Worth the Wait: A Look at Early-Term Elective Deliveries

By: Jennifer Thew, Former National Nurse Editor at Nurse.com
Jennifer Thew, RN

Jennifer Thew, RN

I swore I would have an easy pregnancy. I took prenatal yoga and was planning to use hypno-birthing techniques rather than an epidural. But life doesn’t always go as planned.

About 29 weeks into my pregnancy, my blood pressure began to steadily rise, but I didn’t have any other symptoms of preeclampsia. Still, I ended up with twice-a-week visits to my obstetrician, weekly non-stress tests, biweekly ultrasounds and some admissions for observation here and there. I was extremely worried about my baby. What if the hypertension caused developmental problems? Or worse.

I also got well-meaning but not very reassuring words of advice from all sorts of people. At the top of the list was, “Oh, you’re past 32 weeks. You’ll be fine.”

I was shocked so many people would take such a cavalier attitudes toward an early delivery. But, it’s not that uncommon for people to be, uninformed about the risks associated with early-term deliveries — especially those that are non-medically indicated. For this reason, Nurse.com will be exploring the topic of early-term elective deliveries.

Perhaps this is because there have been such huge advances in neonatal care. Now, infants born as early as 24 weeks gestation have a chance to survive. Because of these advances, the public may mistakenly assume if a woman has had a low-risk pregnancy there’s no harm in a non-medically indicated early delivery between 37 and 39 weeks.

Statistics show otherwise. As rates of these deliveries have increased, so have neonatal complications such as respiratory distress syndrome, feeding problems and the need for ventilator support. These infants also have death rates three times higher than infants born after 39 weeks, according to the March of Dimes.

The March of Dimes and the Association of Women’s Health, Obstetric and Neonatal Nurses have begun  campaigns to educate healthcare professionals and the public about the dangers of elective early-term deliveries. And many hospitals have implemented policies to decrease rates of these deliveries.

Nurses, and not just those who specialize in obstetrics, also can educate patients about the importance of forgoing elective early-term deliveries by explaining the risks of these types of deliveries to women of childbearing age, soon-to-be parents and grandparents you know.

At one of my many prenatal visits, I asked my obstetrician how much he thought my daughter weighed. He explained gestational age at birth was much more important than birth weight and that we would do our best to get me as close to 40 weeks as possible. Just a few days shy of 37 weeks, I ended up having an emergency cesarean section (she was also breech) when my blood pressure reached 195/125 and I had four plus protein in my urine.

Fortunately my daughter had no complications and seems to be developing right on target. In my heart, I feel she had a good outcome because we waited as long as we could, without risking both our lives, to deliver her. A healthy baby is definitely worth the wait.

Learn more with our CE course, Late Preterm Infants Need Special Care.

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