For Your Baby’s Best Interest, Don’t Be Overanxious to Deliver
SIOUX FALLS (March 1, 2013) - Reaching the 37th week of your pregnancy is a milestone – you’ve made it to full term! Yet experts advise against getting overanxious to deliver, saying it’s best to wait until 39 weeks.
“At Avera McKennan, we have determined it’s best for the baby and the mother to deliver at 39 weeks or after if at all possible. So we now no longer allow elective deliveries before 39 weeks,” said Dr. Amber Saloum, OB/GYN specialist with Avera Medical Group Obstetrics & Gynecology.
What difference does two weeks make? Dr. Saloum said fewer babies at Avera McKennan now require NICU care, thanks to this new policy. Also, more new moms and dads are going home with healthier babies. “It’s a good indication that this policy is important for the well-being of the babies we deliver,” she said.
Babies born before 39 weeks are more likely to experience respiratory issues, feeding problems, trouble latching on, difficulty regulating their own blood sugars and less ability to stay warm.
Going into labor at 37 weeks is not cause for alarm. Most babies born at that gestation do very well. “When women go into natural labor at 37 weeks, it’s fine to go ahead and deliver – we don’t try to stop labor,” she said. Also, there are medical indications for an earlier delivery such as gestational diabetes, high blood pressure, inadequate fluid surrounding the baby, and restrictions on the baby’s growth.
“New moms may have had a sister or friend who delivered before 39 weeks and everything was fine – and it usually is,” Dr. Saloum said. Yet research shows that babies have a higher risk of needing NICU care if delivered before 39 weeks. NICU care is not only costly, it’s distressing to parents who have to wait days or weeks to take their new infant home. So waiting until 39 weeks for elective inductions is a good precaution.
“Elective deliveries” are when moms request to have labor induced for reasons such as discomfort, fear of labor going too fast before getting to the hospital, job or military leave, or a family member’s visit.
When a pregnancy reaches 39 weeks and over, induction can be scheduled, provided there’s reliable dating of the pregnancy. This includes the mother’s report of her last menstrual period, an early dating ultrasound, and/or documented fetal heart tones which are heard through the abdomen for at least 30 weeks.
A baby is technically “post date” at 42 weeks. “If the baby is overdue, we do tests to make sure the fetus is still doing well, for example, an ultrasound to see if there is enough fluid around the baby,” Dr. Saloum said. Most physicians will consider inducing labor after 41 weeks if the mom has not gone into labor on her own by then. Providers check for a “favorable cervix,” meaning the cervix is ready for delivery. If an induction is started with an unfavorable cervix, there’s a greater chance of an unplanned c-section, particularly for first-time mothers.
In terms of how well the delivery will go, natural and induced labor are similar. “Labor contractions hurt, regardless of whether they are natural or induced. However, painful contractions can ramp up faster with induced labor. It’s specific to each patient,” Dr. Saloum said. That’s why it’s important to discuss options to manage labor pain before your delivery date arrives.
If you are very uncomfortable toward the end of your pregnancy, there are several solutions short of requesting to have labor induced. This may include massage for muscle and low back pain, warm packs to the back – not to the front, taking Tylenol as directed, mild exercise, and drinking plenty of water as being dehydrated can irritate the uterus.
“Trouble sleeping is a big complaint,” Dr. Saloum said, along with generalized discomfort, pelvic pressure, back pain, and urinary frequency from the baby’s head pushing on the bladder.
“The best advice is to work with your provider to manage the symptoms as best you can, knowing they are short lived, and you are doing yourself and your baby a favor by waiting until at least 39 weeks to deliver,” Dr. Saloum said.
To learn more about pregnancy and childbirth, visit www.AveraWomens.org