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Baby Wellness: Scheduling a C-Section

Mamas-to-be who plan on scheduling their babe's birth to coincide with a special day or one that is convenient need to think again. A new study of American births shows that babies do best when they debut no earlier than seven days before their due date. Even a few days can make a difference in the child's lung development. One report said:

The rate of Caesarean sections in the United States is at an all-time high, accounting for about 31 percent of births. There are lots of reasons: older moms, multiple births, the threat of malpractice lawsuits, the preference of mothers and doctors and the risks of having a vaginal birth after a previous Caesarean.

Other complications of infants born at 37 weeks included infections and low blood sugar.

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vegasstef vegasstef 8 years
I know a girl who had to be induced for insurance reasons. She was past her due date and they said they would not cover her unless she gave birth within the next couple of days but after that they couldn't cover. So she got induced and then the baby was in distress so she had to have a c-section. The baby was also born with undeveloped lungs and had to be on oxygen for 6 months after it was born. The mother believes that if she just had the baby on the baby's time that she wouldn't have had the problems and had to have a c-section. The mother said when she was born she was 3 weeks late. I was also 3 weeks late when I was born--they day before my mom was supposed to be induced. I guess now the time frame is different then it was back then.
SuzieQ3417 SuzieQ3417 8 years
While I don't agree with the practice, I can see why some doctors push for the scheduled c-section. Anyone who has followed around an OB for a few days quickly sees how tiring the job is, how sleep-deprived they often are (how often they are sued for things completely beyond their control), and why they might choose scheduling a c-section at 8am when they are well-rested rather than delivering someone at 3am after hours and hours of labor. I don't have any kids and likely won't for a good 2-5 years, but it seems kind of obvious that you would want the baby to "cook" until they're ready. I can't even imagine how uncomfortable the last trimester becomes, but you owe it to the baby to keep them growing/maturing until they're ready. Hopefully the docs will start to realize this and lessen their pressure on unsuspecting women. Who knows, maybe we'll stop relying strictly on due date to determine what constitutes "full-term", and begin to develop other tests that determine when baby is ready to arrive. Wishful thinking? :)
nevadamtnbear nevadamtnbear 8 years
It may come across as judgemental, but you're applying it as a blanket statement to *all* women. I'm referencing what I've personally observed for the past 6 weeks or so on a particular message board, where there have been extensive discussions relating to the benefits of a child *cooking* until at least 39 weeks, where there's been enough premies born of to the women on the board, and heartache from the mothers having to leave their babies at the hospital in NICU. Then you see, women who are so ENVIOUS of those who've already had their babies and are saying their tired, uncomfortable, sick of being pregnant, etc. and even though they _know_ it's better for the baby to gestate longer, they're willing to start doing things (like taking Castor oil) to bring on labor at 36 or 37 weeks and are approaching their doctors about trying to get an early induction scheduled. To that end, yes, I may be a bit judgmental in this situation. I don't judge woman who don't know better. I believe the doctors are responsible for helping to educate their patients, and we're contantly learning more and new information is becoming available. Shoot, so much is different this pregnancy for myself than four years ago with my first.
facin8me facin8me 8 years
As I said above, "the facts" are really only now being flushed out with data. If you would have asked a doctor last year about having a baby at 37 or 38 weeks, they probably would not have had a problem with it. If the women are depending on those doctors for advice, they are ignorant of the facts as you and I know them, but they are not ignorant or reckless with the baby's welfare as implied above. If doctors disregard the recommendations of the NEJM study and the one from Pediatrics last month, then yes, they are ignorant. The good news is that when doctors are educated about the recent findings, they stop doing inductions and c-sections before 39 weeks and you see a huge drop in NICU stays!
Greggie Greggie 8 years
Well the fact is, many are ignorant of the facts. I don't necessarily blame them, but if they are totally uneducated on it, they are ignorant. It's up to their doctors to educate them. It's not judgmental to say a woman doesn't know the risks. In the end yes, the doctor is the truly ignorant one who disregards the risks, which is not the woman's fault.
facin8me facin8me 8 years
You're right, Greggie. Most of the posts here are not judgemental. I am mostly responding to nevada's assertions seem to indicate she believes that pregnant women are driving the early scheduling: "But, the frightening thing (to me at least) is the ignorance and/or disregard many women have for the development and wellbeing of their baby because their *uncomfortable* *want the tax break before the end of the year* *tired of being pregnant* etc." Calling these women ignorant and such is judgemental. If these women are being advised by their doctors that this kind of thing is safe, that is a reflection on the poor healthcare that these women have received.
Greggie Greggie 8 years
Yeah she's not a bright woman. Obviously her doctor isn't either. facin8me, I still don't see anyone judging the women, harshly or otherwise. The tone of the thread is disbelief at doctors, not women. Except my sister-in-law. But seriously, I hold her doctor to blame. She could've told my sister-in-law no or at least educated her.
luckyme luckyme 8 years
I would not have gone for an early induction. No way. No how. I do know several people that have done their own methods at home to try and get baby out early too. Someone I know used Castor Oil and that ended badly for her. 25 hours of labor and still had a c-section. And she said it was um, messy. She just had her second and went for a successful vbac sans any at home methods. Greggie- your sister in law sounds awesome :P. She's not going to let a silly inconvenience like the birth of her child rearrange her schedule! Ha. People are funny.
facin8me facin8me 8 years
All of the people who I know who discussed early induction with their doctors were told the same thing: no. People around here are told upfront by their doctors that they won't induce without medical need because of the likelihood that the the delivery will end up as a c-section. But we could compare anecdotes all day...it's just a reflection of the different communities we are exposed to and the attitudes towards childbirth contained within them. I guess we have lost sight of the study and what it has shown: as for women having C-sections at 37 weeks or 38 weeks, until this recent NEJM study and one before it, most people (mothers and doctors) were not fully aware of the risks because most people consider 37 weeks to be full term (early, but still term). So for people to be judgemental about women choosing a c-section during this time period is misguided. To be sure, most of the women who have "elective c-sections" are women who are having repeat c-sections due to complications during a previous labor. Technically, there is no medical need in most cases to have a c-section if a subsequent pregnancy is uncomplicated, but many doctors won't perform VBACs and the women end up having to go the surgical route. If these women know in advance that they will have to have a section, and their doctors are telling them that 37 weeks is safe, why are we judging these women so harshly?
Greggie Greggie 8 years
My favorite inductions have been my sister-in-law's. She decided at 38 weeks with her first that since they were estimating an 8 lb baby, she wasn't going to wait another two weeks for a 10 pounder. Rather than clarify that they meant 8 lbs at birth or anything else, her doctor scheduled the induction. That one went fine. Her second, she was sick of being pregnant, again at 38 weeks. He ended up with a broken collarbone because he moved up rather than down and had to be forced out. Third, she wanted her husband to be able to play a summer league baseball game. That time, she ended in a c-section. I obviously have no problem with medically indicated inductions and c-sections, considering I've had both.
MissSushi MissSushi 8 years
and to clarify, i DON'T see anything wrong with c-sections when they are needed. I will perosnally request a c-section with my second child becuase of all of my complications with the first that resulted in me nearly dying. I just agree that if you're going to do things at the conveinence of you or the doctor, either way, you shouldnt do it too early, it should be 38-40 weeks, or if you naturally go into labor. I refused the induction with my first, and gave birth at 38 weeks when i started labor naturally and my water broke.
MissSushi MissSushi 8 years
My original point, was by successfull, i meant, most end in c-sections. But, i was referring more to early inductions, before hte body is showing any signs of readiness, just for doctors conveinece. Not for situations like yours, or my good friend whos amniotic fluid was drying up. Doctors just dont turn down people who wish to be induced, and more often they suggest it before anyoen asks, whether for medical reasons or non medical like my doctor with her talk of vacations, tax refunds, etc. My sister was induced becuase she was rapidly gaining weight and they were afraid she would have a huge baby, or so they said.. they also long before then pushed the whole, oh you wnat your OWN doctor right, etc type things. She was dilating and effacing, so my sister wasnt as worried, but sure enough she ended up with the baby in distress and a complete lack of further dilation halfway through. Ruh roh, c section time.
luckyme luckyme 8 years
MissSushi - I was successfully induced! My daughter went overdue by about a week and the doctor indicated that there were no signs of her coming at all on her own (she wasn't dropping down, I wasn't dilating, no contractions, etc.). I scheduled the induction and it really wasn't all that bad. I wouldn't have tried to go before my due date, and my doctor didn't even bring it up until I past my due date.
Greggie Greggie 8 years
Also, just so I'm clear, I do not blame women for requesting early dates for either childbirth method. The number of doctors who allow it is what alarms me. I had trouble finding a doctor who would allow me to go to 40 weeks with a repeat c-section. Now I'm hanging onto mine with everything I have.
MissSushi MissSushi 8 years
Honestly, I dont know ANYONE who approached their doctor to be induced earlier and was shot down, they always agree. My sister has a group of several pregnant women friends due dec/jan, with differnet doctors, and they all discussed their doctors pushing them to induce early. My doctor told me she "might be on vacataion" when I go into labor, and tried to talk me into inducing at 36 weeks for several appointments before hand. Its not uncommon at all.
Greggie Greggie 8 years
C-section rates are rising at an alarming rate and it doesn't take much to realize that medical reasons can't be on the rise at the same rate.
nevadamtnbear nevadamtnbear 8 years
Facin8me - my point/issue which is admittedly a digression from the original subject, although related, is relating to the timing of the scheduling of these procedures. Whether it be a *schedule* c-section (and I see a difference between and "scheduled" and an "elective" cesarian), an induction or what not. The timing of these procedures and when women begin requesting them and are now getting them in many cases (early more often with a cesarian vs. an induction).
Greggie Greggie 8 years
The records show it differently because drs have to code it medically for most insurances to cover it. Doctors aren't going to put "needed to make golf game" on the insurance form.
fsquaash fsquaash 8 years
Who are these doctors that schedule C-sections/inductions so early? I had twins and my dr. suggested 1. A Vbac and 2. A C-section between 39 and 39 weeks. None of my friends have successfully scheduled such early births. Friends I know who've asked for early deliveries were denied by their doctors. Also, I think moms have a right to CHOOSE. Not just to have/not have a baby but also how they want to have it. If a woman can have a homebirth with no medical equipment, than I certainly can decide to have my child surgically. It's my body, I'm paying for it, and they are my children.
facin8me facin8me 8 years
Yes, lilsugar, but talk and reality are often two completely different things. I also know many women who talked about wanting to be induced early, but many times that was just out of frustration from being pregnant for so long and wanting it to be over with. Those who actually approached their doctor to be induced were shot down. But like I said above, anecdotal evidence is no substitute for facts. And neither is media hype.
facin8me facin8me 8 years
Anecdotal evidence from an internet chat board does not substitute for facts. The percentage of c-sections with no medical indication are quite low- I've read around 0.7-2.0% from various sources. The reason we think that there is a increase in maternal request c-section is because it is something the media is talking about more often which gives the impression that it is something on the rise. And when the media discusses this trend (like lilsugar does here), they place the blame on the mother. As as greggie has pointed out, it is often the doctor that is driving inductions or c-sections that have no medical necessity. I found this article to be informative when I read it a few months ago: http://www.rhrealitycheck.org/blog/2008/06/27/the-myth-elective-csection
Moms Moms 8 years
facin8me — the link in the beginning of the post connects to other lilsugar c-section coverage including a story (based on a Time Magazine piece) about women choosing c-sections. Articles aside, I hear moms talking about scheduling their due dates for their or their doctor's convenience all the time.
Greggie Greggie 8 years
A novella but very well said. :)
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