Those with repeat c-sections...how close to your due date were you scheduled?

[jerseygirl07067]

Based on my history of preterm labor with my 2nd pregnancy, this may not even be a concern but I was just curious. It seems OBs are now scheduling them only 5 days to 1 week away from the due date.

My OB told me that if I make it that far, he will schedule me right at 38 weeks. He even talked about the new study that said it's better for the baby closer to the due date, but said he still prefers to do them at 38 weeks. He feels that the risk of going into labor is higher, and with a history of previous c-sections he wants to avoid any emergency situations and keep the experience and pleasant for the mom and family as possible. He also told me that in his experience, he did not see a difference at 38 vs 39 weeks.

Interesting, since it contradicts the study. The ariticle was recently in USA today.

Marcy

[salsah]

my second c-section (1st was an emergency) was scheduled at 38 weeks (exactly). however my doctor's personal preference is to schedule a little later, closer to 39 weeks because it is better for the baby to in as long as possible and he supports v-bacs. so he was of the opinion that if i go into labor before the scheduled date we could try a v-bac. he advised coming to the hospital asap so that he could monitor me. if the labor progressed smoothly w/o signs of complications, we would go for the v-bac (but be prepared for the section just in case). unfortunately, that didn't happen and i had the section at 38 weeks as planned.
i heard if you have had more than one c-section, then going into labor is riskier than if you have only had one. that could be why he prefers earlier than later.

[belovedgandp]

My repeat c was almost two years ago. My OB pushed for the 5-7 day early window. I really begged for 9 days early because it helped my mom (watching older son) and DH work schedules.

[Edensmum]

Labor has benefits as does being born when babe is ready. I would ask more about and research more about waiting and the downsides to a section after labor has begun. Personally I would not consent to 38 weeks.

[MMMommy]

With DD2, my OB told me I could schedule my c-section no more than 7 days before my due date. Of course, I ended up going into labor 3 days before my scheduled c-section, so go figure. DD1 was an unplanned c-section, so no advice on scheduling was given there.

[KHF]

I also was not able to schedule any more than 1 week before my due date (which was December 26). My c-section was on December 22nd. I tried to get it moved to ensure I would be home by Christmas. My doc agreed to December 19th, but there was only one OR open at the hospital on Friday and it was already booked. So we ended up not moving the date, but thankfully, we came home on Christmas Eve.

[KBecks]

I had Alek and John at 37 weeks and Mark at 38 weeks. I had uterine fibroid removal surgery prior to pregnancy that put me at high risk for rupture. So, I had fetal lung maturity testing at 36 weeks and if those tests showed maturity, we would have delivered at 36 weeks.

I was happy to wait longer, and would have liked to go as long as possible (while still avoiding the rupture issue) I found that nursing went better with Mark than the other boys, and also less jaundice, which equaled fewer trips to the pediatrician for blood tests. Our pediatrician and pp doula both said that an earlier born child is more likely to have difficulty with BF and jaundice.

They're all healthy and great, but going longer seems better.

[kdeunc]

My OB will not schedule before 39 weeks. With DS2 I was scheduled for exactly 39 but delivered at 37 5 days due to decreased fetal movement and Dd was 39. If you are more comfortable with 39 then I would push for that.

[JBaxter]

I didnt but a good friend just had a repeat Csection. She goes to the same office I do. They will not schedule repeat csections or inductions before 39weeks. I dont know if its the practice or the hospital but its now their standard of care. She went into labor at 38weeks anyway.

[egoldber]

There was a big study that came out about 2 years ago (right around the time Amy was born) saying that while they used to believe that c-sections done at 36-38 weeks were fine, there was increasing evidence that we were creating a whole generation of "near term" preemies. While not as severely impacted as earlier preemies, there was increasing evidence that there were consequences for these babies. Many had suck/swallow/coordination issues making initiating breastfeeding harder, they were more prone to jaundice, reflux, asthma, allergies, etc.

Because I actually had a uterine rupture with Leah, so we ended up delivering Amy at 34 weeks. She had 2 weeks of NICU time and it was really wretched. Sarah was an unplanned c-section at 36+5 weeks and while technically not a preemie, she had many of those issues: jaundice, hard to breastfeed and has had continuing issues....mild hypotonia (low tone), asthma and allergies. Was that related to her being a near term preemie? Well, we'll never know. But I would definitely do anything I could to get as close to term as possible (as long as baby and mom are doing fine) with a planned section.

[Melbel]

DS 39 weeks
DD1 38 weeks (amnio confirmed lungs were mature)
DD2 39 weeks

Given the most recent study, I would not want to schedule before 39 weeks absent medical necessity.

[TonFirst]

My son was done at 41 weeks (following a failed induction that came close to uterine rupture).

For #2 (my OB is v-bac friendly, but didn't think I was a good candidate for one), my OB told me I could schedule at 38.5 weeks, but I ultimately scheduled for 39 weeks, 5 days.

[tnrnchick74]

39 weeks- OB would not schedule before then. My scheduled date was 39.2 due to Memorial Day holiday. I had been in preterm labor since 35 weeks. DS didn't have any issues besides jaundice, which is normal for ANY baby.

[ThreeofUs]

Mine was at 37 w 6 d, if you take the lmp calculation seriously. It was at 39w 4d, if you took the 19w ultrasound prediction. It was at 41w, if you took the estimate from my last ultrasound.

I thought it was just right. I was in early labor when I got there. :)

[LarsMal]

My OB told me that, legally, she cannot schedule a c/s earlier than 39 weeks. The last time I saw her she mentioned that article that came out about elective c/s before 39 weeks. Both of my kids were born at 38 weeks, though- DD a c/s. I was scheduled for a 39 week c/s with her, but went into labore the week before (she was breech).

My OB told me she will only move it up (if I decide not to try VBAC) if it looks like I *could* go into labor earlier again.

[jenmcadams]

My first CS (due to failure to progress after an induction) was at 41weeks5days. My second CS was scheduled for just shy of 39 weeks, but my water broke at 37 weeks exactly.

My DD was a big baby (almost 9 lbs in Colorado...we typically are about 6-8oz smaller than average) and my son looked like he was on track for the same (7bs 8 oz in Florida). My DD did need oxygen for several hours after birth (but that was probably due to my being in labor for almost 26 hours) -- other than that and a wicked cone head, she had no other issues. My DS on the other hand coming 3 weeks early was pretty severely jaundiced...he needed the bili-blanket for several days after we were discharged.

[brittone2]

I think in an old thread on this topic, tarahsolazy (the neonatologist that posts here) had also mentioned 39 weeks. Hopefully she'll see this and chime in... I may be remembering incorrectly.
eta: here's an old thread on induction. She responded on page 2 recommending 39 weeks. SHe also mentions c/s briefly.
That was also prior to this newest study that came out about babies that are born via elective cs at 39 weeks, vs. even just a few days earlier.
http://www.windsorpeak.com/vbulletin/showthread.php?t=242445&highlight=weeks+neonatologist

[gatorsmom]

My second c/s was scheduled one week before my due date.

[daniele_ut]

My c/s with dd2 was scheduled for 39 weeks exactly and I showed up for my surgery in labor and 6cm dilated. I came pretty close to changing my mind and having a VBA2C, but though my doc left it up to me, he felt the c/s was a better idea given my previous loss.

Because of my experience with DS, who was born at 36w4d and spent 3 weeks in the NICU, I would never schedule before 39 weeks unless there was a medical necessity.

[tarahsolazy]

The American College of OB/GYN, the main professional organization for OBs in the US, currently recommends that elective c-sections be scheduled for no earlier than 39 weeks. This is because of the research that others have alluded to, which is that for every week earlier than that, the risk of NICU admission for respiratory distress increases significantly. Most of these NICU admissions are less than a week, but who wants to be there at all? Also, babies born after a c-section without labor have a small risk for a life-threatening problem called persistent pulmonary hypertension, which increases the earlier they are.

I have personally had two c-sections, the first after a long, failed, post-dates induction with pre-eclampsia. My second was scheduled for 39 5/7, but I was hoping to just go into labor before that. Luckily, I went into labor the night before the scheduled date, and labored for about 12 hours without progress. I felt more comfortable that my baby was ready to come.

I would not schedule before 39 weeks, unless there is a specific surgical reason to do so, such as classical incision, past uterine surgery, etc. If you are otherwise considered a VBAC candidate, presenting to the hospital at the earliest sign of labor and having a section then shouldn't incur a significantly higher risk of rupture than just being pregnant, I think. So the argument that a previous baby was born at 37 weeks is not a great one for early scheduling in low risk moms, IMHO.

[jerseygirl07067]

I would not schedule before 39 weeks, unless there is a specific surgical reason to do so, such as classical incision, past uterine surgery, etc. If you are otherwise considered a VBAC candidate, presenting to the hospital at the earliest sign of labor and having a section then shouldn't incur a significantly higher risk of rupture than just being pregnant, I think. So the argument that a previous baby was born at 37 weeks is not a great one for early scheduling in low risk moms, IMHO.

Thanks for your input everyone.

Tarah, I have a follow up question to your post. I did have 2 previous sections, and 1 uterine surgery, that was done laparoscopically 1.5 yrs ago (2 small incisions along my previous c-section scar). Does that sound like a specific surgical reason to schedule at 38 weeks?

My husband and I are big proponents of not delivering until the body is ready so I'm really not comfortable with the 38 week window. Both labors that I did have were long, so it's not like I'm likely to have a quick delivery anyway.

It's funny because everyone in my moms club raves about this OB, but it's instances like this that have me second guessing him. (I also had to push to get them to do the first and second trimester screen, since it was never even offered to me.)

I wonder how flexible he'll be if I push for closer to 39 weeks.

Marcy