Delivery

Photo courtesy of the March of Dimes

Despite wide-spread recognition that a baby reaches full-term at 39-40 weeks of gestation, nearly half of Florida consumers responding to a statewide survey indicated delivery before this time is safe. Nearly half of the survey respondents who had a baby in the past 18 months reported being offered the option of scheduling an induction or C-section by their health care provider.

The survey was conducted by the Florida Association of Healthy Start Coalitions (FAHSC), Inc. as part of a three-year effort to raise consumer awareness about the importance of the last weeks of pregnancy. Funded by the March of Dimes Florida Chapter, the “Think 39 Weeks: Healthy Babies are Worth the Wait” initiative is aimed at reducing the number of early elective inductions and C-sections in the state.

Unless it’s medically necessary, delivering before 39 weeks of pregnancy can pose risks for both mothers and babies. Both consumer demand and medical practice have contributed to increases in early elective deliveries, which have been linked to a rise in late preterm births and NICU admissions. Early delivery also impacts healthy brain development and infant morbidity. Unless there’s a medical problem, waiting for labor to begin on its own is best.

According to the March of Dimes:

During the last six weeks of pregnancy, a baby’s brain almost doubles in size, adding vital connections needed for coordination, balance, learning and social functions.

Babies born early have more learning and behavior problems than babies born at 40 weeks.

Babies born early have more feeding problems because they can’t coordinate sucking, swallowing and breathing as well as full-term babies.

Babies born early are more likely to have breathing problems.

Babies born early are at higher risk of a sleep-related death.

More than 85 percent of the survey respondents stated that a baby is full-term at 37 weeks or more, with 60 percent correctly indicating 39 weeks or later. However, 45 percent stated that it was safe to deliver earlier than 37 weeks. Nineteen percent of pregnant respondents said their doctors presented the option of a scheduled delivery, as did 49 percent of women who recently delivered. Nearly 40 percent of survey respondents agreed with the statement, “In the last 3-4 weeks of pregnancy, a baby is already fully developed and is just getting bigger.” Despite acknowledging risks to the baby of delivering early, more than half of the respondents agreed that “it is OK to schedule deliveries a week or two before the due date as long as a pregnancy is healthy.” A majority of respondents (60+%) cited prior pregnancy complications and doctor recommendations as appropriate reasons for scheduling a delivery. Only 15 percent though convenience was acceptable. For additional findings, read the full report.

The consumer survey was implemented by Healthy Start Coalitions in Miami-Dade, Broward, Palm Beach, Hillsborough, Sarasota, Lee and Santa Rosa Counties. The 276 respondents represent consumers statewide in terms of race/ethnicity; half were privately insured and half were uninsured or covered by Medicaid. Respondents were either pregnant or had delivered a baby within the last 18 months. Most of the respondents (43%) were 24-29 years old with one-third having a college education or higher.

The results of the consumer survey will be used to measure the impact of the statewide campaign which will employ a variety of strategies, including social media, to get the word out to childbearing families. For more information on the initiative, visit our homepage, continue reading our blog, and follow us on Facebook and Twitter.

According to a new study by the National Institute of Health, women are spending more time in labor that they did 50 years ago.

After comparing almost 40,000 births from 1959-1966 to almost 100,000 births from 2002-2008, researchers found that labor was, on average, about 2.6 hours longer for first-time mothers who had given birth in recent years. For women who had previously given birth, labor lasted about two hours longer.

Women from the contemporary group were about four years older than those from the 1960s group and also had a higher body mass index than the earlier cohort of delivering mothers. Babies from the contemporary group were born an average of five days earlier than those born in the 1960s, but were slightly bigger and healthier at birth.

Though these factors may have influenced the increase in delivery times in recent births, the researchers concluded that much of the change is likely due to changes in obstetric practices.

Medical intervention during delivery was much more common among women giving birth in the 2002-2008 group. Only four percent of women delivering in the earlier cohort received epidural anesthesia, compared with 55 percent in the contemporary group. About 12 percent of women in the first group received oxytocin to induce labor, compared with 31 percent in the contemporary cohort. The study also found the rate of cesarean delivery was four times higher today than it was 50 years ago. Oxyctocin, which is commonly used to induce labor and speed up the birthing process, may not always work and can thus lead to unplanned cesarean births.

These findings mirror recent concerns that more and more deliveries are being electively induced prior to 39 weeks of completed gestation. Research shows that babies born prior to 39 weeks are at greater risk for both immediate and lasting health problems. The Florida Perinatal Quality Collaborative is working to eliminate elective deliveries prior to 39 weeks of completed pregnancy in Florida by placing hard stops in Florida hospitals to prevent the scheduling of deliveries prior to 39 weeks without a medical reason, including the standardization of oxytocin usage protocols. For more information on the initiative, funded by the March of Dimes Florida Chapter, click here.

Florida Consumers Say Early Baby Delivery is Safe

Study Shows Childbirth Takes Longer than 50 Years Ago