Wednesday, November 16, 2011

Why I'm convinced it's important to wait until 39 weeks

Before I start this post, I want to put a disclaimer.  This is, obviously, just my personal opinion.  I realize that I have very strong feelings in regard to inductions over all.  I also realize that there are medically necessary inductions/Cesarean sections.  Those are not included in my feelings or opinions.  I am strictly referring to planned inductions or c/s based on convenience.  Even then, I'm not saying "don't get induced!" I'm just saying "wait until 39 weeks!"

Ideas in the medical community seem to change rapidly.  Especially when it comes to children/babies/pregnancy.  Put them on their tummies to sleep.  No, wait.  Put them on their backs.  Keep them rear facing until age one.  Now, it's age two.

These changes are important.  They keep our children safe.  For example, we no longer have to worry about our child being thrown through the car window in an accident on the way home from the hospital because we have infant car seats.  We know to buckle them up before we head out and to make sure they are in a 5 point harness until certain age and weight.

Here's a newer recommendation that you may not have heard of, though.  The American College of Obstetricians and Gynecologists (ACOG) recommends that no elective delivery should be performed before the gestational age of 39 weeks. 

The reasoning for the recommendation is for the safety of mother and baby.  studies report rates of 28–35.8% of elective deliveries occurring before 39 weeks and reveal that they also contribute to increased rates of late-preterm births These deliveries are associated with increased neonatal morbidity, neonatal intensive care unit admissions, and associated hospital costs compared to deliveries occurring at 39–40 weeks. (taken from this website.)

In regular people terms, they found it causes more breathing issues and deaths in babies when they are "forced" to come before 39 weeks, (and, again, we're obviously NOT talking about pregnancies with health concerns for momma or baby here.)

This recommendation has even changed since O's birth. I was induced with her at 38 weeks (of course, one could argue that I was 5 cm dilated, 70% effaced, I was contracting, and she was very low. My OB's conclusion was that I may not make it to the hospital in time. Therefore, it would be under the ACOG's list of "okay to induce". But, I still believe her breathing issues stemmed from her c/s and being forced out before she was completely ready.)

Now, my last three children have entered this world on their own timing.  A was 38 weeks, Isaac was 37, and Eliza was 39.  I can tell you, from experience, that Eliza is, by far, more "advanced" at 4 weeks than my other kids.  When I say "advanced" I don't mean that she's talking in full sentences.  I mean that E and I have noticed a marked difference in several things when we compare her to the other kids.

1. How alert she is when she's awake
2. How well and fast she nurses
3. How she's able to hold her head up sooner/more
4. How she cries a lot less
5. How she just "looks" older

Eliza at 2.5 weeks

Now, obviously, these are in no way medical issues that would be a cause for concern in a 37 weeker versus a 39 weeker.  But, I firmly believe that a lot of these things are due to the fact that her brain is more mature.  I mean, if you figure it all out, she's really 2 weeks "older" or "more mature" than Isaac and Olivia were at this same out-of-the-womb-age.  She's had more time for her nervous system to mature.

So, there you have it.  My soap box post for the month.  Let your babies pick their own birthday if you can.  If not, wait until they are 39 weeks before you induce.  Their little baby brains will thank you.


Mommy Attorney said...

I'm completely with you on this. I was induced at 39w5d with Lily, after fighting off my OB starting at 37 weeks. I had a good bishop's score at that point, but I'm really glad I waited.

I was induced at 40w1d with Annabelle, and part of me wishes I had waited even longer, but there were crazy family circumstances involved (DH got a new job the week after AB was born and thus had no leave).

Christi said...

I totally agree with you. Also boys lungs development take longer so if a gestational age or lung development if off and a dr induces (for non medical reason) closer to 37 weeks it could not only increase a chance of cs but for breathing issues that could be life long. My dear friend had her water break a day before 37 weeks and it was a c-section and her son has grown up with a NICU stay and asthma issues.
My son was born at 38.5 weeks because my water broke but I would have had him before 39 weeks due to medical reasons and the girls came after 39 weeks anytime. As uncomfortable and ready to have babies as very pg ladies can's about having the baby's best interest at heart. Also, I was told that jaudice and body temp issues are more likely to occur for babies under 39 weeks...don't know if that is true except my son had both.

Mary Lindsey said...

Thank you for this post! I'm 35 weeks pregnant, and while I feel more and more ready to have my sweet baby girl, this is just what I need to keep going! I'm having a VBAC, so no induction will be taking place - just waiting on baby girl to arrive on her own. I'm sure I will be coming back to re-read this post in the next few weeks as long as she stays put! :-)