Strollerderby

Barb: Apparently docs schedule them early often for convenience, especially so they're not taken by surprise by an early labor, but also to avoid holidays, mothers' or docs' vacations, etc.

Chiken: I am not an expert, so I don't know about the stress of an "emergency" c-section, but I do know that if labor doesn't start, mom and baby miss out on the benefits of oxytocin. Still, 39 weeks is full term, so it doesn't sound like you need to worry.

gpgirl: Yes, I would be hesistant to hand the decision to insurance cos. I think it would make a difference if the insurance companies just made docs justify the timing and then took their word for it if they said it was necessary. Some would make something up, I'm sure, but at least the point would have been made that scheduling a c-section pre-term was something that needs a pressing medical reason.

I had an emergency C-section with my daughter, ad for lots of reasns scheduled one with my son -- who was due right after my OB's 40th birthday. You can see where this is going, right? I could have scheduled it at 38 weeks or right on my due date, but the OB would be on vacation in  between then. I had read, right here on SD as a matter of fact, the risks of 38-week elective C-sections so opted to wait. And I am so glad I did -- he's had a ton of colds and I am glad he had those two extra weeks of lung development. I think they generally like to do them at 39 weeks so you don't end up going into labor on your own if you want or need a c-section. I would have felt OK about 39 weeks but 38 just didn't feel right.

I'm with the mothers who would worry about what an insurance company would deem "necessary." I wouldn't advocate for anyone to do a C unless she has to, of course, but insurance companies already have a track record of refusing to cover plenty of VERY NECESSARY health services. My friend had a horrible delivery with her first child, he was too far into the birth canal by the time they realized they should have done a C, he ended up with dislocated shoulders, she had excessive bleeding the ended up needing a D&C . . . the works. So she ended up scheduling a C for her second child. Ironically, her second child was a petite little thing, and the doctor said she probably would have delivered her fine if she'd gone vaginal . . . but they didn't know. But if an insurance company had that power, they could walk in, look at the chart, and say "hey, why did they do a C with this woman, she didn't need it..." Aach, sorry, I just hate insurance companies!

gpgirl: There's a study cited in the op-ed that talks about pre 39 weeks vs post 39 weeks. Sounds like Amy read other stuff too.

Jeanne: As I said above, I think it should be up to the docs to document necessity, not the insurers to judge it. And I definitely don't mean don't insure scheduled c-sections, just not unjustified pre-term one. But it is hard when you can't trust anyone to make their decisions based on best interests of kids or moms.

Sarah: Thanks for the tip. That's worth a post of its own.