C-sections

why wait for 39 weeks

Ok so I went to hospital Sunday night for contractions. I was having them for over 12 hours and they were really close (2-5 minutes apart). They did a u/s and said that she was measuring 37 weeks and full term. They ended up trying to stop my contractions and got them back to 20-30 minutes apart. Went to doctor Monday and he said that we still weren't going to do a c-section until 39 weeks.

Why do I have to wait that long. If she is ready to come out with contractions and starting to dilate why do I have to wait till 39 weeks to have section. I know that she will prolly be here before then but my doctor is getting on my nerves...

 

 

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Re: why wait for 39 weeks

  • Ditto what PP said.

    There is significant evidence that supports the need for babies to stay inside until 39 weeks unless there is an indication that the baby is in trouble.

    My niece just had her second baby at 37 weeks bc the baby was in distress. Her LO was in the NICU for a week bc she had breathing and feeding issues.

    With this pregnancy, I started having contractions at 38w4d and my OB wouldn't do my c/s unless I started progressing into active labor or LO was in distress. I went into active labor at 38w6d and then we did the c/s though by the time we got in the OR, I was at 39w.

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  • Keep that baby in there as long as possible! I was born at 38 weeks and everything looked good on the ultrasound, but my lungs actually hadn't fully developed, and I was born with pneumonia. Not something you want to deal with. LO will be here before you know it!
  • Just because she is measuring 37 weeks, doesn't mean that she's at the same development as a 37 weeker.
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  • Because babies aren't meant to be born before that point.  Enjoy these last few weeks. You will enjoy them much more with a healthy baby on the inside than a potentially sick baby (being born too early) on the outside.
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  • When we were scheduling my c/s, due to hospital issues, the only available date was when I was 38 weeks 5 days.  The ONLY reason my OB consented to that date before 39 weeks is because I had had the steroid shot for LO's lungs when I was 31 weeks and had PTL.  Lung maturity is the biggest factor.
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  • By that logic, are babies born at 32, 34, heck even 24 weeks actually ready to come out just because the mom went into labor? Of course not, or the concept of a preemie would not exist. Do you really want a preemie? I know it's hard to wait, but really, every day closer to full term is beneficial to a baby's development. Size =/= lung maturity, which is one of the biggest concerns of having a premature (even late preterm or early term) baby. Yes, some 36 weekers are "done," but many are not. IMO your doctor did you a favor, many would just go ahead and deliver LO and worry about NICU time later.

    Patience, mama. Go get a nice haircut, go to Starbucks and enjoy a hot chocolate, spend some special time with your DS's for his last few weeks of being an only child.

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  • There are multiple studies that show that c/s babies are more likely to suffer respiratory distress than those babies born naturally.  And c/s babies born prior to 39 weeks are even more likely to suffer this distress and require NICU time.  Because of this, the ACOG recommends not performing a c/s prior to 39 weeks unless medically necessary. 

    Many women have contractions and start to dilate around 36 weeks and then not have their babies for several more weeks.  

    As for u/s measurements, particularly late term u/s, those measurements can be way off.  Two days before DS1 was born, the u/s measured him at 8lbs 2oz.  He was born two days later weighing 5lbs 12oz.  

  • I live in Oregon and pre-term csections with no medical distress to mom or baby have been banned. My doc can't schedule my RCS (3rd) before 39 wks even if he wanted to. 

    If you go into labor and it can't be stopped then they will go for it. What is your reason for a RCS? Is a vbac an option?  

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  • imagemagdalina.h:
    Just because she is measuring 37 weeks, doesn't mean that she's at the same development as a 37 weeker.
    This!
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  • my doctor wont let me go past 37wks because i have an IC and have an abdominal cerclage. i had my csection schedualed at 36wks 5days my LO was just fine just on the smaller side at 5lbs 13oz but 19"

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  • imageMOMMA OF TWO 2010:

    my doctor wont let me go past 37wks because i have an IC and have an abdominal cerclage. i had my csection schedualed at 36wks 5days my LO was just fine just on the smaller side at 5lbs 13oz but 19"

    The difference between you and her: you have a medical reason to deliver early. She doesn't. I had a 6lb 3oz 36 wk baby who was measuring at 37.5 weeks. He had to go to the nicu for 4 days due to breathing problems.
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  • im just saying my experince. I was lucky to have him at 36wks 5days with no problems and only two days in hospital.
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  • imagemagdalina.h:
    Just because she is measuring 37 weeks, doesn't mean that she's at the same development as a 37 weeker.

    This!  Plus, not to mention u/s growth measurements are not always very accurate especially late in pregnancy.  Please be patient.  From a mom of 2 preemies, there is not a whole lot worse than having to leave the hospital empty handed, why take that risk?

  • imageGhostMonkey:

    DS measured 40 weeks at around 34-35 weeks. No way was he remotely close to ready. It meant he was above average size, not that he was maturing at a super fast pace. Doctors shouldn't really tell you how many weeks you are measuring after the anatomy scan- they should only talk in percentiles. If you go by size alone, then I have an almost 2 year old. Right. Being in an upper percentile now doesn't make him developmentally equal to a 2 year old, and the same concept applies in utero after 20 weeks.

    37-38 weeks is early term and should not be considered an option unless there is another pressing medical issue or labor starts on by itself.

    39-40 weeks is full term.

     

     

    No.  37-42 weeks is considered full term.

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  • It is important to wait until 39 weeks so the baby is fully developed. The lungs and brain need more time. Even though you are having contractions, it doesn't mean the baby is fully developed yet. Try to find a diagram of a baby's brain at 37 weeks compared to a baby's brain at 39 weeks. It makes a big difference. My doctor wanted to induce me at 39 weeks, and I told her no. I didn't let them until after 40 weeks and then it ended in a c/s anyway.
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  • imagelnyost:
    imageGhostMonkey:

    DS measured 40 weeks at around 34-35 weeks. No way was he remotely close to ready. It meant he was above average size, not that he was maturing at a super fast pace. Doctors shouldn't really tell you how many weeks you are measuring after the anatomy scan- they should only talk in percentiles. If you go by size alone, then I have an almost 2 year old. Right. Being in an upper percentile now doesn't make him developmentally equal to a 2 year old, and the same concept applies in utero after 20 weeks.

    37-38 weeks is early term and should not be considered an option unless there is another pressing medical issue or labor starts on by itself.

    39-40 weeks is full term.

     

     

    No.  37-42 weeks is considered full term.

    No, GhostMonkey is correct.  Doctors have been doing research and realizing they are pushing the envelope too far when it comes to elective inductions and cesareans. That is why they no longer do them before 39 weeks unless medically necessary. It's nice when doctors learn things that make us all healthier. 

    https://journals.lww.com/greenjournal/Abstract/2010/07000/Rethinking_the_Definition_of__Term_Pregnancy_.22.aspx 

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  • I never went into labor due to LO's high breech position, but I was supposed to have him at 39 weeks after the New Year. He was born at 36 weeks, 6 days (considered 'near' term) and he didn't have any issues with breathing being born at that stage. My OB never mentioned to me about lung development when i was in L&D for observation hours before having my emergency c-section.
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  • Ditto everyone else about waiting.  I had Gestation Diabetes and also developed pregnancy induced hypertension.  Things started getting scary, they kept checking for pre-eclampsia and I was still told 39 weeks.  I went in at 38 weeks and 4 days and my blood pressure was climbing, they sent me to the hospital for monitoring and then sent me home and decided to wait 3 more days.  It matters.

    Also, I'd remove your child's last name from the name badge.  There are scary folks on the interwebz and all.

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  • imagegirllennon:
    I never went into labor due to LO's high breech position, but I was supposed to have him at 39 weeks after the New Year. He was born at 36 weeks, 6 days (considered 'near' term) and he didn't have any issues with breathing being born at that stage. My OB never mentioned to me about lung development when i was in L&D for observation hours before having my emergency c-section.

    my son was born at 36wks 5days and i was told there was less then a 5% chance he would have trouble breathing'

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  • imageGhostMonkey:
    imageMOMMA OF TWO 2010:

    imagegirllennon:
    I never went into labor due to LO's high breech position, but I was supposed to have him at 39 weeks after the New Year. He was born at 36 weeks, 6 days (considered 'near' term) and he didn't have any issues with breathing being born at that stage. My OB never mentioned to me about lung development when i was in L&D for observation hours before having my emergency c-section.

    my son was born at 36wks 5days and i was told there was less then a 5% chance he would have trouble breathing'

    You aren't seriously condoning pre term deliveries, are you? Because that is certainly how it reads.

    I have to have a csection before 37 wks every pregnancy because of abdominal cerclage im just saying what that doctor told me. im not saying deliver the baby at 34 wks because they are big enough im just stating that doctor said at 37 wks ther is less then 5% chance of respitory problems. believe me i know what its like to have premie problems too DS#1 was born at 26wks 1day because of IC/PTL and spent 11 wks in the NICU and coming home at 4lbs 12oz

    im just sharing my experiance thats what she asked for

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  • imageGhostMonkey:
    imageMOMMA OF TWO 2010:

    imagegirllennon:
    I never went into labor due to LO's high breech position, but I was supposed to have him at 39 weeks after the New Year. He was born at 36 weeks, 6 days (considered 'near' term) and he didn't have any issues with breathing being born at that stage. My OB never mentioned to me about lung development when i was in L&D for observation hours before having my emergency c-section.

    my son was born at 36wks 5days and i was told there was less then a 5% chance he would have trouble breathing'

    You aren't seriously condoning pre term deliveries, are you? Because that is certainly how it reads.
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  • imageMOMMA OF TWO 2010:
    imageGhostMonkey:
    imageMOMMA OF TWO 2010:

    imagegirllennon:
    I never went into labor due to LO's high breech position, but I was supposed to have him at 39 weeks after the New Year. He was born at 36 weeks, 6 days (considered 'near' term) and he didn't have any issues with breathing being born at that stage. My OB never mentioned to me about lung development when i was in L&D for observation hours before having my emergency c-section.

    my son was born at 36wks 5days and i was told there was less then a 5% chance he would have trouble breathing'

    You aren't seriously condoning pre term deliveries, are you? Because that is certainly how it reads.

    I have to have a csection before 37 wks every pregnancy because of abdominal cerclage im just saying what that doctor told me. im not saying deliver the baby at 34 wks because they are big enough im just stating that doctor said at 37 wks ther is less then 5% chance of respitory problems. believe me i know what its like to have premie problems too DS#1 was born at 26wks 1day because of IC/PTL and spent 11 wks in the NICU and coming home at 4lbs 12oz

    im just sharing my experiance thats what she asked for

    I think you're missing the point of the post. She doesn't have a medical condition that would make her have to deliver early. You did/do.

    She's just asking why she can't deliver early.

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  • imageJ9melissa:
    imageMOMMA OF TWO 2010:
    imageGhostMonkey:
    imageMOMMA OF TWO 2010:

    imagegirllennon:
    I never went into labor due to LO's high breech position, but I was supposed to have him at 39 weeks after the New Year. He was born at 36 weeks, 6 days (considered 'near' term) and he didn't have any issues with breathing being born at that stage. My OB never mentioned to me about lung development when i was in L&D for observation hours before having my emergency c-section.

    my son was born at 36wks 5days and i was told there was less then a 5% chance he would have trouble breathing'

    You aren't seriously condoning pre term deliveries, are you? Because that is certainly how it reads.

    I have to have a csection before 37 wks every pregnancy because of abdominal cerclage im just saying what that doctor told me. im not saying deliver the baby at 34 wks because they are big enough im just stating that doctor said at 37 wks ther is less then 5% chance of respitory problems. believe me i know what its like to have premie problems too DS#1 was born at 26wks 1day because of IC/PTL and spent 11 wks in the NICU and coming home at 4lbs 12oz

    im just sharing my experiance thats what she asked for

    I think you're missing the point of the post. She doesn't have a medical condition that would make her have to deliver early. You did/do.

    She's just asking why she can't deliver early.

     sorry for sharing what the doctor said about lung development! Dont worry I wont post on your Boards for advice or my experiences again

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  • imageJ9melissa:
    imageMOMMA OF TWO 2010:
    imageGhostMonkey:
    imageMOMMA OF TWO 2010:

    imagegirllennon:
    I never went into labor due to LO's high breech position, but I was supposed to have him at 39 weeks after the New Year. He was born at 36 weeks, 6 days (considered 'near' term) and he didn't have any issues with breathing being born at that stage. My OB never mentioned to me about lung development when i was in L&D for observation hours before having my emergency c-section.

    my son was born at 36wks 5days and i was told there was less then a 5% chance he would have trouble breathing'

    You aren't seriously condoning pre term deliveries, are you? Because that is certainly how it reads.

    I have to have a csection before 37 wks every pregnancy because of abdominal cerclage im just saying what that doctor told me. im not saying deliver the baby at 34 wks because they are big enough im just stating that doctor said at 37 wks ther is less then 5% chance of respitory problems. believe me i know what its like to have premie problems too DS#1 was born at 26wks 1day because of IC/PTL and spent 11 wks in the NICU and coming home at 4lbs 12oz

    im just sharing my experiance thats what she asked for

    I think you're missing the point of the post. She doesn't have a medical condition that would make her have to deliver early. You did/do.

    She's just asking why she can't deliver early.

     sorry for sharing what the doctor said about lung development! Dont worry I wont post on your Boards for advice or my experiences again

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  • imageMOMMA OF TWO 2010:
    imageJ9melissa:
    imageMOMMA OF TWO 2010:
    imageGhostMonkey:
    imageMOMMA OF TWO 2010:

    imagegirllennon:
    I never went into labor due to LO's high breech position, but I was supposed to have him at 39 weeks after the New Year. He was born at 36 weeks, 6 days (considered 'near' term) and he didn't have any issues with breathing being born at that stage. My OB never mentioned to me about lung development when i was in L&D for observation hours before having my emergency c-section.

    my son was born at 36wks 5days and i was told there was less then a 5% chance he would have trouble breathing'

    You aren't seriously condoning pre term deliveries, are you? Because that is certainly how it reads.

    I have to have a csection before 37 wks every pregnancy because of abdominal cerclage im just saying what that doctor told me. im not saying deliver the baby at 34 wks because they are big enough im just stating that doctor said at 37 wks ther is less then 5% chance of respitory problems. believe me i know what its like to have premie problems too DS#1 was born at 26wks 1day because of IC/PTL and spent 11 wks in the NICU and coming home at 4lbs 12oz

    im just sharing my experiance thats what she asked for

    I think you're missing the point of the post. She doesn't have a medical condition that would make her have to deliver early. You did/do.

    She's just asking why she can't deliver early.

     sorry for sharing what the doctor said about lung development! Dont worry I wont post on your Boards for advice or my experiences again

    I didn't tell you to GBCB. Stick around and post. I just find it very funny that you felt the need to tell two seperate people, in this post alone, your experience when the OP wasn't asking for experience.

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  • imageJ9melissa:
    imageMOMMA OF TWO 2010:

    my doctor wont let me go past 37wks because i have an IC and have an abdominal cerclage. i had my csection schedualed at 36wks 5days my LO was just fine just on the smaller side at 5lbs 13oz but 19"

    The difference between you and her: you have a medical reason to deliver early. She doesn't. I had a 6lb 3oz 36 wk baby who was measuring at 37.5 weeks. He had to go to the nicu for 4 days due to breathing problems.

     

    Us too... I was induced at 36w0d because of pre-e and my dd was 6lbs 4oz. I didn't get to see her for 14 hours because she was rushed to the nicu for breathing problems and because of my bp they wouldn't' let me out of bed. I know we were lucky and her breathing problems were pretty minor compared to how it could have been but that didn't make it any less scary for us. I would have given anything at that point to keep her in as long as possible. Every day you can keep them in helps!  


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  • Your drs want to make sure that the lungs are mature. My ds was born at exactly 38 weeks and spent time in the nicu due to breathing difficulties.
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  • There are a variety of reasons that babies need to stay in.  In addition to the lungs and other structural issues (the earlier the baby the higher the risk of various things like reflux, etc.) the earlier a baby comes the higher the risk for developmental disorders even if that baby is full time at 37 weeks.

    While full term is good, those last couple of weeks can make a difference in other areas-- babies that are born on the earlier side can have more issues that a preemie might face.  Studies demonstrate that preemies are harder to care for, more difficult to bond with, and harder to sooth.  A less fully developed baby is also going to have more trouble with things like temperature regulation.

     Unless there is a compelling reason to deliver early, then babies should be encouraged to wait until those 40 weeks.

  • I am an OB nurse and we also do not schedule CS for earlier than 39 weeks, unless there is a medical reason to do so.  Studies have shown that the difference in how a baby does at 39 weeks is vastly different from even 38 weeks gestation.  That one week does wonders for babies.  Not to say that if your baby is born at 37 weeks, he/she won't be fine, but there is a much less risk at 39 weeks.  However, with that being said, if you are dilating at 37 weeks and contracting regularly, if you are making cervical changes, then this would be a medical reason to schedule sooner.
  • Go ask this question on the preemie board and you will find out why you should wait until 39 weeks if at all possible. Even a 37 weeker can have feeding/lung issues that can require a NICU stay...
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  • imageScout2005:

    39 weeks is important for lung maturity. My OB would not schedule my c/s until after that point, even though I was taken off my blood thinners at 36 weeks. Nor would I have signed off on it any earlier than that.

    Baby needs to cook as long as possible. 37 weeks may be "full term" but that doesn't mean it's ideal for him/her to be born at that time. 

    AH! Good to know!!

  • My C/S was scheduled for my due date, but started having contractions at 38 weeks. My OB said that they could try to stop them, but they probably wouldnt stop for long. I delivered a healthy 7 lb, 7 oz baby girl at 38 weeks exactly via c-section. No NICU time, no problems whatsoever. 
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  • There is new evidence that each week at the end increases baby's lung function and 39 weeks is now the new recommendation for scheduled C/S's.  They were doing them at 37 just a couple years ago.
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