Study: Elective CS prior to 39 weeks carries risks

[brittone2]

DH was just talking about this yesterday because he heard it discussed on NPR. It caught DHs attention as this is a local doc. I thought it might be of interest. IIRC, tarahsolazy (a neonatologist) has posted her opinion about this before on the boards and I believe she said the same thing if I'm remembering correctly.

http://www.cnn.com/2009/HEALTH/01/07/c.section/index.html#cnnSTCText?iref=werecommend

http://www.chicagotribune.com/features/lifestyle/health/chi-c-sectionsjan08,0,1159372.story

http://www.wral.com/lifestyles/healthteam/story/4263707/

I can't find the original study on Pubmed yet.

FWIW, this doc Thorp seems to have some published research on VBAC, etc. and I know someone was looking for that info recently.

[saschalicks]

You know what's interesting is that I go to a world renouned hospital to have my babies and they will not budge on no c-sections to be *planned* before 39 weeks. Now this confirms their policy.

ETA: I should add that although both DS2 and this baby were/are scheduled for 39 weeks I've never made it that far. I went into labor w/both boys the exact same day in pregnancy 37 weeks and 6 days. DH & I will be really surprised if she stays in until our scheduled 39 week appt.

[daniele_ut]

My doctor will also not allow any patients to schedule a c-section earlier than 39 weeks. My experience with ds bore that out. I went into labor completely on my own at 36 weeks and 4 days. They couldn't stop my labor and when they realized my fluid level was so low and that it wasn't safe to try to turn him from frank breech, I had the repeat c-section immediately. Even though we were so close to "term" he was born with respiratory distress syndrome and needed a surfactant treatment to help his lungs. He spent 24 hours on c-pap and 3 weeks in the NICU for feeding issues. I cringe every time I hear someone say "I can't wait to get this baby out" or " I can't believe my doc won't deliver me at 37 weeks".

With dd, I scheduled for exactly 39 weeks and showed up at the hospital for my scheduled appointment in labor and 6cm. I very nearly had a VBA2C, but with my past history with dd1, I was just too afraid and my doc agreed.

I really hope that as time passes docs will be more reluctant to perform medically unnecessary c-sections before 39 weeks.

[JBaxter]

When I was pregnant with Jack my OB's office had paperwork they would not schedule csections OR inductions prior to 39weeks.

[tnrnchick74]

My OB will not schedule a c-section prior to 39 weeks. I was in preterm labor, contracting every 5 minutes - but intact waters from 35 weeks on...his motto was if baby is good let them cook!

I was REALLY ready to be delivered at 38 weeks - but we held out until 39 weeks. No resp problems. I'm glad more hospitals/mds are taking a stand...now if HOLLYWOOD would quit glorifying early c-sections in their stars to prevent stretching. Sigh.

[KrisM]

I had found similiar information a year or so ago. My then OB wanted to schedule AT 39 weeks and I really wanted to be later than that. He wouldn't consider 40 or past. My reasoning was that DS1 was 5 days late and DD was 12 days late, so for me 39 weeks was quite early. If I had scheduled DD at 39 weeks, she'd have been born 19 days earlier than she was!

I switched OBs to someone who said as long as things were fine, I could go into labor and then come in for the c/s or schedule at 41 weeks. He agreed with me that for me, 39 weeks would be too early.

DS2 surprised us all and came at 40weeks exactly :).

[KpbS]

Very interesting. Thanks for the post.

[mikeys_mom]

I have not found any references in the articles about the study that discuss twin pregnancies and when the ideal time for a c/s is. Has anyone seen anything?

I am pregnant with twins and am currently scheduled for a c/s at 37.5 weeks. I had originally discussed the timing with my OB and he felt strongly that he did not want this pregnancy to go beyond 38 weeks. Based on his recommendations and my own research, I was comfortable with this plan. I am now wondering if I need to discuss it with him further.

DS was a scheduled c/s due to breach presentation, but he flipped late in the pregnancy and I delivered at 41.5 weeks.
With DD I attempted a VBAC and despite everyone's best efforts, ended up with another c/s at 40 weeks after my water broke and I developed a high fever about 26 hours later.

I know that my OB will not schedule a c/s for a singleton before 39 weeks.

I would much rather wait an extra week or two if it means healthier babies. If anyone has any further information on this study, I would appreciate it.

Thanks.

[hez]

Yup, my OB doesn't schedule before 39 weeks, either. DD was born at 39 weeks & 6 days.

[g-mama]

Interesting....my second and third were planned c/sections and my OB told me to pick any day beginning at 38 weeks. Both were born at about 38 1/2 weeks.

I guess I should consider myself blessed, but then again, I already do!

[BeachBum]

I have not found any references in the articles about the study that discuss twin pregnancies and when the ideal time for a c/s is. Has anyone seen anything?
.

I was looking for the same type of info. Twins are just different in that they mature faster, but don't grow as much at the end....IMO it would need to be a twin specific study to be helpful.

That said, my baby B is breech and my C-section is scheduled for 38 weeks. My Dr. says he could give me a few more days if I want to go into labor but he wants them out before 39 weeks. (It would mean delivering at a different hospital). That sounds right in line with what your Dr. is saying.

[mikeys_mom]

That's what I thought, I just figured I'd see if there was anything I was missing.

My OB does not want me to go into labour because with 2 prior c/s's and now the twin pregnancy, he is concerned that the uterus could be significantly weakened where the prior incisions were. This increases the chance of uterine rupture. Otherwise, he would have allowed me to wait to 38-39 weeks and see if I went into labour on my own.

[Momof3Labs]

I interviewed an OB practice yesterday (that I'll probably go with) and 38 weeks is about their cut-off for twins, too. That's not to say that they wouldn't let things go a few days past that (I didn't ask but they seemed like reasonable people), but not a week, and definitely not two weeks. The reason they gave was that twins have different issues with placentas starting to weaken earlier than with singletons.