What’s the Rush?

Reality Rounds has been posting on different issues with her role as a NICU nurse, and a recent comment inspired this post. The post itself was on the realities of prematurity, and the struggles that the babies (and their parents, nurses, and doctors) face when they’re born too soon.

The comment was from a mother whose two children were both born early — at 30 and 31.5 weeks. She relates:

As a side note, one day when my second was still in the NICU, I was taking the elevator up to the NICU floor and another NICU mom was in there with me. There were a couple of pregnant women going to see their OBs on a higher floor and they were lamenting that they wished their babies would just come *now*. As the elevator doors opened at the NICU floor, the other NICU mom and I gave each other knowing looks and as we walked out the door, we simultaneously said “No, you don’t.”

Yes, indeed! I remember what it’s like to be “great with child,” getting anxious for the pregnancy to be done, to meet the baby, to no longer have him kicking you 24/7, to get your body back, to not have your back hurt any more, etc., etc. But you don’t really want your baby born too soon!

I think it may would probably cut down on the numbers of elective inductions (and requests for early inductions or C-sections that are not medically indicated), if women were to be given a tour of the NICU sometime in their second trimester (much like they might take a tour of the L&D unit prior to giving birth), so that they could see the realities of premature birth. And it doesn’t even have to be really preterm birth — even slightly preterm may have problems, as At Your Cervix attests:

A [fetal lung maturity] test was done and showed “mature” levels for a recent “near term” gestation infant. Baby was delivered. Guess what? Baby had respiratory distress shortly after birth and was sent to the NICU. Baby was NOT ready to be born. The lungs were NOT fully ready for life outside the confines of his former uterine home. One can only wonder how much brain growth and development was also lost, from not having the last few precious weeks in the womb.

[Make sure you read all the comments at AYC, especially “Lonely Midwife.”]

Plus, there is research to show that babies born by elective C-section at 37 weeks have double the risk of problems as those born at 38 weeks; and the 38-weekers have double the problems of those born at 39 weeks. So, what’s the rush?!?

I don’t know. Have we gotten so arrogant, that we are doing what Jeff Goldblum’s character said in Jurassic Park? — “Your scientists were so preoccupied with whether or not they could, they didn’t stop to think if they should.”

Obviously, doctors will not induce before 36 weeks for no maternal or fetal indication. At least, I hope that would not be the case! So, it’s not like most preemies are intentional. Yet, if a baby is born before his due time, but is born just because “well, it’s term, and you’re tired of being pregnant, so why not?” he will likely have complications that he would not have had, had birth started naturally. While the worst and most difficult NICU stays are likely to be unavoidable, there are some that could be avoided — like the one AYC mentioned — by waiting on nature. What’s the rush?

6 Responses

  1. Are most premature births related to elective inductions?

    • No, they are not — as I said in my last paragraph. However, enough doctors are willing to play fast and loose with elective inductions (at 36-39 weeks) that the subject should be discussed, and mothers should know that the likelihood that their child will end up in the NICU due to problems with prematurity of one sort or another, goes up as the gestational age of the child goes down.

      The problem is enough that the average length of pregnancy is no longer 40 weeks but is 39 weeks, with more and more doctors and mothers willing to induce at 37 and 38 weeks for no reason. (Also, they are unwilling to go much beyond 40 weeks, inducing mothers who likely would have gestated to 41-43 weeks, again, with no maternal or fetal indication.)

      I don’t have a problem with necessary inductions or C-sections; it’s all the unnecessary ones that introduce risk without benefit (unless one considers not having to waddle for another week or two to be a sufficient benefit for one’s child having to be in the NICU for several days or possibly for a few weeks).

  2. Mmm, I read that but if doctors do induce at 37 weeks or above, a woman can very easily give birth to a 35 weeker.😦
    Of course, these premies aren’t intentional but I do think, based on accumulative reading, that most are a result of mismanagement.

  3. This article was appropriate for this discussion — hospitals cracking down on elective inductions. About time!

  4. That is great!
    Now, I hope it will also work that way. Papers can be changed and all…😦

  5. […] childbirth educator/doula community has long commented on how one reason the prematurity rate has risen in the past years is because of all the early […]

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