Women have been told for years that a pregnancy reaches full-term at 37 weeks. “After that, so the story goes, you could give birth at any time and not really worry about the complications of preterm delivery,” Robin Aronson wrote back in December. She noted then that “On the heels of new data showing higher rates of respiratory problems, pulmonary hypertension and admissions to neonatal intensive care units for babies born at 37 and 38 weeks than those born at 39 or beyond, doctors in Florida and other states are stopping the practice of elective early induction.”
A new study to be released in the June issue of Obstetrics & Gynecology echoes the idea that giving birth before 39 weeks is dangerous. According to TIME, infant mortality rates “are halved by waiting until at least 39 weeks rather than 37 weeks to give birth.”
The study is the largest to confirm a message that public-health agencies and professional medical groups have been eager to spread: early elective deliveries are a bad idea. “Up until the last several years, we thought term pregnancies between 37 and 41 weeks were the same,” says Alan Fleischman, medical director at the March of Dimes. “This is not the case. It’s a biological continuum. The new data makes us pause and realize we ought not intervene unless there’s a very good medical reason.”
Of course, there often is a very good medical reason to induce labor or schedule a C-section before 40 weeks. But, TIME says, “the new research highlights the importance of not scheduling delivery electively before 39 weeks at the earliest, which dovetails with a recommendation from the American College of Obstetricians and Gynecologists.”
Some in the media have accused various actresses and models of being “too posh to push,” and as a result scheduling elective C-sections at 37 weeks to avoid abdominal stretching. Posh herself, Victoria Beckham, says all of her C-sections took place under doctor’s orders. (And let’s be real, if these women wanted to avoid abdominal stretching, they wouldn’t have gotten pregnant in the first place.)
But TIME suggests that there’s an even more compelling reason doctors have scheduled so many elective C-sections in the past few years: money. Rochman says, “Doctors want to be able to better control their schedule, eliminating middle-of-the-night deliveries and ensuring that they — and not one of their partners — delivers a baby since the delivering physician often receives the bulk of [insurance] reimbursement.” Oy. Rochman notes that “Earlier this year, the March of Dimes called on hospitals to actively combat the surge in early elective deliveries by requiring proof of medical necessity from doctors scheduling such procedures.”
I can’t help but wonder how long it will be before there are state laws against scheduling non-medically necessitated C-sections. What do you think? Is a law required?