Scheduled C-Sections: Too much control can be dangerous

The holidays have arrived. I know it because my iphone told me today. The calendar reminder that helps me remember birthdays and other important stuff today read, “Begin Holiday Preparation.” I love my smart phone. I love planning and organization. I love any amount of control I can have over an otherwise fun-filled, sometimes crazy life. So, when I hear a mom say she wants to schedule the delivery of her baby, I get it. With so many things out of our control, anytime we can exert control it is very tempting.

So, why should a mom endure the serendipitous adventure of labor and delivery when she can schedule a c-section? You know, schedule a C-section and schedule all that goes with it: the start of her time off work, the babysitter for the other kids, the plane flights of parents who live out of town.  When you think about it, a scheduled C-section, especially a couple weeks before the due date to prevent an unscheduled, inopportune onset of labor, sounds like a really intelligent decision.
So, why not? Because infants born at 37 weeks are considered premature. They are not as developed at those born at 39 or 40 weeks. The earlier a baby is born, the higher the likelihood he will need to be admitted to intensive care, will have trouble breastfeeding, won’t be well enough to go home when his mom leaves the hospital, will have a lower IQ. Basically, the more likely he will not be as overall healthy as a term infant. We used to think a couple weeks didn’t matter. We used to think, “35, 36, 37 weeks gestation versus term at 40 weeks, no big deal” Now we know, it does matter. In fact, it matters a lot.

What about waiting until term and then having a scheduled C-section? Again, we used to think that was ok. We used to think there wasn’t a difference in the outcome whether the baby was born vaginally or via C-section. Now we know. Babies born via C-section don’t benefit from the biochemical cascade that starts in the mother in response to contractions and cervical change. That biological waterfall results in changes in the baby’s body that make her more prepared for life outside of her mother. We are just beginning to learn of all the good imparted by those changes. We have already learned, babies born via C-section struggle more from a breathing standpoint than babies born via vaginal delivery. We know that some term babies born via C-section will be very sick. Babies that, if born vaginally, would not have been sick.

I had a C-section at 33 weeks gestation. I was pregnant with triplets and my body was decompensating, so it was time for them to come before their lives were at risk. For many very good reasons, yourOBmay deliver your baby early or via C-section. Talk to your doctor about what that list includes. Really talk about it.

When you are very large and very miserable, remind yourself, the “C” in “C-section” doesn’t stand for convenience and convenience shouldn’t be the reason to deliver early or via C-section.

 

 

Kelly Ross, M.D. About Kelly Ross, M.D.

Kelly L. Ross, MD is an assistant professor in the Department of Newborn Medicine at Washington University School of Medicine in St. Louis and a pediatric hospitalist at St. Louis Children’s Hospital. She also serves as Director of Pediatric Hospitalist Medicine at Missouri Baptist Medical Center. As mother of premature triplets, Dr. Ross’ clinical interests include multiple birth, neonatal prematurity especially the late preterm infant and post partum depression, especially as it relates to high risk pregnancies. She is the Medical Director of Mothers of Supertwins (MOST), an international organization that exists to support families who have triplets, quadruplets or more. Dr. Ross is also a member of the MOST professional advisory board. She has co-developed two educational videos about multiple birth families, has been featured in a TLC documentary about a family of quintuplets, interviewed by Newsweek, Pregnancy magazine and various other local news programs and is currently editing a book for couples expecting triplets or more. Dr. Ross is featured on a monthly email from Babycenter.com and along with her hospitalist group, runs a health information discussion group on momslikeme.com. Dr. Ross served as a consultant on a National Institute of Mental Health-funded grant to educate medical professionals about post partum depression.

Connect with Dr. Kelly Ross on Facebook: ChildrensMomDocs and

Comments

  1. I loved reading this and wish every mom and ob would read it. My babies were born prematurely and both had minor problems the first week after their birth. (we were very lucky) It breaks my heart when I hear moms scheduling c-sections or inductions early for convenience. I wish my babies could have that extra 5 or 3 weeks in the womb.

  2. Love!!

  3. Thanks for this! I am going to have a scheduled c-section (after a failed induction turned c-section and a failed VBAC because I didn’t go into labor) in October. I charted before conception mostly so I could get the baby a couple extra days inside. My doctor said 39 weeks is standard for repeat sections, but I managed to get him to move my due date 3 days later.

  4. Thank you for this. I am an OB nurse. My first was born at 36 weeks by c-section because my water broke and the cord prolapsed. I begged and pleaded and fought to be allowed to VBAC with my second. In the end my doctor didn’t want me going past 40 weeks, and took her by c-section on my due date. With my third, I was willing to do almost anything to be able to VBAC. I found a doctor who was willing to take me on, and was willing to let me go as late as 41 weeks. At 40 and 5 I vaginally delivered for the first time. The differences in the way my body responded were amazing. The way my psyche responded was even more amazing. I can testify first hand that a vaginal delivery trumps a c-section for me every time. And I had a lot of issues post partum.

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