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38 wks vs 38+5?
16 replies to this topic
Posted 21 April 2017 - 01:56 PM
C section scheduled for 38+5
I am so over it and have asked to be scheduled at 38 weeks exactly.
OB hasn't said no, but has said I may need a steroid shot to ensure everything is ok and has advised that if I can manage it, I should aim for 38+5.
Does 5 days really make a difference once you hit 38 weeks? I thought it was full term?
What would you do??
Posted 21 April 2017 - 02:07 PM
There was an article recently that linked to a study that suggested it does make a difference - from memory there were overall improved outcomes for waiting that additional week - i will see if I can find it.
Posted 21 April 2017 - 02:10 PM
There is no medical reason. My first 2 were elective c-sections as they were both breech. Both born at 38+something to avoid me going into labour naturally.
This last one is in the correct position (maybe that's why it is so uncomfortable).
I thought it would be fine but when he mentioned the steroid shot this morning, I felt guilty at the thought of even pushing to go earlier...
Posted 21 April 2017 - 02:59 PM
Mine were 37w5d (cs due to labour and footling breech)
37w5d (eviction cs)
36w3d (cs after labour started)
Even my 36w3d baby was only kept in SCN overnight due to protocol and discharged 7am the following morning.
Posted 21 April 2017 - 03:08 PM
Every single day after 37 weeks lessens the chance your baby will have respiratory distress issues post delivery.
Delivering at 38 weeks however is not regarded as high risk...it is term and the majority of babies do perfectly well.
There is very little to gain by having steroids in the last 4 weeks or so of pregnancy so I think it odd for a doctor to suggest them at 38 weeks ?
Posted 21 April 2017 - 03:35 PM
if there were no medical reasons I would definitely wait. Especially given the ob has warned you of the possibility of needing extra care. You have made it this far....only 5 more days! (From someone who very overdue x 2)
Posted 21 April 2017 - 03:57 PM
It really sucks having a baby in special care. There's no bub next to your bed to peek at or watch sleeping, no bub to show to friends and family (easily). You potentially need to do some expressing. It's just a bit disappointing after such a long build up.
Posted 21 April 2017 - 04:29 PM
At the hospital I work at they always attempt to book elective Caesars at 39+ weeks.
If an elective Caesar is booked before 39 weeks for whatever reason, steroids are given.
This is a new protocol at our hospital to avoid RDS.
Posted 21 April 2017 - 04:41 PM
I'm having an early CS at 38+1wks on Monday for DS2. This is for medical reasons as I had severe pre-eclampsia with DS1 (who was born at 30wks) & is to minimise the risk that it develops again. I had my 1st steroid injection today & will have the 2nd tomorrow. I'm really really hoping DS2 won't need to go to special care & can come strait to the room with me as I obviously didn't have this experience with DS1.
I think if there was no medical reason I would wait as long as possible. I've been feeling awful the last week with heartburn, nausea, insomnia & pain, but knowing im so close to delivery is getting me through. I really feel for the women who go overdue!
Posted 21 April 2017 - 05:13 PM
My elective caesar 25 years ago was 37 1/2 weeks because it was important I didn't go into labour outside hospital, if at all possible.
She had jaundice, which I understand is now one of the things that they say make good reason to wait the extra days.
Posted 21 April 2017 - 06:15 PM
My first was an "elective" (due to three previous pregnancy losses) at 38 weeks, scheduled early because my ob was going on holidays... I trusted everything would be fine, because, hey, specialist and all that.
Our daughter went straight to SCU for three nights with RDS. Barring medical need for early delivery there is no way I would go through that again. It was horrendous. She was on IV fluids, constant monitoring and needed expressed colostrum fed via syringe. The first few days, we could only hold her for short periods before she had to go back in her oxygen crib.
This time around I have a new ob who won't go less than a week before due date for planned caeserean deliveries (will obviously do emergency earlier if required). We are booked for 39 weeks on the dot.
Posted 21 April 2017 - 08:24 PM
It has become standard best practice to not deliver via elective cesarean before 39 weeks now due to the increased risks when there's no medical reason to do so. Basic risk benefit equation. Technically Full-term is now defined as being 39 weeks or over with those born 37-38w 6 d being classed as 'Early term'. Because early term babies seem to have such a distinct risk profile as compared to later term the distinction is important. Neurodevelopment issues exist too in the risk profile for early term babies vs full term not just immediate issues like RDS.
In other words, your OB is doing the best they can to mange you and your baby's care as there is actually a small benefit to steroids even up to this late. There is a difference in a week.
So try to hang in there. Is there some things that you can plan, people to see that can help you get through?
Posted 21 April 2017 - 08:40 PM
The new standard is to get to 39 weeks if possible, and although it is dangerous for me to go into labour naturally my OB was happy to wait until 39+2 to deliver DD. I went into labour at 38+6 so that's when she came and all was well. My OB's concern is for the baby's lungs and also that their suck reflex will be stronger at 39 than 38 weeks. 38 weeks is now considered "early term", and I wouldn't risk it if there were no medical reasons. That said I'd do 38 weeks in a heartbeat if need be, the likely outcome is extremely positive.
Posted 24 April 2017 - 07:17 PM
My boys (3.1 kg and 2.9 kg) were born at 37+1 by c-section due to late stage pregnancy complications. They didn't have breathing problems but they did need ng tubes for a few days as they weren't strong enough to suck for very long.
There weren't any steroid injections (maybe because the decision about the c section happened in the morning and the c section was that evening).
From this thread seems like lots of different outcomes for many different reasons - talk to your dr and then make the right decision for you and bub.
All the best
Posted 24 April 2017 - 08:46 PM
Hey guys, just wanted to update you all that I had my 1st steroid injection on fri (37+5wks) then went into labour later that evening!
A 2nd steroid dose was given about 12hrs after the 1st & Ethan was delivered by CS on Saturday morning (at 37+6). So far he's been absolutely fine - no need for SCN!
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