When is too early for a Caesarean?

[~Emma~]

I had a Doctor's Appointment up at my local hospital today and was discussing my caesarean with the Doctor (who for ages was trying to talk me out of having one). From the start of this pregnancy, I was told that my caesarean would be on the 19th of December when I was just 38 weeks. Today the doctor tells me that 38 weeks is too early and now I have been pushed back to the 27th of December.

So when is too early? I thought any time from 38 weeks was okay - Doctor said babies get too distressed at 38 weeks.

And apparently you cant be induced after you have had one caesarean (cause I asked him to induce me instead if he didnt want to do the caesarean).

The date my baby is born doesnt particularly worry me (cept I have bought all his Christmas presents already :rolleyes: ) I have just imagined all pregnancy he would be here before Christmas :)

[cwsmum]

I always thought 38 weeks was fine too...maybe your dr is just being careful and wants to leave bub in for as long as possible.

Can I ask...why are you having a caesarean? Is there a reason you aren't waiting to go into labor naturally?

[annb]

Well god knows what planet your Dr is on....I had my DS#1 by elective c/s at 38 weeks and in 2 weeks time will be having DS#2 by c/s at 38 weeks as well, my obs never said it wasnt safe, in fact that was the date he suggested i work from!

[Stretchmark Diva]

Maybe just being cautious? I know that at say 37 weeks more baboes have breastfeeding problems than say 40 weekers. Perhaps your earlier date was when you were "just" 38 weeks and he wanted to give the baby a couple of extra days?

Basically I dunno :rolleyes: you'll have to ask your OB!

[tickle]

The later you can have it the better. Babies are cooked from then on, but only if they decide to be born then. Caesarean babies are much more likely to have breathing problems and need special care as sometimes they just aren't ready to be born. I had my c/section at 38 weeks, but that was mainly due to the fact that it would be dangerous for me to go into labour.
Honestly, I would much rather an OB who was over cautious about my babies health than one who would just do it at 38 weeks because they can.:)

[Rainbowbrite]

What Tickle said :yes:

Naturally, bubs are born when they are ready to be born, whether its 38 weeks or 42 weeks. MJ was born at 38 weeks, i went into labour & she was just ready to make an appearance without any interventions.

Goodluck with your decision

[kirstenriley]

Both my c/s were at 38 weeks, i thought that was pretty much the standard time for a c/s???

[Lila]

emma,
ditto what tickle said, the longer the better.
i was induced with no.2 (after my waters had broken and nothing happend) but ended up with another em. cs (with an uterus rupture!) rather then my soooo longed for vbac.
this time around i had a ele. cs (med reasons) and they booked me in for exactly 38 weeks. but for me as well, it was very risky to go into labour, so they had bubby out pretty early.
i would appreciate the fact your doc gives bubby a couple more days- it is better- at least thats my opinion :yes:
good luck:thumbsup:

[bekkyboo]

Most C/S they want to get in before a real chance of going into labour... So between 38 and 39. Mine was booked in for just before 39. I went into labour with G at 37 weeks, they didnt bother stopping it...

[~Emma~]

Thanks for your replies :)

I had a caesarean last time after they induced me and I failed to progress at 41.5 weeks. So this time around, I felt choosing a caesarean was the best option for me. Don't get me wrong, if I go into labour before my caesarean and things are progressing I wont be even mentioning having a caesarean.

(I am working on the theory that if i go into labour by myself this time things will progress :fingerscrossed: )

The doctor knows this and is happy with my decision. I guess I just dont want to run the risk of them having to induce me again, being in labour for however long and then having to have a caesarean anyway.

So in short, if i go into labour by myself with no intervention I will have bubs naturally. But if it hasnt happened by the 27th of December I am choosing to have another caesarean.

I am grateful that bubs will have another week to cook - just since the time i was 14 weeks pregnant I was told that he would be born on the 19th of December. So now I have to add a week onto my countdown....

Only 3 weeks and 6 days to go :party:

[tickle]

I'm glad that you've come to a decision you are happy with. It's hard sometimes when there's something we've been waiting so long for and for someone to tell you you have to wait longer again, it can drive you nuts!
Hope you have a wonderful experience.:thumbsup:

[Bronwyn]

Good luck Emma with your birth (whichever way it happens).

I had a c/s at 37 weeks, was booked in for 38 weeks but had pre eclampsia and was getting dangerous so he decided to do c/s under general at 37 weeks. Got a phonecall at home one morning to say come to hospital you are having this baby today...great way cause there was no sleepless night the night before the planned date. The best part was that I left hospital with her the day that I was meant to be having her.

Good luck

Bronwyn

[becca74]

If I ever had to have a scheduled c/section, and there wasnt some health issue threatening to kill me or my baby, I would insist upon waiting until I go into labour naturally, as at least I would know my baby is ready to be born.

Iatrogenic prematurity really freaks me out :eek: ! I would feel so guilty to pull my bubba out and steal those last days he/she needs inside my body.....:gloomy:

From: http://www.transitiontoparenthood.com/ttp/birthed/duedatespaper.htm




Iatrogenic Prematurity. In cases of elective cesarean section or medically-indicated induction, a serious risk is iatrogenic prematurity: a baby that is premature because the interventions were performed too early due to error in determining gestational age. This could be prematurity in the more typical sense: if the estimated date of conception (based on LMP) is significantly wrong, then the baby would be delivered prior to 38 weeks of age. It could also be any infant who had not reached full maturity, regardless of weeks of development. “Thus a preterm birth can occur even at the 42nd week just as a postterm birth is possible even at the 38th week.” (Klimek)

Incidence: It has been estimated that 10% of the time the gestational age based on LMP is significantly inaccurate. In some studies, as many as 10% of admissions to neonatal intensive care are due to inadvertent iatrogenic prematurity. (Clewell) Shreiner et al. examined a sample of 47 infants that developed respiratory distress syndrome following elective abdominal delivery “at term.” The mean difference between the gestational age determined pre-natally (by methods such as LMP or ultrasound) and post-natally (by clinical exam) was 2.6 weeks, +/- 1.6 weeks.

Ways to reduce risk: some hospitals and groups (e.g. ACOG, College of Physicians and Surgeons of Manitoba) have established protocols to determine fetal maturity before elective cesarean. These require clear documentation of gestational age based on multiple indicators such as: clear menstrual history, prenatal exam records, Doppler record of fetal heart tone for 30 weeks, more than 36 weeks since a positive urine pregnancy test, and ultrasound estimates of gestational age performed before 20 weeks. If these data are not available, then they recommend amniocentesis: amniotic fluid analysis of the lecithin-to-sphingomyelin (L/S) ratio and phosphatidylglycerol to provide evidence of fetal lung maturity.

Allowing the woman to go into spontaneous labor before c-section would also markedly reduce the risk: The risks of iatrogenic prematurity and lung disease for those infants delivered by elective cesarean before labor are 30 percent versus those born by cesarean after labor begins (11 percent). (PCRM)

[theycallmemum]

I'd wait as long as you can. I've had a c/s at 37w3d and my baby spent 9 days in the NICU with wet lungs. This time we waited until 39w1d and my little boy was perfect and didn't spend anytime in the NICU.

I know it seems like it's only 7 days or so but that can make a big difference to lung maturity.