Probably not a clinic day goes by that I’m not asked to move up someone’s due date.  Not to say all moms-to-be are naughty, but there may be a sense of “I’m so over this pregnancy,” especially as we enter the third trimester.  This question even comes up around the time of the 20-week ultrasound if the associated “due date” is sooner than has previously been assigned.  By this time, though, the due date should already be established and only changed in very rare circumstances.  Here’s why:

The most accurate dating we can use involves the day for either IVF or embryo transfer as this is a certain date.  In fact, we can even know the specific time of the procedure.  After IVF, the next most accurate criteria to use is a first trimester ultrasound (prior to 14 weeks) that shows a fetus with a heartbeat (one with just a sac and no fetus isn’t as accurate).  It is accurate to within 5-7 days.  As we move into the second trimester, ultrasound can vary as much as 2 weeks from the actual due date, and in the third trimester, we can variation from 21-30 days.  This can be a full month discrepant from when a patient is due!

If you think about it, this totally makes sense.  If asked to compare a bunch of 6 month olds to determine their age, you’d probably be within a few months of their actual age.  Looking at 6 year-olds, you might be within a year or two.  With 16 year-olds?  Good luck!  You’d probably be fortunate to be within 5 years for some of them.  For babies in-utero, the same holds true.  The earliest estimates of age are going to be the most accurate, so that’s what we go with.  The due date at each ultrasound is the average due date for a baby of that size.

So, even if your baby grows faster than average, that doesn’t mean we get to deliver early.  There are still developmental milestones for the brain and lungs and other parts of the body that we’d you’re your baby to reach before delivery.  To put it in perspective, you wouldn’t expect a 12 year-old to graduate high school just because he’s now 6 feet tall.  Whether the biggest kid in 6th grade or the smallest in 6th grade, they are still 6th graders.  They’re probably not quite ready for the college application process just yet 😊

Interestingly, I’ve yet to have a patient ask me to push back their due date.  No one’s ever said to me, “You know.  I just love being pregnant.  Do you think you could move my due date back a week or two?  Maybe a month?”  In fact, it’s more the opposite.  I can almost hear the nervousness of those whose baby is growing a little slower than average, and their thoughts seem to be going a little like this:  “Maybe Dr. Denson won’t notice my new due date is later than we thought.  If I don’t make eye contact and rush him through the report, then maybe I won’t have to stay pregnant any longer.”  Fortunately, for those moms (and the health of the doctors who would have to ask them to stay pregnant longer), pushing back the due date at that point would be like making a smart child stay in kindergarten because he or she is too short to go to first grade.

There you have it.  Earlier dating is best!  Once you’ve been assigned a due date after an ultrasound showing a fetus with a heartbeat, you can mark it on the calendar, and the countdown can begin!  So even though we can’t move up your due date, you don’t have to worry about us moving it back either 😊

​Dr. Nick

​We’ve talked about the recommended amount of exercise in the past, so I’ll just take a moment or two to review the guidelines.  You should generally get 150 minutes of moderate aerobic exercise (swimming, brisk walking, push mowing, etc.) or 75 minutes of vigorous aerobic exercise (i.e. running) each week in addition strength training at least twice per week.  In order to see significant weight loss, this amount should increase to closer to 300 minutes per week, or about an hour a day for 5 days per week.  We often get really excited about our workout goals in the beginning, but sometimes, those workouts can begin to feel like even more “work” than usual.  Here are a few signs that you may benefit from a day off:

1. Ever feel so exhausted that you just can’t fall asleep?  That means your sympathetic nervous system may be working overtime.   Pushing too hard for too long can sometimes cause constant release of stress hormone that keep you wired for “flight or fight,” and that imbalance can totally throw off your sleep.  Another sign may be the disappearance of your menstrual cycles.
2. Constantly sick?  Either you have a toddler, or your immune response could be lowered due to inflammation and stress from overtraining.  Make sure you’re getting adequate breaks between hard workouts.
3. Reached a plateau in your workouts that no amount of training can push past?  Sometimes a short break for either a rest day or simply changing your preferred workout activity can help you resume making gains in your 5K pace or your weightlifting one-rep max.
4. Are you so tired that every day feels like a blur?  After sleep and dietary change, constant stress, either from workouts or even daily life, can really wreck your body.  We’re made to undergo cycles of work and rest, so being constantly “ramped up” can keep you from reaping some of those down-time benefits and even make it harder for you to rest when you finally have a chance.
5. Does that walk from your car to the gym make you tired just thinking about it?  The reason that people often begin to look forward to their daily workout involves the brain’s own reward system.  Dopamine, the body’s feel-good hormone that provides positive feedback for everything from workouts to intercourse, and endorphins, the body’s natural painkillers, are both released during and after exercise.  That being said, excessive training can blunt that response, and thus, blunt your satisfaction with your workout routine.

The bottom line:  working out and exercise are good, but be sure not to overdo it.  This is especially common when just beginning more intense exercise.  If you notice any of the symptoms of burnout listed above, it may be time for a little break or a change in your routine.  If those symptoms persist, then it may be wise to check in with your doctor to see if these symptoms are a sign of something else.  Before you do that, though, you might consider one last try for some fun exercise outside where you can really enjoy this lovely spring weather 😉
Dr. Nick