So 39 weeks is the full term cut off now?

[perfexion]

Im sure everyone has seen AWHONN's campaign to reduce elective inductions and ceseareans before 39 weeks but does that mean 39 weeks is the full term cut off now? Is it no longer 37 weeks? I ask as both an OB nurse and a woman who is currently 37 weeks pregnant. I was so relieved that I finally made it to term but my doctor told me to be patient because my baby needs to stay in for two more weeks to reach maximum maturity. Is this the new standard or does my doctor just want to torture his patients? 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)?

[klone, MSN, RN]

Hey, we should take any victory we can. Used to be, OBs would do social inductions all the time at 38 weeks.

The NIH (via the Eunice Kennedy Shriver MFMU) is conducting a nationwide study on elective inductions at 39 weeks, hoping to show that they result in fewer comorbidies than allowing them to go to 41+ weeks.

With that I mind, I guess you're right - we do have a long way to go.

[ixchel]

Hey, we should take any victory we can. Used to be, OBs would do social inductions all the time at 38 weeks.

The NIH (via the Eunice Kennedy Shriver MFMU) is conducting a nationwide study on elective inductions at 39 weeks, hoping to show that they result in fewer comorbidies than allowing them to go to 41+ weeks.

With that I mind, I guess you're right - we do have a long way to go.

Did I just read that right? They're trying to prove its BETTER to induce at 39?

[klone, MSN, RN]

Yes, they are. I suspect it's backlash from AWHONN and March of Dimes campaigns.

But officially, no. They're trying to figure out "Is inducing at 39 weeks better/safer than waiting for spontaneous labor?" That's the official problem statement the study is trying to answer.

Pretty much every midwife I know is fairly disgusted with the whole premise, though.

[Red Kryptonite]

Pretty much every midwife I know is fairly disgusted with the whole premise, though.

As well they should be! Any responsible professional connected with birth should be disgusted by that. Why is it we Americans are so compelled to meddle? SMH

[Elvish, BSN, DNP, RN, NP]

The NIH (via the Eunice Kennedy Shriver MFMU) is conducting a nationwide study on elective inductions at 39 weeks, hoping to show that they result in fewer comorbidies than allowing them to go to 41+ weeks.

We're participating in that study. They're inducing people with a favorable Bishop score at 39 weeks. Most of our 41 week inductions are closed/thick/high - duh. In my mind they're already starting with an uneven playing field. So of course inducing someone who's already soon to go into labor anyway is likely to have fewer comorbidities.

[dinah77, ADN]

PP nurse here.

We currently take babies on our no younger than 35. Earlier than that is NICU admit.

We call 35-37 weeks old "late-preterm" And those kiddos RARELY do well-they may start out rooming in with mom, but generally around the 18-24 hour mark they crash (low temps, blood glucoses most common) and end up in NICU

37-38 weeks do better, but the ones who are 39 and above do the best

[figureskating]

I've had four kids. 2 came at 38 weeks, one came one day before her 36th week , and the last at 40 weeks plus 1. My 35 weeker had a hard time getting over jaundice. It took her almost two weeks to get rid of it. After one week they sent her home and then we ended up right back at the hospital. She also had to have air by nasal cannula and an IV. The last few weeks are bad but it's better to wait for the baby come on their own time frame unless there's a true medical emergency. 37 weeks is considered term but it's early term. Plus a due date is just an estimation. I'd have to say 40 plus 1 baby was the most alert.

[figureskating]

My first three kids I had a doctor that was pretty much by the book and used a lot of standard interventions. At that time I just did whatever my doctor told me because I figure it was always best no matter what. I didn't know anything about birth plans or that I had choices. My third was a c section and my fourth was a VBAC. During research for a VBAC I learned the U.S. has too high of an induction/C section rate. True there's instances where an induction or section is really needed, but sometimes so much meddling done it messes with the birth process and causes other interventions that may have not been needed in the first place.

[figureskating]

Just to play devil's advocate here, as someone whose patients regularly include anything from 24-weekers to 42+-week shoulder dystocia/HIE babies, I'd dispute the assertion that mom's body and baby always "know when it's time." That said, if you're cooking along and healthy at 37 weeks, no reason to induce or section at that point (and lots of reasons not to, as previously enumerated).

I think for the most part in most healthy pregnancies your body does usually know when it's time. Then there are the exceptions that do require some intervention. There's a balance.

[figureskating]

ok tried to reply to someone . it didn't put the reply underneath their statement.

[figureskating]

We're participating in that study. They're inducing people with a favorable Bishop score at 39 weeks. Most of our 41 week inductions are closed/thick/high - duh. In my mind they're already starting with an uneven playing field. So of course inducing someone who's already soon to go into labor anyway is likely to have fewer comorbidities.

Question: Why would 41 week inductions necessarily all be closed , thick , high? Some people go weeks dilated several cm before they go into labor. My sister in law was induced the day before her 40th week and she was already 3 or 4 cm before induction. Ok never mind. Maybe I was reading this wrong. Are you saying the study is biased?

[OB-nurse2013, BSN, RN]

I just want to say I agree with many of the response. I am baffled but the fact that you're an ob nurse and feel this way.