Your Pregnancy Matters

You’re ready, but is your baby? Why to wait until (at least) 39 weeks

Your Pregnancy Matters

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A couple recently delivered their baby girl at UT Southwestern after waiting at least 39 weeks of pregnancy.

You’re uncomfortable. Your back hurts, and you can’t seem to get a good night’s sleep.

The nursery is complete, the new baby clothes are washed and the diapers unpacked. But you are still a few weeks from your due date.

Forty weeks can seem like an eternity when you’re pregnant, and the last few weeks are the longest. It can leave you asking, “Why can’t I just have this baby now?!”

All the discomfort and fatigue during the final weeks of pregnancy have more women in the United States and Europe opting for “early-term” deliveries – ones that are planned two or even three weeks before the due date.

In 1990, only one in five women delivered their babies between 37 and 38 weeks gestation. By 2006, almost one in three babies were delivered at that gestational age, mostly for non-medical reasons.

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Why an early-term delivery isn’t the best option

Electing to deliver early can negatively affect a baby’s development for years to come. A tremendous amount of brain development takes place in the final weeks of pregnancy. Sometimes, these early-term deliveries cause more complications to the baby or mother.

Although neonatal death rates in the United States are very low at 37 weeks, the risk of death at 37 weeks is double the risk of death at 39 weeks. Just because you know friends or family who had a baby at 37 weeks without complications doesn’t mean there aren’t risks.

Ironically, some of the same women who do everything “by the book” during their pregnancy want to deliver early when facing the discomfort that comes at the end of their third trimester.

Many risks for early-term deliveries

Delivering your baby two or three weeks before the due date poses the following risks:

Risks to the mother
Risks to the newborn
If you have your baby early and don’t have any immediate complications, some long-term effects are still possible. Studies, for example, suggest early-term babies face an increased chance of delayed verbal development or hindered math performance in school.

Most hospitals have a policy against elective delivery before 39 weeks. Likewise, some insurance carriers won’t pay hospital or physician bills for elective births before 39 weeks. Obstetricians are usually open to elective induction of labor after 39 weeks, and repeat cesarean sections are routinely scheduled at that time.

Of course, situations arise where we recommend delivery before 39 weeks because of risks to the baby and/or mother. In these cases, we have determined, based on individual circumstances, that the risk of carrying the baby to term outweighs the risks involved with early delivery.

  • Higher possibility of cesarean section
  • Increased bleeding after delivery
  • Longer hospital stays
  • Higher risk of respiratory problems
  • Higher rates of infections
  • Increased chance of needing care in the neonatal intensive care unit, rather than sharing a room with the mother
  • Higher risk of death

Do your research, then relax

We always recommend that parents-to-be inform themselves as much as possible. Great resources are available, including the March of Dimes website, which show the week-by-week development of a baby during pregnancy. Hospital and insurance carrier websites also may have information about policies on early induction and rates of early delivery at your local hospitals.

As you approach those last few weeks, spend as much time relaxing as possible. Don’t worry if the nursery isn’t perfect or if you haven’t written all of your thank-you notes. Splurge on a few big pillows to help you get comfortable in bed, and grab naps when you can. Accept all offers of help that come your way. And remind yourself that the trade-off in putting up with your discomfort could well be significant short- and long-term benefits for you and your baby.