March of Dimes: Less than 39 weeks

madwife2002, BSN, RN · May 25, 2011

Interesting thank you for sharing

merlee · May 25, 2011

When I was pregnant with my now-19 year old, I discussed vbac vs c-section with my doc. Had a c-section with my older son.My due date was 10/17, I wanted the C-section on 10/10 if possible, if I didn't go into labor before that. Doc said that was the earliest he would do it, one week before due date.

So on 10/10 I went in for my scheduled c-section, and he says my cervix was just ripening, did I want to wait a few more days. He was concerned the baby wouldn't be very big. With all their fancy equipment, they thought he was maybe 6 lbs. An hour later, I was holding my 8 lb baby boy!

But I agree with the premise about 39 weeks, and am glad to see that there is education available for it.

Pixiesmom, BSN, RN · May 25, 2011

Thank you for sharing this Elvish. This is music to my ears!

nicu4me · May 25, 2011

Yes they are implementing it in our area. Never seen such an influx around a certain holiday of a bunch of 37 weekers where moms just couldn't wait anymore. Most of them ended up on BCPAP and slow eaters, low sugars and IV fluids. Yeah and they didn't get them home by their holiday parties..... However, to get it justified we all know the OB says low amniotic fluid. It's that easy, so if they want to do it and not get into trouble for going against the recommendation, that's how they do it. Please hang onto your babies til 39 or more weeks. Theres probably plenty on the MOD website about brain growth in those last three weeks. Late pretermers and nippling especially. Sad there were a few twins and some could only take one home at a time.

mkjh · May 25, 2011

Good for the MOD!

I was scheduled for a c/s b/c of a breech baby. My doc scheduled it for the day before my due date and said we'd just deal with it if I went into labor earler. I was really happy.

RainDreamer, BSN, RN · May 25, 2011

That's great that they're doing this!

It doesn't surprise me that some docs induce for convenience of dates, but the fact that some moms are actually willing to endanger the health of their babies for their own selfish reasons, is appalling to me.

sandi1743 · May 25, 2011

whenever i talk to people about the risks of non-medially needed inductions/sections before 39 weeks I almost always get the same reply "but my doctor would not do it at 37 weeks if it was not safe" and i just want to bang my head. 39 weeks should be the standard - Even the NEJM article, the most common ref for the timing of repeat sections says that 39 weeks is best.

the article if anyone has not read it http://www.nejm.org/doi/full/10.1056/NEJMoa0803267

a few more days of discomfort are well worth the greatly reduced risk of having a baby in the NICU.

Elvish, BSN, DNP, RN, NP · May 25, 2011

However, to get it justified we all know the OB says low amniotic fluid. It's that easy, so if they want to do it and not get into trouble for going against the recommendation, that's how they do it. Please hang onto your babies til 39 or more weeks. Theres probably plenty on the MOD website about brain growth in those last three weeks. Late pretermers and nippling especially.

One of the biggest things in the handout I got from the OB (who got it from the MOD) talked about the amount of brain growth that happens between 35 and 40 weeks. IIRC, it shows the progression from 35 to 37 to 40 in terms of brain size, which I think is a good thing. It's written at 6th-grade level or so. :up:

I am not a fan of 'tired of being pregnant' inductions, even after 39 weeks.

sandi1743 · May 25, 2011

I am not a fan of 'tired of being pregnant' inductions, even after 39 weeks.

I totally agree - someone I know was induced at ~37.5 weeks as she was tired of being pregnant and feared that allowing the baby to grow more would make her "loose" (her comment not mine) and ended up with a very bad experience, a section and a baby in NICU. In talking to her after the fact she said that there were a number of women in her ICAN meeting that had similar experiences and that they all agree that looking back they would have been pregnant a bit longer just to have NOT had that NICU experience.

pockunit, ADN, RN · May 25, 2011

I love seeing this. Our first was alleged to be 11 lb so an section was offered. She was an 8.5# SVD. Our third was born right on the dot at 37w, and was also 8.5#. The doc might actually have been right if she'd been two kids later :icon_roll . Kids 2&3 were both homebirths, so no induction possible anyway and that's how pockspouse and I wanted it.

The rush to deliver is a mystery to me. I think either docs don't educate their pts on the risks, or the pts don't believe them, and I don't know which is more worrisome. It's one thing if the pt delivers at 37w on her own, but for a doc to induce because she's tired of being pregnant is appalling. Sure, we have NICUs, but that doesn't mean we should be filling them with near-term babies. Besides, 37 weeks isn't even that bad, from what I've seen and heard. It's 41/42 that deserve the sympathy.

Long Term Care Columnist / Guide · May 25, 2011

Grooooooooooan...........The only one of my kids who didn't go to 42 weeks was the 10-lb.-11-ouncer. Thank God they didn't let HIM get past due!!