growing at a good rate at that point. And so we were questioning the due date, how accurate that is. And I just wanted to throw in the membrane sweep too. All these different medical procedures that are offered, it's always good to question and to look into yourself. So even that, it seemed like something that, okay, it's pretty standard to do. But even that, we weighed quite heavily. It weighed on us that we should know for sure that it's okay that we're going to be doing this. There are still some risks that Jessica could get hurt, or we could induce labor too early still, because it is a mechanical way of inducing, right? So the membrane sweep, we did decide to go with that.

Just a little fun fact, I had a consult with a postpartum woman today, and her providers told her her baby was over eight pounds, and at birth the baby was five pounds ten ounces. They also told her that the cord was around the neck and it wasn't. And they also told her that there was a knot in the cord and there wasn't.

Wow, all that added stress.

Can I ask you really quickly about your due date? How you got your due date? How was it determined?

So it was determined the first day of my last period and the dating ultrasound.

Did you have an early dating ultrasound in the 10 to 12 week range when you did the blood work?

Yeah, it was 10 weeks when we had it.

So those are pretty accurate. So your due date was probably pretty accurate.

At this point in the story, how far along were you now?

42 weeks and five days.

Wow. I can't believe this. You booked an induction at 43 weeks, which is, first of all, bold, so congratulations. I love it. What's second, it's also preposterous, because few women, not none, I've worked with several, but few women go that far, and somehow you actually had it right there. It's truly so. You're 42 and five, and you do have that induction date. Of course, you could always decline it and move it, but you did have that looming, which we never thought would happen.

We did either.

It's also a good thing you got your family off your backs, because most people get tremendously stressed because the family is freaking out by now. If you had said, oh, we're maybe going to be induced at 40 weeks and three days, they would be on you for weeks noticing what happened with your induction. Why are you still pregnant? Wow. Okay, so what happened?

Yeah, so then we, because that is probably why we booked the induction too, is to get everyone off our back, because the amount of people that were asking us about it, and the most common question was, how far are the doctors going to let you go? And I think it's pretty clear that Aaron and I were very firm in protecting ourselves. So our response every time was, they're not letting us do anything, we're telling them what to do. A lot of people, I think that might have ruffled feathers, but we had to say it.

A lot of our family was very understanding too. There were just all the people that asked. There's a lot of people that understood too. So we're surrounded by a lot of supportive people. We come from a Christian background, and a lot of people also took the same stance as us. There were some that were worried for us too, for sure, and we empathize with their concern, but we also just felt in our spirit that we were doing the right thing.

For sure, the whole affectionate joke about Canadians, if it's true, that they're very reasonable, compliant, they don't like discord. So here it is, like, what do you mean you're saying no to your doctor, of all people? It's just culturally not something people expect. Americans, it's almost like a badge people wear when they're a little rebellious, but your culture is notably polite and compliant, and it's very interesting. It makes your story all the more interesting.

We'd love to be down there.

We'll meet you there.

Our family was great. They prayed a lot for us, and they prayed for good decision making too, because they wanted us to follow our gut and our instinct. So yeah, we're very grateful for that. And our midwives were also great, because they kept saying, our job is to make sure you have informed consent, which was like, they were definitely on our team, which was what we really needed.

But yeah, so then 42 and five is when labor actually started. It was after that last midwife appointment. We went for a walk with my mother-in-law, and then it started at 5 p.m. that night. It was intense. I didn't have the slow, maybe I'm having two contractions an hour. It went right into every six minutes for 30 seconds. So it was very intense. And we did plan a home birth, but in Ontario, after 40 weeks, your provider can no longer attend a home birth, so we planned for a hospital birth.

But in Ontario, at 42 weeks, your midwives don't feel comfortable at that point to do a home birth. That was the cutoff.

So then we went into labor at 42 and five, and then we went to the hospital at around 10:30 that night. It was about a 45 minute drive for us, so I was having contractions every four minutes for a minute for 45 minutes in the car, which was not pleasant. And then we got into triage, and my water still hadn't broken at this point. Our midwife was talking about breaking my water, and I was like, there's no way, I've waited so long to go into spontaneous labor. But we talked about the risks, and she said we're not there yet, we can walk around for two hours.

Then we got admitted, and at 11:35 my water broke spontaneously right after that conversation. I couldn't believe it. Labor was very intense. I tried all the things, the comb, the TENS machine, different positions, peanut ball. It was pretty rough for six hours. We did one cervical check after my water broke, and I was already at eight centimeters. I couldn't believe it. I pushed for about an hour and a half, and then our daughter was born at 5:15 in the morning at 42 weeks and six days.

Would you have gone for the induction had you continued with your pregnancy a few more days? Would you have actually done it at 43 weeks?

No, we were planning on canceling the appointment.

It was funny. Jessica was doing the final pushes, it might have been her third last push there, and the midwife said, well, I think it's clear that we're not having that induction appointment tomorrow.

She was probably so relieved. She was really so relieved. How were your midwives treating you in those last weeks when you were still pregnant at 42 plus five? What were they like?

They were very calm. Our midwives were very calm. They are all about informed consent, but I could tell that they were getting a little bit nervous. They knew the stats of stillbirth, which still is relatively low, but they did repeat themselves a lot, because I think they just wanted us to be really firm in our decision, especially as first time parents. We obviously know as much as we can get from your podcast and reading, but we don't have that medical training, so I think we were making them a bit nervous. But I think in the end, they really appreciated how much we took a stance, because there was another woman on a different midwife team that was also 42 weeks and six days when she gave birth. And we are the two longest in Thames Valley care that have gone that long. So I hope it, and I think it definitely gave them confidence. But they still treated us well, and they did say at one point, it's your baby. As long as I've done my job in giving you informed consent, that's all I can do.

I'm glad to hear that. I thought they were a little more forceful than that. Is this common up there for there to be so much respect and flexibility? I mean, this is state run, is it not? Don't they have policies that are basically applicable across the provinces? How does that work?

We have Ontario Health Insurance Plan, so that's in Ontario, and our Thames Valley midwives fall under that. OHIP is the acronym. They do have policies and procedures. I don't know if it would have been different if we were with an OB, but our midwives did say we can't force you to go into the hospital and get induced.

Well, thank God for that. So do you have informed consent laws there?

Yeah, there are some on the books. Obviously they disregarded them during COVID for certain things. Our laws were contradicted in some ways. Canada has a softer version of rights, and they can be overwritten if the government deems there is enough of a threat. But as far as the medical part of it, our taxes go toward health care, and I think the midwives have their own personal stance on things. They have to recommend what they're taught to recommend, but we can still say no. They're doing their job, even if they are pushing things we don't agree with.

Still, my understanding in Canada is that liability concerns are far less than in the United States. Your midwives are a lot less concerned about getting sued for a bad outcome than practitioners in the US. In the US, so much of the pressure comes from liability. We can sue for an unlimited amount of money, and we're very sue happy here, whereas in Canada it's not the norm.

The other major difference that we have to mention is that hospitals here are literal corporations and they are for profit entities. That conflict of interest complicates birth terribly, and there is pressure on doctors to drive revenue. It would be like telling your local firehouse that they have to turn a profit. It changes everything. So that's another major difference. We are very litigious as a society, and doctors say they are doing things because they don't want to be sued, but there is also the part where hospital administration is talking about revenue. So it's very different culturally in every way.

You do have better birth outcomes than we do.

I should add too, in our town, our hospital is a level one hospital, so they also made a recommendation for us to deliver in London, which is a level three hospital, and they also had a NICU. That was a great recommendation because they felt more comfortable there since I was so far past due. Our local hospital has a very high cesarean rate because they don't have an OB in the facility at all times. So they have a lot of births that end up with interventions and then a cesarean, because they don't have the resources to let a mom labor without escalation.

And just for our listener, when Americans hear London, they're thinking of England, but you mean London, Ontario.

Yes.

And is it very different from province to province, or does it basically work the same way? Do you ever hear of people leaving where they live to give birth somewhere else?

I've never heard of that.

We do have a family member in Alberta who is pregnant right now, and it sounds like she's had a similar experience with midwives. She wanted a VBAC after multiple C-sections, and they declined that. We know that would be the same in Ontario. I think it's pretty similar across the board. I don't think I've ever heard of someone going to a different province for birth.

Because here, from state to state, it can be dramatically different.

If you're hurt in another province, like if you break your arm, our system will still cover it. So I think there is coordination between provinces. It wouldn't be the same in the States.

So did either of you ever have any worries as you went from 40 to 41 to 42 weeks?

I think there were definitely points where I was getting anxious, because I had taken off work two weeks before my due date. So I was home for five weeks by myself. Getting texts from family members about how I was feeling or how long the doctors were going to let me go started to weigh on me, even though they were coming from a good place.

Idle minds can make things worse. That must have been difficult.

Yeah, it was. I had to open my Bible, and I memorized a psalm that I repeated a lot, even during labor: wait for the Lord, be strong and take heart and wait for the Lord. I just kept saying it. I knew I had to be patient. My biggest fear was losing the baby or something happening, and I didn’t want people’s fears to be confirmed.

Well, I hope you appreciate how lucky you are to have been on the same page, because that’s not common. Often the mother is more informed, and the father just wants a healthy outcome. There can be tension when the father is anxious and pushes for induction. But you both were aligned.

Very blessed. We've been together 11 years and there isn’t much we disagree on. I didn’t feel anxious during that time. Jessica seemed healthy, the baby was moving. I'm a simple man. If I see my wife glowing and the baby is active, things seem fine. When Jessica felt anxious, I supported her and reminded her of what was going well. We trusted that her body would do what it needed to do.

I needed that. If he had wavered, I probably would have too. Toward the end I just wanted someone to tell me what to do. But he grounded me.

I love how Aaron explained it. Sometimes we just need that simple perspective: you look good, you feel good, there’s no problem.

Yeah, when she was feeling anxious, we prayed through it.

And then he'd say, listen to this episode of Down to Birth.

Thank you for joining us at the Down To Birth Show. You can reach us @downtobirthshow on Instagram or email us at Contact@DownToBirthShow.com. All of Cynthia’s classes and Trisha’s breastfeeding services are offered live online, serving women and couples everywhere. Please remember this information is made available to you for educational and informational purposes only. It is in no way a substitute for medical advice. For our full disclaimer visit downtobirthshow.com/disclaimer. Thanks for tuning in, and as always, hear everyone and listen to yourself.