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Going the Distance: Why reaching full term matters

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           At 37 weeks pregnant, you’re on the home stretch and eagerly awaiting the arrival of your baby. Your doctor warned you that these last few weeks of pregnancy would be the toughest. And she was right. You can’t sleep. You can’t get comfortable, and every five minutes you have to go to the bathroom. What’s wrong with just having your baby now?

            Gather your patience. Most doctors discourage elective inductions or cesareans before 39 weeks, which is considered full-term, unless waiting poses a health risk to a mom or baby.

            If everything is normal, “safety for baby comes first, and so 39 to 41 weeks is ideal as far as the growth of baby,” says Rabiya Suleman, OB/GYN, Overland Park Regional Medical Center. “Before that, we can’t guarantee that your baby isn’t going to have a NICU stay.”   

            The risks. Babies born before 39 weeks are at higher risk of suffering from breathing problems and other health issues.

            “For baby, one of the last organs to fully develop is the lungs,” says Raschelle Schowengerdt, OB/GYN, Meritas Health Obstetrics & Gynecology, North Kansas City. “Every week the baby is born early significantly increases the chance of respiratory distress after birth.”

            And that means an increased likelihood that your infant will need supplemental oxygen or respiratory support in your hospital’s Neonatal Intensive Care Unit (NICU). In addition to breathing issues, babies born prematurely may have more trouble eating and are at greater risk of developing jaundice.

            Necessary medical evaluation and treatment also can mean time apart from your newborn. “This disrupts bonding—a very crucial time in the cycle of the mom-baby dyad, and may be a source of anxiety and depression for them both at the time of separation and possibly later down the road,” says certified nurse midwife Eva Miller, APRN, clinical director, New Birth Company, Overland Park. Furthermore, Miller says this separation can negatively impact breastfeeding success.           

            Benefits of waiting. Going into labor naturally without medical intervention increases the chances that your labor will go quickly.

            “With an induction of labor, oftentimes multiple medications are needed to coax your body into labor. The process can last several days,” Dr. Schowengerdt says. “An elective induction of labor increases the risk of needing a cesarean by 50 percent.”

            What about scheduled c-sections? Or what if you choose VBAC? “Repeat c-sections we deliver at 39 weeks,” Dr. Suleman says. For women who choose vaginal birth after a previous cesarean (VBAC), she advises waiting for natural labor to occur to increase the chances of success.

            Medical interventions that can prevent preterm birth. According to the March of Dimes, preterm birth can cause lifelong disabilities for a baby, and often death. Women who are low in progesterone, which is a hormone that helps maintain pregnancy, are at higher risk for problems with conception, miscarriage and preterm labor. Let your doctor know at your first prenatal visit whether you’ve experienced preterm birth in the past. If so, your physician may recommend a weekly injection of 17-hydroxyprogesterone between 16 and 36 weeks.

            “It has been shown to decrease the chance of recurrent preterm birth by approximately 50 percent,” Dr. Schowengerdt says.

            What you can do. Healthy habits and a healthy lifestyle before and during pregnancy can also help prevent preterm birth.

            At your first prenatal visit with your health care provider, share your pregnancy history and discuss any drugs, vitamins or herbal supplements that you take, your emotional and physical health and your lifestyle habits.

            As soon as possible—at least three months prior to conception if you can—begin taking prenatal vitamins (available over the counter) that contain at least 400 mcg folic acid, which can help prevent brain and spinal cord birth defects.

            Maintain a healthy weight through a nutrient-rich diet and moderate exercise. Most pregnant women only need to add about 300 more calories to their daily diet. Exercises like walking, swimming or prenatal yoga can help you stay fit and strong and help you manage low back, hip and pelvic pain.

            Don’t forget to see your dentist. “Studies have found that women with infected gums/teeth are at higher risk for preterm labor,” Miller says.

            Avoid high risk sexual behavior or switching partners during pregnancy. “A sexually transmitted infection can cause the water around the baby to break early causing preterm labor,” Miller says.

            As always, notify your health care provider if you have any concerns during your pregnancy. “Something as simple as a UTI (urinary tract infection) can cause an expectant mother to go into labor,” Miller says. Symptoms of a UTI include painful urination, frequent urination, feeling of inability to empty the bladder, burning, and irritation that may or may not be accompanied by a fever.

            Above all, remember that you’ll reach the finish line soon enough. In the meantime, make every week count toward giving your baby the healthiest start possible to the marathon of life.            

Common reasons for early induction.

Your doctor may recommend an induction before 39 weeks if you or your baby faces health risks. Common reasons for early delivery include:

Source: Dr. Rabiya Suleman, OB/GYN, Overland Park Regional Medical Center

Freelance journalist Christa Melnyk Hines resides in Olathe with her family, which includes her husband, two active boys and a menagerie of pets.

As always, please consult your health care provider with any questions or concerns.

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