Monday, November 28, 2011
There are a variety of reasons why expectant parents might want to schedule their baby’s birth earlier than 39 weeks into pregnancy. If it’s not discomfort, then it might be a desire for predictability. Picking a time to deliver a baby, whether by C-section or induction, allows out-of-town relatives to make travel plans and could prevent a middle-of-the-night rush to the hospital.
Yet births scheduled too early put the immediate health of the child at risk and could pose long-term problems as well. The March of Dimes hopes to increase awareness of those dangers with its Healthy Babies are Worth the Wait campaign, which encourages holding off until at least 39 weeks to schedule a delivery or otherwise letting nature take its course. “A lot of the hospitals are just starting to tackle this issue, but this is something we’ve made a priority in our health system for the last four to five years,” says Deona Ryan, director of Women’s Services at Summerville Medical Center (SMC).
By the spring of 2007, Trident Health System (THS) had stepped forward as a leader in this area as part of a pilot project for its parent company, HCA Healthcare, in partnership with the March of Dimes. As a result, neither SMC nor Trident Medical Center (TMC) allows deliveries to be scheduled before 39 weeks, unless there is a medical reason. Pregnancy is technically considered “full-term” by 37 weeks, so the effort has required educating eager parents about the benefits of being patient.
THS Neonatologist Arthur Shepard, MD, treats newborns requiring special care, and he explains that not all babies are prepared to leave the womb at the same point in pregnancy, regardless of size. The fetus continues to develop and mature through the last trimester and ideally goes through several important last steps before entering the real world, with the most critical involving the lungs.
“If you spring labor on the baby, the baby may not be ready,” Dr. Shepard says,
“even if you think the calendar says so.” Babies who arrive unprepared might require longer hospital stays with specialty nursery care, even mechanical ventilation. That’s not only expensive but can cause obstacles to early breastfeeding and bonding. Overall, children born before 39 weeks are prone to the following: • lung and breathing problems, including respiratory distress syndrome • jaundice • gastrointestinal tract disorders • cardiovascular and blood problems • vision and hearing problems, including blindness and deafness • long-term developmental disabilities including cerebral palsy, language disorders, learning disabilities, attention deficit-hyperactivity disorder (ADHD), motor skill and coordination disorders • future behavior problems, plus social and emotional difficulties.