Elected C-sections before 39 weeks

[daisymommy]

C-Sections before 39 weeks
http://www.prnewswire.com/news-releases/newborn-deliveries-are-scheduled-too-early-according-to-hospital-watchdog-group-114651404.html

Quote:
Experts, including those from the American College of Obstetricians and Gynecologists (ACOG), Childbirth Connection, and the March of Dimes, caution that the amount of time a baby needs to develop fully, which includes having a fully developed brain and other organs, is at least 39 completed weeks.

I hear so often of scheduled C-setions at 37-38 weeks.

[luckytwenty]

My second c-section was scheduled at 38.5 weeks because my son was born at 37 weeks. I went into labor at 38.0 weeks anyway. Sometimes they schedule early to avoid you going into labor first, which can cause other complications.

[bubbaray]

There are valid MEDICAL reasons to schedule a c-s before labor starts.

Frankly, I'd rather trust the opinion of my specialist than those of non-physicians on an internet forum.

JMHO

[KrisM]

For my 3rd, I switched to an OB that didn't schedule at 38 weeks automatically. I think there are plenty of good reasons to do it before labor and plenty of good reasons not to. It'll depend on the mom. So, for DS2, I was scheduled for 41 weeks. This was because DS1 was 40w/5d and DD was 41w/5d. I had no reason to believe my kid would be ready anywhere near 38 weeks! Turns out I went into labor at 40w (which was my hope - to go into labor) and just went in for the c-section. It worked well for me. I never had any reason not to do that and I was happy to find an OB that looked at ME and not just the calendar.

[SnuggleBuggles]

There are valid MEDICAL reasons to schedule a c-s before labor starts.

Frankly, I'd rather trust the opinion of my specialist than those of non-physicians on an internet forum.

JMHO

It's not a non-MD saying it, it is the ACOG and the March of Dimes. Legit organizations. Not that I disagree that this decision is one that generalizations shouldn't apply to as some situations may warrant an earlier than desired delivery. But, the research shows in lots of ways how getting to 39 weeks is a good, healthy thing for most babies and moms and some Dr.s and moms still see 37-38 weeks as close enough. The article and policy positions are just trying to get people to be aware of the risks and make an informed decision- that's how I read it.

Beth

[secchick]

Due to complications with my first, my second and this baby will be scheduled C-Sections. With no complications or medical circumstances to warrant otherwise, I was not given the option of scheduling before 39 weeks.

Hasn't research to this effect been out for a while? I know that this was the recommendation when I had DS in 2009.

[toystorymama]

Due to complications with my first, my second and this baby will be scheduled C-Sections. With no complications or medical circumstances to warrant otherwise, I was not given the option of scheduling before 39 weeks.

Hasn't research to this effect been out for a while? I know that this was the recommendation when I had DS in 2009.

I was also not given the option of scheduling before 39 weeks. My OB's office is very strict about that, which I think is good. I have heard a lot of people scheduled before 39 weeks for convenience reasons and I am always really surprised. The longer the baby is in the tummy the better usually. This of course does not apply for valid medical reasons like Pre-enclampsia, etc.

[LarsMal]

I didn't think it was possible to schedule a c/s before 39 weeks, unless it was medically necessary. My OB told me she wasn't allowed to schedule before 39w, legally. I had L at 38, a scheduled c/s with M at 39, but went into labor at 38. With C I was scheduled for 39, but at my 38 week check my doc was convinced I wouldn't make it so she moved it up to avoid labor. I had C at 38w3d.

[daisymommy]

I wasn't saying that there aren't medical reasons that some babies need to come out before 39 weeks (or to avoid labor for some moms).

But here in the U.S. you wouldn't believe how prevalent it is that I hear in person--and read about about moms having scheduled C-sections because their doctor wants to go on vacation, they feel huge and miserable and don't want to get any bigger, they are estimating that the baby is too big via-ultrasound (and then surprise! it's average weight), and the list goes on.

I think it's great that moms here are educated and know this. But a large part of the U.S does not, and their doctor's aren't helping matters any by not giving them the info. When we say that term is 38 weeks, then of course it makes sense that people will think a scheduled elective C-section at 38 weeks for no valid medical reason is perfectly fine and good. I think that whole idea needs to be seriously rethought.

[salsah]

i agree that there are a lot of seemingly non-valid reasons that people schedule before 39 weeks. but there are a lot of valid reasons to do so. in most (but NOT all) cases, the longer the baby is in there, the better. many babies are born perfectly healthy before 39 weeks and even before 38 weeks.

[scrooks]

I didn't think it was possible to schedule a c/s before 39 weeks, unless it was medically necessary.

I had the same experience as others. DD was an unexpected c-section (at exactly 40 weeks). The very earliest I could schedule DS's was at 39 but my doc did say she likes to do scheduled c's before 40 weeks to avoid labor beginning.

[JBaxter]

My OB practice will not schedule an elective csection or induction before 39 weeks. Its up front on your ob intake papers and has been since I was pregnant with Jack. They will require a amnio before scheduling either at 37-39 weeks. Our local hospital does not do them so you need to drive 45 miles away to have it done.

Even a repeat c section is scheduled on or after 39weeks. If you go into labor before they will do one as an "emergency"

[bubbaray]

It's not a non-MD saying it, it is the ACOG and the March of Dimes. Legit organizations. Not that I disagree that this decision is one that generalizations shouldn't apply to as some situations may warrant an earlier than desired delivery. But, the research shows in lots of ways how getting to 39 weeks is a good, healthy thing for most babies and moms and some Dr.s and moms still see 37-38 weeks as close enough. The article and policy positions are just trying to get people to be aware of the risks and make an informed decision- that's how I read it.

Beth


I was responding to the OP, not the article. She said that she hears about scheduled c/s at 37 & 38 weeks so often. Well, there are VALID MEDICAL REASONS to schedule c/s early, notwithstanding other risks. Those medically indicated early c/s are not discussed in this article.

Secondly, the title of her thread was "elected (elective?) c/s before 39 weeks". However the article is about elective DELIVERIES (c/s and inductions), not just elective c/s.

So, really, why the beef with elective c/s before 39w in the OP? Any elective delivery before 39w has risks associated with it. In some cases, an early delivery may be medically indicated -- those aren't considered elective, even if they are scheduled procedures.

[daisymommy]

Well excuuuuuse me! Why the snarky attitude today? I didn't see the part that said deliveries, I only read C-section, otherwise I would have included induction in my title as well. This was meant as a PSA, not as a personal judgment against you. And the term "elective" carries the connotation that it is by choice--not a medically necessary procedure. That's all I was talking about.

[smilequeen]

I ended up choosing to VBAC with #2 (and 3), but when I was pregnant with #2 I was also told by my OB that elective c/s were never scheduled before 39 weeks. Of course, I was also told that it was not a big deal and might even be better for my baby (in a low risk, healthy pregnancy) if I did go into labor even if I wanted the c/s.

Clearly there are valid reasons to go before 39 weeks, but the term elective indicates that there are no other medical reasons...

I'm dealing with possible pre-e right now and trying to come to terms with the possibility of delivering a baby boy (boys are more at risk...) before 39 weeks if it gets too bad. That's scary to me. But I'm 38 weeks right now so I'm hoping to keep him in for a bit longer...

[KpbS]

Our local hospitals will not longer schedule repeat or non-medically necessary c-sections before 39 weeks. I was surprised b/c I remembered differently like the OP when I had my first but policies have changed to decrease NICU stays.

[Fairy]

I guess I don't understand why this is newsy. I think it's good to keep us all informed :-). But for this one, it seems akin to staying in school. I used to talk to inner city HS'ers as part of my company's outreach program, and the "talking points," so to speak, were #1 "stay in school." I always thoguht, well, duh. I mean, honestly, who doesn't knwo this. So, I'd start my speech with "Ok, who here doesn't know that you should stay in school?" And they'd snicker cuz it's so trite. I kind of feel the same way about this statement that elective c-sections (or inductions) before 39 weeks are ill-advised. Not that it's trite, but more like, who doesn't know that that's a bad idea? On this board, anyway? There are absolutely medical reasons, but we're talking elective, here. Like, I just am done being pregnant, my hemorroids are killing me, I have cankles, and I am a house, so I say the baby is ready now at 38 weeks, so let's hop to it. That's elective. It just doesn't seem ... newsy, for lack of a better term.

[TwinFoxes]

It's not news. PRnewswire is what publicists use to get press releases to the media. It's not a real wire service like the AP. In this case some group you've never heard of (Leapfrog) has issued a "call to action". This is a press release written by a publicist whose job it is to get attention for a client. It wasn't written by a journalist.

But you never know who reads these boards, maybe it will help someone out.

[trcy]

DD was breech so they were talking about doing a c-section at 39 weeks. But then she started falling off the growth charts...went from the 30% to the 10% to 5%. So they did a c-section at 37 weeks. I wish she could have stayed in a week or two longer, but I understand my Dr's concerns. I don't understand why anyone would want to go earlier if there is not a medical reason. JMO though.

[toystorymama]

I know a first time mom who was recently induced at around 38.5 weeks for no medical reason. I was really shocked. Her reasons were strictly in the "I'm uncomfortable and don't want to gain any more weight" camp. I was surprised that she didn't know better (if that makes sense) so I don't think starting this thread was a bad idea. I think lots of women really don't understand the risks, even if we think they should. :wink2:

[carolinamama]

I ended up choosing to VBAC with #2 (and 3), but when I was pregnant with #2 I was also told by my OB that elective c/s were never scheduled before 39 weeks. Of course, I was also told that it was not a big deal and might even be better for my baby (in a low risk, healthy pregnancy) if I did go into labor even if I wanted the c/s.

Clearly there are valid reasons to go before 39 weeks, but the term elective indicates that there are no other medical reasons...

I'm dealing with possible pre-e right now and trying to come to terms with the possibility of delivering a baby boy (boys are more at risk...) before 39 weeks if it gets too bad. That's scary to me. But I'm 38 weeks right now so I'm hoping to keep him in for a bit longer...

I know you are educated about all this (and maybe you've had your little boy by now!) but just wanted to give you a real life story where all worked out fine. DS1 was born at 38 weeks. I had Pre-E and he was induced. He did wonderfully even though I also had reservations about him being a boy. Hope all works out well with your delivery.

[AnnieW625]

There are valid MEDICAL reasons to schedule a c-s before labor starts.

Frankly, I'd rather trust the opinion of my specialist than those of non-physicians on an internet forum.

JMHO

:yeahthat: I was told with DD1 that I had a 1 in 5 chance of having a c section due to placenta previa, which ended up not being an issue as it had moved up enough by 32 weeks, but I wouldn't have had an issue having a c section between 39 and 40 weeks, but I never ended up having to ask when they scheduled c sections so I had no idea when I would've been scheduled. DD1 ended up being born vaginally at 37 weeks.

[Fairy]

None of these stories are elective. They're all medical.

[RunnerDuck]

I know you are educated about all this (and maybe you've had your little boy by now!) but just wanted to give you a real life story where all worked out fine. DS1 was born at 38 weeks. I had Pre-E and he was induced. He did wonderfully even though I also had reservations about him being a boy. Hope all works out well with your delivery.

I had my girls via c/s at 35 weeks. I had pre-e, and baby A was breech - most docs won't do a vag. delivery of twins if A is breech. There is no doubt in my mind that labor would have done me in - my bp was off the charts and continued to rise after delivery, which is not the norm- so I'm fine with going right to c/s. One baby roomed in, the other went to NICU for blood sugar issues. We had nursing issues for a variety of reasons - but otherwise, generally, they were fine.

I'm really never sure what to make of topics like this. Honestly, the fact that doctors won't do elective c/s before 39 weeks does not exactly mean that you can automatically conclude they are very risky - doctors' actions are often as not more about covering their own asses than providing patients with all their options. Juries almost always side with the mother of the injured child so IF something were to go wrong, the doctor doesn't want there to be anything that he/she can be held responsible for doing or not doing. Even if it's highly unlikely a 38 weeker will have problems, even if it's highly unlikely the early delivery caused whatever problems, if it comes out that the baby was taken electively prior to term, questions and doubts will be raised.

Statements such as "The Leapfrog Group, issued a Call to Action in response to its new data finding that thousands of babies are electively scheduled for delivery too early, resulting in a higher likelihood of death, being admitted to a Neonatal Intensive Care Unit (NICU), and life-long health problems." are a classic example of taking facts and spinning them a little to make you draw the desired conclusion. Does it raise the risks to take a baby before labor starts on its own? Probably. But do babies born non-electively at this gestation tend to have many problems? Generally not. So the risk is going from what to what? I would suspect the vast majority of babies born at this gestation, electively or otherwise, are perfectly fine and do not suffer "life long health problems." If there is an increase in risk it's from very low risk to low risk.

Yes it would be nice if every women went to term - but I can't help but wonder when people get up in arms about this sort of thing, how much is medically justified concern for the baby, and how much is delight in criticizing another mom's choices?

Would I personally elect to be induced or have a c/s early out of convenience? Nope. Would I be completely aghast if another mom chose to? Nope.

My biggest concerns would be - is a women were being pressured to go early, c/s or induction, for her doctor's benefit? ie he/she has a vacation planned, and doctors don't like to miss deliveries because then they don't get paid. Or, is a woman electing to have an induction, not really being aware of how many inductions result in c/s, and that she might be in for a long, stalled labor and an undesired c/s in the end? Because it does bother me when women elect to be induced, not realizing it doesn't always work, and if your baby is ready to come out, all the drugs in the world might not make it come out - but once labor starts you're on the hospital's clock.

But if a women were to chose this route, knowing all the risks and drawbacks, I can't say I would have a problem with it. Especially if we're talking something like 38.5 weeks vs. 39, and it seems like most women do "elect" at a late point such as this.

[SnuggleBuggles]

deleting :)

[Fairy]

I had my girls via c/s at 35 weeks. I had pre-e, and baby A was breech - most docs won't do a vag. delivery of twins if A is breech. There is no doubt in my mind that labor would have done me in - my bp was off the charts and continued to rise after delivery, which is not the norm- so I'm fine with going right to c/s. One baby roomed in, the other went to NICU for blood sugar issues. We had nursing issues for a variety of reasons - but otherwise, generally, they were fine.

I'm really never sure what to make of topics like this. Honestly, the fact that doctors won't do elective c/s before 39 weeks does not exactly mean that you can automatically conclude they are very risky - doctors' actions are often as not more about covering their own asses than providing patients with all their options. Juries almost always side with the mother of the injured child so IF something were to go wrong, the doctor doesn't want there to be anything that he/she can be held responsible for doing or not doing. Even if it's highly unlikely a 38 weeker will have problems, even if it's highly unlikely the early delivery caused whatever problems, if it comes out that the baby was taken electively prior to term, questions and doubts will be raised.

Statements such as "The Leapfrog Group, issued a Call to Action in response to its new data finding that thousands of babies are electively scheduled for delivery too early, resulting in a higher likelihood of death, being admitted to a Neonatal Intensive Care Unit (NICU), and life-long health problems." are a classic example of taking facts and spinning them a little to make you draw the desired conclusion. Does it raise the risks to take a baby before labor starts on its own? Probably. But do babies born non-electively at this gestation tend to have many problems? Generally not. So the risk is going from what to what? I would suspect the vast majority of babies born at this gestation, electively or otherwise, are perfectly fine and do not suffer "life long health problems." If there is an increase in risk it's from very low risk to low risk.

Yes it would be nice if every women went to term - but I can't help but wonder when people get up in arms about this sort of thing, how much is medically justified concern for the baby, and how much is delight in criticizing another mom's choices?

Would I personally elect to be induced or have a c/s early out of convenience? Nope. Would I be completely aghast if another mom chose to? Nope.

My biggest concerns would be - is a women were being pressured to go early, c/s or induction, for her doctor's benefit? ie he/she has a vacation planned, and doctors don't like to miss deliveries because then they don't get paid. Or, is a woman electing to have an induction, not really being aware of how many inductions result in c/s, and that she might be in for a long, stalled labor and an undesired c/s in the end? Because it does bother me when women elect to be induced, not realizing it doesn't always work, and if your baby is ready to come out, all the drugs in the world might not make it come out - but once labor starts you're on the hospital's clock.

But if a women were to chose this route, knowing all the risks and drawbacks, I can't say I would have a problem with it. Especially if we're talking something like 38.5 weeks vs. 39, and it seems like most women do "elect" at a late point such as this.

Duck, you had an early c/s for medical reasons. MEDICAL. There's a reason that gestation is 40 weeks and not 37 or 38. Or 39. We're talking ELECTIVE. And while you're right about doctors wanting to cover their asses, they also want to be responsible. I was miserable my last three weeks of pregnancy. But I thank god every day that I carried full term, because the fact is taht you're wrong about this -->

I would suspect the vast majority of babies born at this gestation, electively or otherwise, are perfectly fine and do not suffer "life long health problems." If there is an increase in risk it's from very low risk to low risk.

The reason babies are delivered earlier than 39 weeks for medical reasons is because they or the mother are at higher risk inside than outside. Plain and simple. So, you got trips and you go at 34 weeks to a planned c-section, there's a reason for that, and it's medical protection of babies and/or mom. You got pre-e and baby is delivered at 38 weeks? It's that or die in many cases. But that does not mean that these babies don't have issues. And lifelong or temporary, problems are not waht you want for your baby.

I'm sorry, I see posts like this, and I just have to comment.

[llama8]

I just don't understand how mom's can be so judgmental of each other. Each pregnancy is different and each woman has their own risks. If a baby is born early through c-section, there is usually a good reason for it. I have too many friends that faced pregnancy complications that needed to go early or the baby would not be here right now. One had an emergency c-section at 32 weeks and was told to prepare for a stillborn...luckily they revived the baby and she is a happy 3 year old...perfectly normal.

Woman and doctors in conjunction make the best decisions together...and although knowledge is power, nothing anyone says on this board will make me delay having my baby if they are in trouble.

My DD was born at 39 weeks via c-section. She was in a transverse breech position and at 9 lbs, there was no possible way to turn her. It would ahve been dangerous for me to go into labor so I went a little early (4 days before due date). I got such nasty comments from some people on this and other boards about how c-section isn't natural, i won't bond with my baby, and I should have tried to turn her. I have a beautiful, healthy 14 month old DD and I give thanks for my c-section because we avoided complications.

Do I have a problem with someone going early just because.....not really. It is there decision and they may not be saying the whole story. This article talks about elective early, but it doesn't really say what it means by elective. Is a possible but not exact threat to the baby elective (like IUGR)? I don't know. Most states, like NY where I live have laws against going early with a c-section with no valid medical reason. Anyone who went early here has a good reason.

I just wish people would stop passing judgment. The end goal is a healthy baby and most women would do anything to make sure that happens. I feel the same about the breastfeeding advocates that target formula feeding moms. Worry about your own and don't pass judgment on what anyone else does.
(I'm off my soapbox now)

[nicepersonfl]

Step inside any NICU in the US - a large % of them are there 35-38 weeks with TTN (transient tachypnea of the newborn) due to immature lungs. While there are medical reasons to delivery a baby early (and those medical issues are real, necessary, and early delivery very critical to survival for either baby or mother), there are still OBs who will deliver before 39 weeks for no real medical reason.

[RunnerDuck]

Do I have a problem with someone going early just because.....not really. It is there decision and they may not be saying the whole story. This article talks about elective early, but it doesn't really say what it means by elective. Is a possible but not exact threat to the baby elective (like IUGR)? I don't know. Most states, like NY where I live have laws against going early with a c-section with no valid medical reason. Anyone who went early here has a good reason.

I just wish people would stop passing judgment. The end goal is a healthy baby and most women would do anything to make sure that happens. I feel the same about the breastfeeding advocates that target formula feeding moms. Worry about your own and don't pass judgment on what anyone else does.
(I'm off my soapbox now)

YES that was my point.

I'm not defending that my early delivery was medically justified - but I feel like I do need to defend that I went right for a c/s because so many will say "Oh you could have found a doctor willing to delivery a breech baby A." I have no regrets going early, no regrets going right to c/s. (Although I do hate the cya my OB had wrt vbac labors which I think up chances of another c/s - so I have switched back to a midwife group - I really do not trust that doctors have OUR best interests in mind when they give us rules)

But if a woman CHOOSES to go early - ie it's not immediately pressing that there is a reason to do so - and it is at the end of pregnancy - I just don't believe the risks are that high, and that the outrage is totally over her making a poor medical decision. Really, even if the risks are slightly higher, overall I think the risks are still quite low, and the outrage is more because moms love to pick apart other moms more than anything else. You're a lousy mom because you formula feed! You're a lousy mom because you use a baby bucket! You're a lousy mom because you use a baby bjorn and not a sling! You're a lousy mom because you chose to be induced at 38.5 weeks instead of waiting! Don't you know how DANGEROUS all that is???

In the end, for the vast majority of women, I just don't think it ends up being a big deal, and I can't see getting worked up about it.

Maybe if there wasn't so much nitpicky stuff going on about small stuff, I wouldn't be so skeptical about the big stuff - but to me this just seems as much of a mommy wars issue as a medical issue.

Like I said so long as the mom is informed, and not being pressured for any silly reason to go early, I think this is a choice women are rationally capable of making.

Now if we're talking for some reason a mom wants to go at 35-36 weeks - that's nuts. But most truly elective inductions are done later than that - I can't imagine why you'd elect to go when the baby would still be considered a preemie - so the outrage just really isn't justified.

[SnuggleBuggles]

It costs me, the health care consumer, more money when people choose things that are not medically necessary (like getting induced for a convenience decision). Any complications baby has because the baby was delivered before 39 weeks that could have been prevented by having a longer pregnancy are also potentially avoidable health care costs that affect all health care consumers, at least in the US. I think it is something we should care about at least some.

Beth

[bubbaray]

It costs me, the health care consumer, more money when people choose things that are not medically necessary (like getting induced for a convenience decision). Any complications baby has because the baby was delivered before 39 weeks that could have been prevented by having a longer pregnancy are also potentially avoidable health care costs that affect all health care consumers, at least in the US. I think it is something we should care about at least some.



You can say this about a lot of parenting decisions though -- early use of boosters as opposed to harnessed seats leads to poor crash outcomes, increasing both vehicular and medical insurance rates. Some would argue that use of formula over BFg has increased medical costs (ear infections, etc) *note, not saying I believe that about use of formula, but it is definitely out there (heard it from my own dr).

[RunnerDuck]

It costs me, the health care consumer, more money when people choose things that are not medically necessary (like getting induced for a convenience decision). Any complications baby has because the baby was delivered before 39 weeks that could have been prevented by having a longer pregnancy are also potentially avoidable health care costs that affect all health care consumers, at least in the US. I think it is something we should care about at least some.

Beth

I can actually get behind that argument much more than the "How could a mom choose that when it's so risky?" argument.

An induction definitely costs more than a natural birth. A longer stay in L&D would be the biggest factor there, and if it leads to a stalled labor and a c/s that's a HUGE jump in costs. It can become a little tricky to argue those as some of the meds used in an induction can be used in a labor that started on its own, too. Ie - an induction can lead to the need for pit which for most women means the need for an epidural - but you wouldn't tell a woman who goes into labor on her own that her request for an epirudal is bad because it will cost patients more for care down the line. And an epi by choice even in a labor that starts on its own can result in the need for pit - which you wouldn't withhold arguing costs.

If a woman is going early with a c/s though and would have had a c/s regardless, then there is no jump in cost. Some docs just won't do a vbac, some women have pelvic issues, there are some reasons a woman might plan a c/s from the start and it won't be something that can change by waiting - ie that breech baby might turn. I think a lot of early c/s are cases where c/s was the planned outcome anyway.

As for problems that could have been prevented by going longer than 39 weeks, though, most elective inductions take place so close to that 39 week cut-off - 38th week, 38th going on 39th - that the risk of things going wrong is more theoretical than real. That's going back to the how risky is it, really?, problem.

But even leaving out medical risks, there likely is in increase in cost doing inductions rather than allowing the mother to go into labor on her own so yes, you could argue that.

[llama8]

YES that was my point.

I'm not defending that my early delivery was medically justified - but I feel like I do need to defend that I went right for a c/s because so many will say "Oh you could have found a doctor willing to delivery a breech baby A." I have no regrets going early, no regrets going right to c/s. (Although I do hate the cya my OB had wrt vbac labors which I think up chances of another c/s - so I have switched back to a midwife group - I really do not trust that doctors have OUR best interests in mind when they give us rules)

But if a woman CHOOSES to go early - ie it's not immediately pressing that there is a reason to do so - and it is at the end of pregnancy - I just don't believe the risks are that high, and that the outrage is totally over her making a poor medical decision. Really, even if the risks are slightly higher, overall I think the risks are still quite low, and the outrage is more because moms love to pick apart other moms more than anything else. You're a lousy mom because you formula feed! You're a lousy mom because you use a baby bucket! You're a lousy mom because you use a baby bjorn and not a sling! You're a lousy mom because you chose to be induced at 38.5 weeks instead of waiting! Don't you know how DANGEROUS all that is???

In the end, for the vast majority of women, I just don't think it ends up being a big deal, and I can't see getting worked up about it.

Maybe if there wasn't so much nitpicky stuff going on about small stuff, I wouldn't be so skeptical about the big stuff - but to me this just seems as much of a mommy wars issue as a medical issue.

Like I said so long as the mom is informed, and not being pressured for any silly reason to go early, I think this is a choice women are rationally capable of making.

Now if we're talking for some reason a mom wants to go at 35-36 weeks - that's nuts. But most truly elective inductions are done later than that - I can't imagine why you'd elect to go when the baby would still be considered a preemie - so the outrage just really isn't justified.


I couldn't agree more.

[liamsmom]

I think the word a lot of people have a problem with is "elective." But I have to wonder if the cases that are labeled elective induction would actually be considered elective by the mothers. For instance, a lot of c-sections are labeled as elective, but they weren't necessarily planned in advance or the desired outcome. A woman might be in labor for 24 hours at the hospital and her OB suggests that it's time for a c-section. She agrees and her surgery is labeled as "elective." Or, a woman has had a previous c-section and her doc doesn't do VBACs so she has an "elective" c-section, but she would argue that she "had' to have the section.

I agree with everyone that it's really up to the patient and her care takers, but the terminology and statistical evidence might be misleading. So, in a situation where a woman is induced at 37-38 weeks due to high blood pressure, while the mom certainly feels the situation was medically necessary (and I would too) it might be categorized differently.

[ha98ed14]

It's not news. PRnewswire is what publicists use to get press releases to the media. It's not a real wire service like the AP. In this case some group you've never heard of (Leapfrog) has issued a "call to action". This is a press release written by a publicist whose job it is to get attention for a client. It wasn't written by a journalist.


You're so smart! How'd you know that? I think I would like to employ you to vet the rest of my life's options & decisions for me, Thanks!

[dogmom]

This is an interesting discussion, I just wanted to bring up another reason some people might elect to schedule a C-section early from the medical providers perspective. All it takes for one perfectly healthy woman to come in for her 38th prenatal check with a perfectly healthy fetus and then come in for her 39th with a stillborn from and umbilical cord incident. I think the numbers are 1/1000 for umbilical cord deaths, but clearly not all in this time range. The death of an infant is horrible for the parents, but it's not like the OB just shrugs it off. I met OB's who sometimes wish the could take all infants out soon as they feel it's safe. Sure, it's a control issue. Health care professionals are trained to see all the problems and avoid them. So it's frustrating when something like this happens that you feel is preventable. (if I had just....) I think some people would mistakenly call it a god complex, but I just think it's a human response. Just like we as parents think about all the things we might have done different. So I can see if an OB had a couple of late term deaths/stillborn and there's this miserable pregnant woman in front of you begging to have it over with it would be really tempting to just go for it. Especially when you NICU is full of babies under 30 weeks, a 38-39 week baby must look like a toddler. I'm willing to bet that an evidence based approach would show this is not a good idea, but I can see how these decisions get made. It's not like there is a lot of good research on best OB practices, being that pregnant woman seldom like being in randomized trials.

[egoldber]

A lot of this has also come from recent research on "near term" preemies. We used to believe that babies born near term, at 36-38 weeks really had no long term issues. In the last 2-4 years, there is more and more research to show that these babies, while generally perfectly healthy as newborns are at increased risk for more subtle issues. They are often more difficult to breastfeed, making mom more likely to give up, especially if she has little support at home or needs to go back to work soon after birth. Babies born near term are at increased risk for things like ADHD, anxiety and other more subtle neurological issues.

Will all near term babies have these issues? No of course not. But at the same time, there are risks associated with these births. And part of the issue is about half of the pregnancies in this country are unplanned. Which means that women often do not know exactly when they conceived and their dates can be off. So a baby thought to be 37-38 weeks, could be 36-37 weeks.

This is just the first thing I found in a quick Google. But I know that this is a current hot button research issue in health care policy.

http://www.nytimes.com/2009/03/30/health/30child.html

[smilequeen]

This really is about ELECTIVE c/s/inductions done earlier than 39 weeks. It is not about the mom who had pre-E. It is not about the mom with placenta previa. It is not about the mom who had a previous stillbirth. It is about the mom who is perfectly healthy, with a perfectly normal pregnancy who just wants it to be over with earlier.

I have a friend who delivered by elective c/s 2x at 37 weeks. No problems. And I have a few friends who delievered by repeat c/s, for no other medical reason other than not wanting to do VBAC and wanting to be done who had babies spend a few days to a week in the NICU b/c the babies just weren't quite ready. They are OK now, but none of them would ever repeat that decision. Having a baby in the NICU b/c you were ready to be done...not a good thing.

That's why I was nervous about it and I absolutely would have done the induction if my pre-E results had indicated neccessity. They have not yet and I'll be 39 weeks on Weds. I will definitely feel better after that point, although I would have done the induction earlier if medically neccessary. Because it would have been MEDICALLY NECCESSARY. It would not have been b/c I'm uncomfortable and tired and ready to be done. Which I so totally am. But it's about HIM being done, not me, barring any medical reasons that we both need to be done.

There is no reason to put babies at risk, even a small risk for no medically indicated reason.

[o_mom]

I guess I don't understand why this is newsy. I think it's good to keep us all informed :-). But for this one, it seems akin to staying in school. I used to talk to inner city HS'ers as part of my company's outreach program, and the "talking points," so to speak, were #1 "stay in school." I always thoguht, well, duh. I mean, honestly, who doesn't knwo this. So, I'd start my speech with "Ok, who here doesn't know that you should stay in school?" And they'd snicker cuz it's so trite. I kind of feel the same way about this statement that elective c-sections (or inductions) before 39 weeks are ill-advised. Not that it's trite, but more like, who doesn't know that that's a bad idea? On this board, anyway? There are absolutely medical reasons, but we're talking elective, here. Like, I just am done being pregnant, my hemorroids are killing me, I have cankles, and I am a house, so I say the baby is ready now at 38 weeks, so let's hop to it. That's elective. It just doesn't seem ... newsy, for lack of a better term.

I went back and re-read the article and I think the reason it is "newsy" is the data that after looking at the data, they found that, in some hospitals, up to 40% of elective deliveries were scheduled before 39 weeks. It isn't so much about nobody knowing that elective (again - not medically necessary) delivery before 39 weeks isn't desirable, but that doctors are still doing it and doing it frequently in some hospitals.

[daisymommy]

I went back and re-read the article and I think the reason it is "newsy" is the data that after looking at the data, they found that, in some hospitals, up to 40% of elective deliveries were scheduled before 39 weeks. It isn't so much about nobody knowing that elective (again - not medically necessary) delivery before 39 weeks isn't desirable, but that doctors are still doing it and doing it frequently in some hospitals.

:yeahthat: And that women are NOT being informed of the possible risks to their babies. Are women being sat down by their doctors, with a form in front of them, listing the possible risks to their babies, and asking that the mother sign an informed consent? Nope! Not that if they did, it would make it okay; because then it' still unhealthy for the baby. But the point is, I'm willing to bet that the moms of these MEDICALLY un-necessary early deliveries (by C-section or enduction) are not being fully informed of what they are risking. They are being told "what's a week give or take". Not okay.

[TwinFoxes]

I went back and re-read the article and I think the reason it is "newsy" is the data that after looking at the data, they found that, in some hospitals, up to 40% of elective deliveries were scheduled before 39 weeks. It isn't so much about nobody knowing that elective (again - not medically necessary) delivery before 39 weeks isn't desirable, but that doctors are still doing it and doing it frequently in some hospitals.

But the data was a survey that hospitals didn't have to answer. Surveys like this are unreliable. That's my issue. It's not a study. If a research organization looked at actual hospital records, and did a peer reviewed study, it's a lot more reliable. We have no idea if this organization hired temp workers who were paid by the number of hospitals who answered (and thus would have incentive for fudging data) or who did the actual surveying. A peer reviewed study gives you some confidence.

I could make up the TF Group, and call up hospitals and ask their policies, and my data would be just as valid. I'm not saying elective c-sections earlier is a good idea, I just have an issue with using a press release as a basis for making medical decisions.

[TwinFoxes]

You're so smart! How'd you know that? I think I would like to employ you to vet the rest of my life's options & decisions for me, Thanks!

Haha, you'd fire me when you found me playing Angry Birds instead of working! :)

[Fairy]

I just don't understand how mom's can be so judgmental of each other. Each pregnancy is different and each woman has their own risks. If a baby is born early through c-section, there is usually a good reason for it. I have too many friends that faced pregnancy complications that needed to go early or the baby would not be here right now. One had an emergency c-section at 32 weeks and was told to prepare for a stillborn...luckily they revived the baby and she is a happy 3 year old...perfectly normal.

Woman and doctors in conjunction make the best decisions together...and although knowledge is power, nothing anyone says on this board will make me delay having my baby if they are in trouble.

My DD was born at 39 weeks via c-section. She was in a transverse breech position and at 9 lbs, there was no possible way to turn her. It would ahve been dangerous for me to go into labor so I went a little early (4 days before due date). I got such nasty comments from some people on this and other boards about how c-section isn't natural, i won't bond with my baby, and I should have tried to turn her. I have a beautiful, healthy 14 month old DD and I give thanks for my c-section because we avoided complications.

Do I have a problem with someone going early just because.....not really. It is there decision and they may not be saying the whole story. This article talks about elective early, but it doesn't really say what it means by elective. Is a possible but not exact threat to the baby elective (like IUGR)? I don't know. Most states, like NY where I live have laws against going early with a c-section with no valid medical reason. Anyone who went early here has a good reason.

I just wish people would stop passing judgment. The end goal is a healthy baby and most women would do anything to make sure that happens. I feel the same about the breastfeeding advocates that target formula feeding moms. Worry about your own and don't pass judgment on what anyone else does.
(I'm off my soapbox now)

I don't know where you see judgment. I haven't seen one post judging an early delivery based on medical reasons. If you're referring to me, however, and you perceive that I judge mothers who choose to deliver early because of anything other than a medical need? Then yes, I guess I am judgmental. I don't apologize for it.

[o_mom]

But the data was a survey that hospitals didn't have to answer. Surveys like this are unreliable. That's my issue. It's not a study. If a research organization looked at actual hospital records, and did a peer reviewed study, it's a lot more reliable. We have no idea if this organization hired temp workers who were paid by the number of hospitals who answered (and thus would have incentive for fudging data) or who did the actual surveying. A peer reviewed study gives you some confidence.

I could make up the TF Group, and call up hospitals and ask their policies, and my data would be just as valid. I'm not saying elective c-sections earlier is a good idea, I just have an issue with using a press release as a basis for making medical decisions.

The survey may be voluntary, but that in itself does not make it useless. Looking at some of the info and data on the website, there is enough to make me think it is fairly decent for what is being claimed, which is that at least some hospitals have high rates.

The release is actually not calling for medical decisions to be made on this data, but actually calling for just what you said. They want physicians and hospitals to make medical decisions based on peer-reviewed data that forms the policies of ACOG and other organizations.

Could the data be better? Sure. That doesn't make it useless. I honestly think the OP's summary wasn't very accurate in what was being conveyed (sorry daisymommy!), but find the data interesting and worth a look, nonetheless.

[egoldber]

The survey may be voluntary, but that in itself does not make it useless. Looking at some of the info and data on the website, there is enough to make me think it is fairly decent for what is being claimed, which is that at least some hospitals have high rates.

Right, they are not trying to say "This is a nationally representative sample of hospitals and their early delivery rates." In that case, the response rate would be a factor. But instead they are saying, this is an example of the disparity in rates between some hospitals.

Also, it is not this group that is saying that early delivery is the problem. It is ACOG, the AAP and other groups that have said this. And there have been many studies in peer reviewed professional medical journals about the potential issues with near term deliveries.

And FWIW, for those who don't remember my story, my younger DD was delivered by planned c-section at 34 weeks because of a specfic set of circumstances. I struggled with that decision at the time and I struggle today with knowing how it may have affected her. And I think it does affect her. But at the same time, I know it was the right decision at the time in my case. But that doesn't mean I shouldn't know about the potenital issues surrounding the circumstances of her delivery.

[toystorymama]

I don't know where you see judgment. I haven't seen one post judging an early delivery based on medical reasons. If you're referring to me, however, and you perceive that I judge mothers who choose to deliver early because of anything other than a medical need? Then yes, I guess I am judgmental. I don't apologize for it.

I am with you.

Let's face it, people are judgmental by nature. So, someone may not be judgmental about this particular issue, but most of us have something that is a "soapbox" type issue for us, whether or not we ever vocalize it. We are also probably much more supportive of one another in real life as well. There are some truly competitive moms out there, but most of my friends support one another no matter our choices and accept that we are different. Differences in opinion are magnified in threads like this though, but I know I don't have any truly negative feelings about any other posters.

I had my first born at 40 weeks 3 days and I had my 2nd by scheduled c-section at 39 weeks exactly. I saw a real difference in how my boys were at birth. My first born was much healthier. My little guy had so many stomach problems that my oldest just didn't have. I truly believe that their gestational age played a part in that. I wish I would have held out a little longer with #2, but I went along with my OB's recommendation. So the issue is a little personal for me I guess, but again, not in a serious, "oh what a horrible mother that person is" type way. :)

I am re-reading my post and realizing it is quite rambly ( is that even a word? LOL), so I wanted to clarify. What I mean is I don't think any of us are truly judging one another, not really. It is OK if we disagree about this issue. The only other mothers I truly do judge are the ones who abuse their children. End of story.

[Fairy]

I am with you.

Let's face it, people are judgmental by nature. So, someone may not be judgmental about this particular issue, but most of us have something that is a "soapbox" type issue for us, whether or not we ever vocalize it. We are also probably much more supportive of one another in real life as well. There are some truly competitive moms out there, but most of my friends support one another no matter our choices and accept that we are different. Differences in opinion are magnified in threads like this though, but I know I don't have any truly negative feelings about any other posters.

I had my first born at 40 weeks 3 days and I had my 2nd by scheduled c-section at 39 weeks exactly. I saw a real difference in how my boys were at birth. My first born was much healthier. My little guy had so many stomach problems that my oldest just didn't have. I truly believe that their gestational age played a part in that. I wish I would have held out a little longer with #2, but I went along with my OB's recommendation. So the issue is a little personal for me I guess, but again, not in a serious, "oh what a horrible mother that person is" type way. :)

I am re-reading my post and realizing it is quite rambly ( is that even a word? LOL), so I wanted to clarify. What I mean is I don't think any of us are truly judging one another, not really. It is OK if we disagree about this issue. The only other mothers I truly do judge are the ones who abuse their children. End of story.

That was a great post. Espescially the bolded.

[TwinFoxes]

Right, they are not trying to say "This is a nationally representative sample of hospitals and their early delivery rates." In that case, the response rate would be a factor. But instead they are saying, this is an example of the disparity in rates between some hospitals.






But said by who? I've never heard of this group before. How reliable is the survey? There's a reason that their findings hasn't been picked up by legitimate news organizations, or even done in collaboration with ACOG. They mention ACOG, but notice there's no quote from ACOG saying "we're glad this survey was done blah blah." When I was a journalist we'd look into surveys like this occasionally, and you'd be surprised at how lax the standards were. Some places would basically call up an organization, and ask the person who answered the phone the survey question, and regardless of that person's knowledge, take that answer. I don't know if this group is like that or not, they could be great. Not all surveys are inherently bad. Groups like AARP do surveys that are done well.

I'm not saying that early deliveries are good AT ALL. I'm well aware that there are studies that say there are problems with near-term deliveries. (Trust me, when I was pregnant with twins I read everything I could find about pre-term delivery, little did I know I would have been ecstatic to make it to even 30 weeks, let alone 37). I'm just saying that people read press releases, and that's what this is, and think they're actual news articles. My response was to the question "why is this news?" My answer is: this is someone sending out a press release, and it's not news. I'm sure most people don't know that PRnewswire is a press release service, not an organization of journalists. People read a press release, and think it's the same as a study (not saying anyone on this board does this, but lots of people lurk, or google once and the board comes up). I'm really not trying to say "eh, 37 weeks, what's the big deal".

[smilequeen]

Regardless of the article posted...the ACOG actually has a pretty strong stance against elective delivery before 39 weeks. I actually think a lot of women, even smart ones, don't realize that there is any risk.

http://google.acog.org/search?site=acogpublic&client=acog&proxystylesheet=acog&output=xml_no_dtd&proxyreload=1&filter=0&q=elective+delivery+before+39+weeks

[o_mom]

But said by who? I've never heard of this group before. How reliable is the survey? There's a reason that their findings hasn't been picked up by legitimate news organizations, or even done in collaboration with ACOG. They mention ACOG, but notice there's no quote from ACOG saying "we're glad this survey was done blah blah." When I was a journalist we'd look into surveys like this occasionally, and you'd be surprised at how lax the standards were. Some places would basically call up an organization, and ask the person who answered the phone the survey question, and regardless of that person's knowledge, take that answer. I don't know if this group is like that or not, they could be great. Not all surveys are inherently bad. Groups like AARP do surveys that are done well.

I'm not saying that early deliveries are good AT ALL. I'm well aware that there are studies that say there are problems with near-term deliveries. (Trust me, when I was pregnant with twins I read everything I could find about pre-term delivery, little did I know I would have been ecstatic to make it to even 30 weeks, let alone 37). I'm just saying that people read press releases, and that's what this is, and think they're actual news articles. My response was to the question "why is this news?" My answer is: this is someone sending out a press release, and it's not news. I'm sure most people don't know that PRnewswire is a press release service, not an organization of journalists. People read a press release, and think it's the same as a study (not saying anyone on this board does this, but lots of people lurk, or google once and the board comes up). I'm really not trying to say "eh, 37 weeks, what's the big deal".

Yes, it's a news release, but many times I would rather read that than a reporter's butchered version of science. ;)

A quick look through their website gives an impressive list of partners, many of whom I feel would not lend their name to shoddy surveys. The largest hospital system in our state (a very well-respected one that reported a shockingly high rate, IMO) was a contributor and has links to this non-profit on their patient info page. March of Dimes is a cosponor of this initiative and several of the press articles contain quotes from MOD talking about this data from what I saw. As far as being picked up by other news organizations.... a quick Google shows it being picked up by Time, USAToday, BusinessWeek and WSJ.

I agree it's not your normal news source or a household name because they normally do not target patients/general public, but rather the healthcare industry. I think it is good to be skeptical, but at the same time to just dismiss it as some sort of propaganda with no meaning because it is a press release isn't right either. Even peer-reviewed research is often disseminated in press releases.

[egoldber]

Some of those results from the Google search smilequeen gave are pretty telling. Several of them are from ACOG's own newsletters talking about how hard it can be to get their own members to not do elective inductions before 39 weeks.

http://www.acog.org/departments/dept_notice.cfm?recno=51&bulletin=5041


Tell us about the program you initiated at Intermountain Healthcare (in Salt Lake City) to decrease elective inductions.

Sometimes, as ob-gyns, we are unaware of the impact that we have on neonatal outcomes. We were alerted by our neonatologists that they were seeing term babies on ventilators. When we investigated this further, we found that these babies were being delivered primarily between 36 and 38 weeks, and, for the most part, there were no medical or obstetric indications for the deliveries. Overall, we found that 28% of elective deliveries were being performed before 39 weeks. We knew we had to do something.

Naively, we thought that this would be an easy fix. We thought that since ACOG had recommended that elective inductions or deliveries not take place before 39 weeks all we had to do was educate obstetricians about ACOG’s recommendations. However, we had quite a bit of resistance from doctors who did not see the harm in early elective deliveries. After we presented hard data showing that babies delivered before 39 weeks had an increase in NICU admissions, respiratory distress syndrome, and the need for mechanical ventilation assistance, we were still met with some physicians willing to schedule early inductions and cesarean deliveries.

[Fairy]

I still fail to see how this is news. I just do. I hear what all of you are saying, but it's not news. Because it's not NEW. I also don't get why we're debating at all. I think the post was meant with the best of intention, but for me, it was a bit like, BTW, please dont' smoke while pregnant. Sorry.

[o_mom]

I still fail to see how this is news. I just do. I hear what all of you are saying, but it's not news. Because it's not NEW. I also don't get why we're debating at all. I think the post was meant with the best of intention, but for me, it was a bit like, BTW, please dont' smoke while pregnant. Sorry.

What is new is the data from this past year, showing that in spite of it being obvious that you shouldn't do it, the MDs are still doing it. It's not like saying please don't smoke, it's like saying that in spite of knowing smoking is bad, XX% of pregnant women still do it. Or, like saying in spite of knowing that you shouldn't give aspirin to kids, YY% of MDs still prescribe it. I don't think it is ground-breaking, but it is kind of interesting that, for example, a major university associated hospital in our area still has over 40% of elective deliveries being scheduled for less than 39 weeks.

The main debate in this thread, I think, was a spinoff of the background in the article that was saying why it is bad to do that. Then there was debate about the credibility of the data, too. That's all. ETA: As I said above, I don't think the OP summarized the article well and actually most of the post was on the background info, not the actual point of the article (sorry, again, daisymommy).

ETA2: I guess you could see this as 'not major news', but I put it in that category of 'planned news' like government statistics and other things where it may not be super-duper groundbreaking or it may not compare to Egypt, etc., but it still is going to get a mention on the Sunday science page. Worth 6 pages of debate - probably not, I'll give you that. :)

[daisymommy]

Sorry I read and posted too fast without being more accurate :) But I'm glad you stats gals summed it up so well for me!

[Fairy]

What is new is the data from this past year, showing that in spite of it being obvious that you shouldn't do it, the MDs are still doing it. It's not like saying please don't smoke, it's like saying that in spite of knowing smoking is bad, XX% of pregnant women still do it. Or, like saying in spite of knowing that you shouldn't give aspirin to kids, YY% of MDs still prescribe it. I don't think it is ground-breaking, but it is kind of interesting that, for example, a major university associated hospital in our area still has over 40% of elective deliveries being scheduled for less than 39 weeks.

The main debate in this thread, I think, was a spinoff of the background in the article that was saying why it is bad to do that. Then there was debate about the credibility of the data, too. That's all. ETA: As I said above, I don't think the OP summarized the article well and actually most of the post was on the background info, not the actual point of the article (sorry, again, daisymommy).

ETA2: I guess you could see this as 'not major news', but I put it in that category of 'planned news' like government statistics and other things where it may not be super-duper groundbreaking or it may not compare to Egypt, etc., but it still is going to get a mention on the Sunday science page. Worth 6 pages of debate - probably not, I'll give you that. :)

Ok, ok, I give. Uncle. We can at least agree that six pages of debate on this is just weird!

[TwinFoxes]

Ok, ok, I give. Uncle. We can at least agree that six pages of debate on this is just weird!

Me too. People seemed determined to paint me as arguing a point that I'm just not arguing, when my point is "this just in, not all hospitals do things the same way, some are better than others" is not news. Despite the fact I said ...This group ... could be great. Not all surveys are inherently bad. Groups like AARP do surveys that are done well. I'm "dismissing it as propaganda" which is pretty much the opposite of what I said. I just want people to know what the source is...I never should have answered a PP question "why is this news?" But at least one person didn't know PRnewswire is a press release service.

Along with the not-so-thinly veiled personal jab dressed up with a ;) and I say adios. :waving4: (to the thread, not the board...you'll never get rid of me!)

[egoldber]

I was not able to get on last night. I did not see it as debate, just discussion. So I dunno what to say. It was never my intent to debate, just discuss. Maybe it isn't "news" per se, but I did think it was interesting and discussion worthy. As you can see from some of the links, I do think it is something that women should be aware of because many times their own doctor may not be aware or follow ACOG's own guidelines.

[o_mom]

Me too. People seemed determined to paint me as arguing a point that I'm just not arguing, when my point is "this just in, not all hospitals do things the same way, some are better than others" is not news. Despite the fact I said ...This group ... could be great. Not all surveys are inherently bad. Groups like AARP do surveys that are done well. I'm "dismissing it as propaganda" which is pretty much the opposite of what I said. I just want people to know what the source is...I never should have answered a PP question "why is this news?" But at least one person didn't know PRnewswire is a press release service.

Along with the not-so-thinly veiled personal jab dressed up with a ;) and I say adios. :waving4: (to the thread, not the board...you'll never get rid of me!)


I'll bite, since you are calling me out.

I don't have a problem with explaining/questioning sources. It was the implication that because you had never heard of them that they must automatically be bad. The way your posts read to me implied that there was serious doubt about this group and seemed to say that this was all spin. You may have been encouraging people to look at the source more, but that is not how it read to me. ETA: I think it is the emphasis on all the ways this could be bad or misleading with just a little 'but maybe not' tagged to it when it really took only a few minutes of research to find that (for my comfort in this context) this is a legitimate organization kind of rubbed me wrong. I think if it had been framed as "Does anyone know anything about this group?" or "It's always good to check sources when dealing with press releases, you may want to look into this group more" it would have been more obvious what you were trying to say. Or, maybe I just read too much into it.

I did not intend the 'jab' to be personal. I'm sorry. I did not see in there that you used to be a journalist, as I do now. It reads much harsher in retrospect than I intended. I really do look for the news releases many times when there is any kind of science or statistics involved because most mainstream reporters are not good at conveying the true meaning. There is also usually more content in there as well, not what was cut to make it fit in a space.

Lastly - it being news or not news.... that is an opinion. I do think it is news. Anytime there is new data that we didn't have before, I think it falls in the 'news' category. Heck, half the time the 'news' is that nothing has changed (see housing market statistics or unemployment).

[daisymommy]

I do think it is something that women should be aware of because many times their own doctor may not be aware or follow ACOG's own guidelines.

:yeahthat: This was the only point I was trying to make when I posted the press release! Just a friendly little PSA for moms to read, so they could be educated in case their OB didn't do it for them. I had no ulterior motive, wasn't trying to start a debate at all.

Silly me though, I am speaking to the BBB which I am reminding daily skews very well educated and informed :)

I usually see myself as a well read, smart educated woman (certainly in comparison to the average woman out there and all of my friends). But honestly, sometimes I feel like hiding under a rock and never speaking a word after posting on the boards. Everyone jumps all over each other with a tone like "well DUH! I knew that! and here's where you're wrong and didn't you know that the study was done by XYZ and really said ABC!" --and not said in a very nice helpful way, but more in a sense of putting each other down to show their own superiority. I'm not digging it. :( Maybe from now on I'll just keep my mouth shut.

[o_mom]

:yeahthat: This was the only point I was trying to make when I posted the press release! Just a friendly little PSA for moms to read, so they could be educated in case their OB didn't do it for them. I had no ulterior motive, wasn't trying to start a debate at all.

Silly me though, I am speaking to the BBB which I am reminding daily skews very well educated and informed :)

I usually see myself as a well read, smart educated woman (certainly in comparison to the average woman out there and all of my friends). But honestly, sometimes I feel like hiding under a rock and never speaking a word after posting on the boards. Everyone jumps all over each other with a tone like "well DUH! I knew that! and here's where you're wrong and didn't you know that the study was done by XYZ and really said ABC!" --and not said in a very nice helpful way, but more in a sense of putting each other down to show their own superiority. I'm not digging it. :( Maybe from now on I'll just keep my mouth shut.

I'm sorry. I think it was a good thing to discuss, including the source discussion. Sometimes it is a matter of trying to read tone on the internet, which we all know is an issue - things stated factually can seem to be one-upping when at the same time writing too familiarly or with humor can seem flippant and dismissive or even attacking. A very fine line to walk, I will say. The underlying issue is clearly a hot-button topic and there is a difference of opinion on how news-worthy it was, but in the end, I think you are right that Beth summed it up best there.