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Success after IF
perry7285
member
huge PSA on delivering before 39 weeks
perry7285
member
i'm posting this on PAIF as well, but i wanted to post it here for all the pregnant ladies.
the wall street journal published an article in which they summarize some research and interview various doctors about the risks of delivering between 37 and 39 weeks. i don't have a link, but if anyone wants to check it out, it's the march 1st issue on page D3. here's my summary:
basically, they say that there is a large and increasing body of research showing that being born before 39 weeks, even by a few days, increases the risk of many issues. we're not talking just issues in the first few days or weeks, we're talking issues lasting into childhood, including respiratory problems, psychological, emotional, and behavioral problems, feeding problems, etc.
of course most babies born at 37 weeks (and many born much earlier) do great and have no problems whatsoever, so the article isn't saying that babies born early are doomed to have problems. however, there is evidence that the RISKS of problems are higher.
of course there are many cases where a baby needs to be delivered early for medical reasons, so nobody is arguing against that; the article basically is just arguing that elective early inductions should not be done, and that early inductions and c-sections in general should not be taken lightly.
i feel guilty posting this because it is kind of a downer of a post, since many of us have babies that came a little early for one reason or another. i just thought i should share this, because although some doctors that i dealt with during my high-risk pregnancy emphasized the importance of getting to 39 weeks, others brushed off the idea that anything after 37 weeks matters. this article confirms the strong mommy's instinct that i have had all along with my baby (who has had some problems, although thank god nothing serious), that it's not trivial that he was born at 37 weeks 6 days. so if you get some doctor acting like going to term is no big deal, please consider seeking other opinions.
This discussion has been closed.
Re: huge PSA on delivering before 39 weeks
the ladies on PAIF are upset with me for posting this over there so i'm going to DD it on that board. we'll see how the ladies over here feel, i'll DD it if the consensus is that it's not an appropriate post. i just feel like i should share the information in case people aren't getting good information from their doctors.
You never know who will read it and who might need to hear it, possibly in opposition to advice they get or are hearing from others. Reinforcement that every day in utero matters is good, right?
I have one of those almost term babies. I had a high risk pregnancy and he had low amniotic fluid from 32 weeks (when we checked it) until delivery at 38w5d. He did have issues, some short term (jaundice), some longer term (speech delay, feeding issues). But for us, the risk of him staying in was great (OB was very very concerned about still birth) and the longer term consequences pale in comparison.
My OB was mentioning their hospital system's research suggested something similar and thus they would never intervene (sced c/s induce) unless medically necessary. I guess it was primarily lung development.
Since my water broke at 38wks with both I didn't have a choice. But DD#1 does have asthma.
I think there are 2 big factors to consider pertaining to this information, one that impacts most of the early delivers on this board, and one that doesn't.
Many women who are delivered early on this board, in fact probably almost all of them, did so for medical reasons indicating delivery was needed. And those factors have the possibility to impact future health.
But on the flip side, we all can pinpoint (with the exception of some surprise BFPs) the exact hour our children were conceived. Gestational age is not a guess, it is known. But ask any OB, and they'll likely tell you that most pregnant women who they see have no real idea of when they conceived. They may sort of remember the date of their last period, but many do not. So it can be super easy to be off by as much as two weeks, which means that 38 week delivery is really a 36 week delivery, and so forth.
FWIW DD was delivered at 37 weeks 0 days. I'd been on strict hospital bedrest for 10 weeks, and even at that point, with concerns rapidly growing over the impact that the bedrest was having on my legs, greater difficulty keeping the eclampsia under control, and the like, they still only considered delivering me at that point because my amniotic fluid droped dramatically. She's had zero issues.
same here--my water broke at 37 weeks 6 days, so that was that! my LO is too young to really tell how he's going to do, so of course this article makes me nervous. =(
World_of_Dennifer
Bloomin'_Babies
Married/Nest_Bio
I don't know if I really buy that because some many babies are born before 39 weeks and are just fine. All three of my kids were born before that. Twins at 36 weeks and 4 days (my waterbroke) and Brady at 37 weeks because he was huge and they were afraid I was going to go into labor over thanksgiving weekend and I am high risk! Brady was born with hypospadias and later had pyloric sten but they told me this has nothing to do when he was born but just genetics.
My sister was born 40 weeks and 5 days and was really sick from the malicomium (spelling) and she almost didn't survive. She had long term problems. So really it long term problems could happen at at gestestion age
This post did not upset me though!
Well this is my take on it:
I could of risked dying or my son dying to buy a couple of weeks for my son or I could have had induction at 37 weeks... I chose the 37 weeks (scheduled induction) and he thought 35 weeks was better (water broke). I was on bedrest since 26 weeks and was oh so grateful each week I "made it". And YES, my doctor needed to reassure me that 32 weeks was good, 34 weeks better and 37 weeks while not IDEAL but needed!
Anyway, I don't think anyone on this board or the PAIF board chooses induction "just because". Many times, IF also comes with problematic pregnancies.
After 7 years trying to concieve, 3 failed IUIs and 2 failed IVFs, my third IVF was a success!
My Christmas baby turned into a turkey bird! Dillon Richard was born at 34 weeks, 5 days on November 28, 2009 after 10 weeks on bedrest for preeclampsia.
<a href="http://smg.photobucket.com/albums/v705/arriinthere/PJ/?action=view
i'm totally not saying that people shouldn't induce early for medical reasons (i thought that was clear in my post, but if not, please let me clarify now, that's not what i meant). but i do think elective early inductions happen, at least occasionally, so i wanted to make sure that people have this information if it's relevant to them.
I'm not offended by this!
I had an induction (ended in C-Section) at 38w2d because of 3 failed NSTs and 2 failed BPPs - she sent me for an induction straight away.
Then I elected to schedule my C-Section (begged, actually!) at 37w1d because, well I was miserable. I had a PUPPS rash, I was measuring 47 weeks...that is pretty much it : )
I wouldn't do it any different if I got to re-do anything. Articles like this don't make me regret my choices.
I completely agree with this. My friend had a repeat c-section for her 2nd baby and scheduled it around 38 weeks. I was a little concerned for her because she couldn't possibly know the exact date of conception. Her baby was born requiring oxygen and ended up having some significant breathing issues and stayed in the NICU for a week or so. The doctors did tell her that the lungs weren't fully mature yet, and of course my friend felt a ton of guilt.
My DD was born at 38w4d because my water randomly broke then. I had a pretty fast labor so she was obviously ready to meet us
I felt guilty though because I had wanted to keep her inside until 39 weeks.
I'm not offended.
My induction was just shy of 37 weeks due to cholestatis. While I do wish that I had insisted on an amnio to test lungs, the induction was needed. 37 weeks doesn't always mean they are ready, even though we knew that I was exactly 37 weeks when he was born. Eli needed two days in the NICU for breathing issues and ended hospitalized with RSV at 1 1/2.
If I get cholestatis again and need to be induced before 37, I will be asking for an amnio and/or steriod shots.
I guess I'm sort of confused as to why anyone would be upset about you posting this article.
Doesn't knowledge = power??
Like qtp2t said, my OB will not induce or perform c-sections before 39 weeks unless medically necessary. He just won't. He is of the school of thought that pregnancy is 40 weeks for a reason, and who is he to screw around with that, assuming Mama and baby are healthy.
I agree. Of course there are always medical reasons, and I don't think this post is saying that 39 weeks trumps any significant medical reason for induction/c-section. I think the point is that we can't say that *every* baby is completely ready for delivery at 37 (or 38) weeks, especially since many (most?) women do not know the exact date of conception.
ETA: I think that maybe the confusion is that there are not many women on this board that are given (or have taken) the option for an elective procedure prior to 39 weeks (for a singleton). I do know many women in real-life who were given this option for second pregnancies, however. Just something to think about.
This.
Not offended. I'd rather have information than not know.
Since my tiny guy was induced at 37w0d, it does worry me a little. He failed his NST and BPP, though; it was not elective. I still worry that it was not the right thing to do, but of course we'll never know if something would have gone wrong in the following days had I not delivered then. I just hope and pray that he is okay.
I'm not really offended, per se.
DD was born at 36w3days. She was a scheduled c/section for 39w3days but had better things to do than wait for family and a crib to arrive first. Born healthy, no complications (IVF baby, so no guesses on gestation).
My OB (the entire practice) will not schedule a c/sec before 39 weeks for any non-medical reasons. Not for Dr. preference, not for dates, family, etc. I wanted a C/section date the first time of 38w6days to get my fav. OB, but they wouldn't even discuss one day early for some of the reasons in the article.
That said, I don't know many people that make that choice, kwim? I mean I realize some people might get that option with their Docs, but if presented with the info (which a good OB would do) who picks that outcome?
Most people are like me, their little ones came early due to medical reasons (whether it be they went into labor or were induced for medical reasons). So, the article is stressful, because it's telling me things to be stressed about after the point of no return. If your baby was early (like so many of ours), you can't fix it! So, of all of the pressures and realities of even conceiving these kids of ours, I just don't want another thing to worry about. One of my biggest fears is this pregnancy going even sooner. We feel like we were barely called safe at homeplate last pregnancy, so I'm so worried about this one.
So, it's stressful. Not offensive, just stressful.
Agreed that knowledge = power. If this impacts anyone who is considering an elective early induction, at least this gives them a reason to consider waiting. It has to be weighted along with everything else!
No one is saying that when an early induction or c/s is needed, the mom should feel bad, just that the decision shouldn't be taken lightly. Perry said that almost exactly.
I know of a few people IRL (not friends, but acquaintances) who elected to have their babies early for no reason other than convenience or a desire to just be done being pregnant (one wanted to quit while she was ahead avoiding stretch marks!). But there are also people who aren't shallow and don't understand that there are risks, and this article does a good job of explaining the cons.
If anyone can't find the article or wants to read it, let me know!
I had a pseudo-elective* induction at 38 weeks (was supposed to be 37) and may do so again, and I'm not offended by your posting this. I do, however, wonder if it really is going to have any positive significant impact on anyone here.
As others have said, I don't think there are many (I can't think of a single one) elective inductions "just cuz" on this board. Hell, I don't know a single person period who has had a baby before 39 weeks for any reason other than significant medical issues or they just plain went into labor. So, when everyone here (with myself as a possible exception) had their babies "early" by medical necessity or because they went into labor without any control over the matter, I'm not sure what effect this post can have besides "crap, what else do I have to worry about?"
Maybe I'm wrong and there are a ton having elective c/s and inductions before 39 weeks but again, I feel like I practically never see that.
*I say pseudo-elective b/c I didn't have a specific medical issue at that point in pregnancy, rather, with my history of abruption and the fact that one of my twins died during labor (the other died shortly after birth), my anxiety was so high I could barely function the entire pregnancy, and I asked my OB at my first appt about induction at term after researching and seeing that many doctors do automatically induce at 37 weeks for those with a history of abruption. It is not the "standard of care" nor their office's standard, but with my history, my request, and my anxiety, she agreed if we had an amnio showing mature lungs. They weren't mature at 37 weeks, but were ready at 38 weeks. I knew there were risks but my POV was that I had already had a dead baby(ies) and any alternative was preferable even if there were some issues, and I couldn't stop worrying that the longer I left him in the more likely my placenta would crap out again. Toodle has no breathing or feeding issues. The only way he is "atypical" is sleep and I think that has a lot more to do with (a) personality and (b) our parenting than his gestation at birth.
For this pregnancy, we will likely do the same but it may depend on how my anxiety is when we reach that point, as we've already discussed that if I can hold out to 39 weeks we don't need the amnio which is a bonus. Again, irrational or unlikely as it may be, my main focus is still that the alternative could be another abruption and dead baby, made scarier by the fact that my OB's office is 1.5 hours away with traffic.
i know. it's stressful for me, too, with my early baby, and i'm very sorry if i have seemed insensitive to the stress factor for everyone who has early babies. i just was/am hoping that this information would be useful for people in their decisions about future babies, in case people have gotten misleading information on this issue in the past. (if this information never ends up being useful to anyone, then i would definitely regret posting it . . . because i definitely don't want to be insensitive to the stress it may cause for everyone with babies born early in the past.)
I agree with Schmoodle. I don't know a single person who actually asked for an early delivery. Not a one.
I have a friend who delivered a stillborn baby at 40 weeks (cord accident) and she was delivered right at 37 1/2 weeks for baby #2 because she was on the verge of a nervous breakdown, and they thought it was best not to put her through that.
Well, my guy was born at 38 weeks and, so far to my knowledge, doesn't have any known issues, but our personal anecdotes really don't do anything to speak to or disprove scientific results of I'm guessing thousands of pregnancies. I don't question the truth of the study at all - and wouldn't, even if I didn't know a single 37-39 week gestation baby with issues, because my personal limited knowledge can't compete with a controlled study of a much larger sample. I know plenty of people whose parents smoked while pregnant with them (myself included) without long term issues but that doesn't mean I don't buy studies showing the link between smoking and adverse effects on pregnancy.
every pg has risks... docs need to make the best choices they can- period.
Going past 38w causes risks to a twin pg that most docs will not take.... hence, my boys delivered at 38w1d.
Griffin was induced at 36w2d for various medical reasons.
Sure- people should not deliver early b/c it works better for their schedule... but the fact is, many babies who go full term or late don't do so well either. I know quite a few moms who lost babies right before their due dates - for various reasons, that would not have happened had they been delivered a week earlier... so how can you make a choice based on a study with "risk factors"? You do what works for YOUR pregnancy.
and ditto the others who said that most women do not truly know when they concieved.... throws a whole other loop into the "study".
Nobody needs to get bent out of shape over it. It's old news, actually... Get an OB that you trust, who is wise, and will make the best decisions for you and your baby.
I think the key here is that delivering before then increases the risk. Maybe the risk is 2% of problems and delivering early increases it by 50%. That sounds huge until you realize that it's still just 3%.
It's not saying it's a guarantee, just that it increases the risk, and a lot of people seem to misread that.
This is what I was thinking. I'm not offended by any means and both of my deliveries were before 39 weeks, but now it leaves me second guessing some things, when really, this was probably a skewed viewpoint of someone trying to prove themselves correct.
I know of 5 in person who asked for a repeat csection at 36 to 38 weeks, for no medical reason, and one who asked to be induced because she was hot. It was summer. ::eyeroll::
That doesn't include the people I have heard doing it here on the bump, and on other boards.
It happens. Sometimes it even happens when a doctor is going out of town and wants to get it all done before he goes (my cousin. she switched OBs at 37 weeks pregnant over that!)
Ethan was born at exactly 39 weeks. My doctor scheduled it that way, citing the dangers of delivering before 39 weeks. I wanted to do it one day sooner (So Ethan would have been born on 7/7. She refused.
As a mom of an almost 38 weeker (plucked early due to IUGR and increased risk of mortality if left to go over 38 weeks) I personally think it's good to be reminded of this stuff.
Yes - there's nothing we can do about it now.
But... many of us are in this situation. IF is the gift that keeps on giving!
Dylan's now apparently developing some mild asthma issues. Could it be associated with his early delivery? Who knows. But in general he's less healthy than my 39 weeker.
Can't change it now and wouldn't have then if I could have. He was better out than in. I'll face what ever we have to face now and for the rest of his life gladly and I'm grateful he's here alive and safe.
It is what it is.
I'm more of a "knowledge is power" kinda gal.
If you'd posted this about a month ago maybe I would have seen the asthma thing in Dylan myself and gotten him to the specialist faster, KWIM?
I think it's still valuable information even post-birth.
Total score: 6 pregnancies, 5 losses, 2 amazing blessings that I'm thankful for every single day.
You know, I'm kind of irked that anyone (here or on PAIF) would take offense to this. It's an article that has to do with pregnancy and childbirth and the lasting effects of such, which applies to all of us. I thank you, perry, for making us aware.
If Cal had been born prior to 39 weeks and I hadn't known that there were possible long-term complications to that, I would have really appreciated knowing this information. Yeah, it might have brought up some anxiety (so many things do!), but it would be good to know, nonetheless.
I welcome any and all info that could impact my child and future children.
Again, thank you.
LO #1 - 1 unmedicated/self-monitored IUI w/ donor sperm.
LO #2 - 1 m/c, 2 BFNs, 4th IUI worked (unmedicated/self-monitored with new donor sperm).
Life is beautiful!
But like everyone has said, it's a balancing act. I'm sure your OB has weighed the risks and benefits and settled on 38 weeks as the best balance. This article is really just for people who have never had to worry about early delivery for medical issues and want one for their own reasons. (And obviously so people who do deliver earlier than 39 weeks for whatever reason can keep an eye out for any issues like respiratory problems, etc.).
I too personally know 3 people who have asked to be delivered at 38 weeks (and their doctors allowed it). Just sayin'.....
"I have four children. Two are adopted. I forget which two. -Bob Constantine
"All for Love,' a Saviour prayed 'Abba Father have Your way. Though they know not what they do...Let the Cross draw men to You...."