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Early Elective Deliveries

Several years ago, new research showed that babies still have a lot of growing to do at weeks 37, and 38. Therefore, babies should not be considered full term until 39 weeks. If there are no complications, inducing or scheduling a C-section before 39 weeks should be avoided, because the baby is still growing.


In 2013 in Upstate New York, one-third of babies born were delivered before they were full term, and a third of them were delivered by cesarean section. Most babies need 39 weeks to develop fully. The American College of Obstetricians and Gynecologists, and the American Academy of Family Physicians both state that “most babies need 39 weeks to develop fully. Induced or planned delivery before that time – without valid medical reason – is not in the best interest of the baby or the mother.”

There may be medical reasons for inducing labor or scheduling a C-section before 39 weeks, the minimum gestational age to be considered full-term, but convenience isn’t one of them.

There are significant differences in health outcomes between babies born early term between 37 and 38 weeks, and those born full term at 39 weeks to 41 weeks.  For example, a baby’s brain will grow almost a third of its total weight between weeks 35 and 39

During weeks 37 and 38 of baby’s development: 

  • The baby may still be developing the ability to swallow and suck. Babies born at this time are at higher risk of having feeding problems.
  • The lungs may not be fully developed. The odds of an early term baby needing respiratory support are almost double that of a full-term baby.
  • The odds of the baby being admitted to the neonatal intensive care unit are more than 60 percent higher in early term babies than full-term babies

Some babies need to be delivered early. This may be because the mother or baby is at risk for complications. The goal is to support more informed discussions between patients and their doctors.

Choosing Wisely, an initiative of the American Board of Internal Medicine Foundation, includes over 300 care recommendations submitted by physician-led medical specialty societies to improve the quality of care and encourage conversations between physicians and patients about services which may be unnecessary and may cause harm. For additional information from Choosing Wisely, go to: http://www.choosingwisely.org/patient-resources/scheduling-early-delivery-of-your-baby/.

To download the Early Elective Delivery infographic from Excellus BlueCross BlueShield, click here: Excellus BCBS.

For a personal story from A Healthier Upstate, read this: Pregnant Moms Take Note: Sooner Isn't Better

For the BCBSA Health of America Report: “Cesarean birth trends: Where you live significantly impacts how you give birth,” click here: https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Nonmedically-Indicated-Early-Term-Deliveries.

 

For additional information, please visit the following websites:

New York State Department of Health:
https://www.health.ny.gov/statistics/vital_statistics/


Choosing Wisely | An Initiative of the ABIM Foundation:
http://www.choosingwisely.org/patient-resources/scheduling-early-delivery-of-your-baby/

The American Congress of Obstetricians and Gynecologists:
https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Nonmedically-Indicated-Early-Term-Deliveries


JAMA Pediatrics- Adverse Neonatal Outcomes With Early-Term Birth:
http://dx.doi.org/10.1001/jamapediatrics.2013.2581


March of Dimes-Less than 39 weeks toolkit:
http://www.marchofdimes.org/professionals/less-than-39-weeks-toolkit.aspx


Centers for Disease Control and Prevention:
https://www.cdc.gov/nchs/data/databriefs/db155.htm

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