So 39 weeks is the full term cut off now?

Ms_barnesRN · May 22, 2015

Why is everyone trying to have their babies at 37 weeks? When did society jump to this convenience of having the baby so early at 37 weeks? Why is it "torture" to let the baby mature for the right given time? Just my personal thought....

JustBeachyNurse, LPN · May 22, 2015

I thought 40 weeks was term..

Katie71275 · May 22, 2015

37 to 40 weeks is considered term. Anything prior to 37 weeks is considered preterm. However, guidelines to prevent docs from inducing prior to 39 are in place as it is preferred to let babies mature until ready to be delivered. You can look up the "late preterm initiative" as well as more info on the website gothefull40.com

SubSippi · May 22, 2015

I'm curious...do you OB nurses notice a significant difference among newborns who are born at 37 weeks vs. 38 or 39 weeks? I know there is data available on the internet but I'm interested in what individual nurses have to say on the subject.

ixchel · May 22, 2015

OP, babies need to bake as long as possible and a healthy cervix should not be rushed. Facilities have to justify births induced prior to 39 weeks because it is evidence based best practice to wait. If you think it's torture to wait TWO more weeks, perhaps you wouldn't mind an induction that leads to fetal distress/demise because baby couldn't handle pit or rupture from too strong contractions, or poor lung development because lungs aren't always magically ready at any particular time. 39, because allowing labor to come naturally is a much better option. 39 because better development.

AspiringNurseMW · May 22, 2015

Early Term: Between 37 weeks 0 days and 38 weeks 6 days
Full Term: Between 39 weeks 0 days and 40 weeks 6 days
Late Term: Between 41 weeks 0 days and 41 weeks 6 days

So full term is really 40. My personal opinion. Your baby and body know when the time is up. Leave baby be until you go into labor. If left alone and not induced, the majority of women will go to 41 weeks. I have my 2 kids all over me, I have to find the source for that information.

So please, for your baby and all your patients, go at LEAST the full 40. Doing so is not torture, its evidence based.

AspiringNurseMW · May 22, 2015

MMS: Error : conclusion: Elective repeat cesarean delivery before 39 weeks of gestation is common and isassociated with respiratory and other adverse neonatal outcomes.

Committee Opinion No. 561: Nonmedically Indicated Early-Ter... : Obstetrics & Gynecology

Part of the conclusion: In fact, there are greater reported rates of morbidity and mortality among neonates and infants delivered during the early-term period compared with those delivered at 39 weeks and 40 weeks of gestation. The differences between 37 weeks of gestation and 39 weeks of gestation are consistent, larger, and statistically significant across multiple studies.

queenanneslace, ADN, MSN, APRN, CNM · May 22, 2015

Am I supposed to be telling my antepartum patients that 39 weeks is the new full term too (namely the ones who bombard me with questions about castor oil and nipple stimulation as soon as they hit 37 weeks)?

Just curious - what are you currently telling these patients trying home induction methods at 37 weeks?

Elvish, BSN, DNP, RN, NP · May 22, 2015

I'm curious...do you OB nurses notice a significant difference among newborns who are born at 37 weeks vs. 38 or 39 weeks? I know there is data available on the internet but I'm interested in what individual nurses have to say on the subject.

In a word, yes. Obviously everyone is an individual and some 37-weekers will do beautifully and some 40-weekers will not. Usually, if a 37-weeker comes on their own I don't worry so much. Bodies know when babies are ready. Consider that due dates can be off by two weeks in either direction, so there is generally no need to rush a 37-week baby to come out. Your 37 weeker may really be 39, but she may also be 35 and those babies are notoriously not trustworthy.

37-week induction babies I do worry about, even if it's for a legitimate medical reason. So much growth happens between 37-39 weeks - a quarter of fetal brain growth, just in those two weeks! A 37-week delivery means less fully-developed thermoregulation and respiratory centers in the brainstem. Less lung surfactant. Less stored glycogen. Less efficient suck and increased feeding difficulty. 34-37-weekers have this thing they do where when it's time to eat where they put their tongues up at the roof of their mouths instead of down at the bottom....makes for a difficult feeding time, breast or bottle. Almost no 38+ weekers do this.

So yes. I am all for babies staying in the oven for at least 39 weeks if not more. An overwhelming majority of the time, they need every single one of those weeks to grow, build up stores, and develop their brain. Don't rush them! OP, just a side note: My daughter will be 4 next week, and my OB gave me a March of Dimes handout at my 36-week checkup, and they had an office insert inside basically saying, "We're not going to induce you before 39 weeks unless there is a really good reason, so don't ask." The 39-week thing has been around for a while.

Obviously there are times when it's necessary and appropriate and life-saving for either mom or baby to deliver at 37 weeks or even earlier. But as a general rule, they really do need all the time you can give them. Babies come when babies are ready. Ma Nature knows what she's doing. Push her enough and she will push back. No one's trying to torture you. Late pregnancy isn't always comfortable (been there, done that) but it is a normal state, not a disease, and it won't last forever.

Apologies for the War and Peace-length post. Passions run strong on this subject.

prmenrs, RN · May 22, 2015

Excellent post, Elvish. 37 week babies can and do, on occassion, get Respiratory Distress Syndrome, and, because of their borderline maturity, may switch into a persistent fetal circulation scenario. In other words, get deathly ill.

Relax, put your feet up, drink your water and "enjoy" the end of your pregnancy. Your doc is not torturing you, s/he is protecting you and your baby. And Best Wishes for a safe delivery!

AspiringNurseMW · May 22, 2015

In a word, yes. Obviously everyone is an individual and some 37-weekers will do beautifully and some 40-weekers will not. Usually, if a 37-weeker comes on their own I don't worry so much. Bodies know when babies are ready. Consider that due dates can be off by two weeks in either direction, so there is generally no need to rush a 37-week baby to come out. Your 37 weeker may really be 39, but she may also be 35 and those babies are notoriously not trustworthy.
37-week induction babies I do worry about, even if it's for a legitimate medical reason. So much growth happens between 37-39 weeks - a quarter of fetal brain growth, just in those two weeks! A 37-week delivery means less fully-developed thermoregulation and respiratory centers in the brainstem. Less lung surfactant. Less stored glycogen. Less efficient suck and increased feeding difficulty. 34-37-weekers have this thing they do where when it's time to eat where they put their tongues up at the roof of their mouths instead of down at the bottom....makes for a difficult feeding time, breast or bottle. Almost no 38+ weekers do this.
So yes. I am all for babies staying in the oven for at least 39 weeks if not more. An overwhelming majority of the time, they need every single one of those weeks to grow, build up stores, and develop their brain. Don't rush them! OP, just a side note: My daughter will be 4 next week, and my OB gave me a March of Dimes handout at my 36-week checkup, and they had an office insert inside basically saying, "We're not going to induce you before 39 weeks unless there is a really good reason, so don't ask." The 39-week thing has been around for a while.
Obviously there are times when it's necessary and appropriate and life-saving for either mom or baby to deliver at 37 weeks or even earlier. But as a general rule, they really do need all the time you can give them. Babies come when babies are ready. Ma Nature knows what she's doing. Push her enough and she will push back. No one's trying to torture you. Late pregnancy isn't always comfortable (been there, done that) but it is a normal state, not a disease, and it won't last forever.
Apologies for the War and Peace-length post. Passions run strong on this subject.

Can't like this enough!