WIBU to have an early elective c-section at 37 weeks

[beclev24]

Please be kind. This is really stressful. I am posting here for traffic as I have to make this decision really quickly and wonder if anyone has a view/ expertise.

I am 36 and a half weeks pregnant after several cycles of IVF. The pregnancy has been relatively uncomplicated so far but considered high risk- I am 43, had IVF and had low Papp-A which can indicate weaknesses with placenta and high risk for pre-eclampsia.

Earlier this week, I had v high blood pressure and some protein in my urine (levels considered borderline for pre-eclampsia)- they decided to deliver the baby the next day by c-section after giving steroids for his lungs etc. I was admitted to hospital. But then, my blood pressure came down, my blood results normalized and I was allowed to go home on bed rest. One doctor is telling me that I should get to 37 weeks and then have a c-section because the benefits will outweigh the risks/ there is a risk of stillbirth etc. Another doctor is telling me that 37 weeks is too early and it increases risk for all kinds of things- eg lung problems/ disease etc but also autism/ learning difficulties ADHD.

It's up to me to decide whether to try and go a little bit longer, to keep the baby inside as long as possible or to get him out now. WWYD?? I have no idea what to decide- feels like so much pressure and I'm filled with anxiety. Does anyone have any personal experience or knowledge on this? Please help if you can. Thank you.

There are risks with having a planned c section early and it is now considered safer to wait until 39 weeks for section eg in the case of breech/ previous section ie healthy baby.
Your baby is potentially going to be compromised by preclampsia so the considerations are different.
I would be like you o think wanton my child to be out unless scanning and blood tests could convince me otherwise. Have you got a foetal medicine or neonatologist to ask?

I personally wouldn't- the risk to a 37 weeker born via csection halving breathing trouble is higher then that of a 37 weeker born vaginally.

I was supposed to a have a planned section at 37 weeks due to previous stillbirth caused by undiagnosed placental failure in an ivf pregnancy. In the end I went into labour at 35 weeks and my baby was born by emergency section as I did not want to risk going through labour. He does have autism but so do 2 cousins who were full term.
If you decide to wait I would want daily doppler scans and a section straightaway if there is any reduction in movements.

This is far far too important to be seeking advice from mumsnetters

You need to be seeking a third and fourth medical opinion

OP - not a doctor, just too much experience of them

My baby was born via csection at 37+4 as she was booked in for an elective 3days later but my waters broke so they got her out then instead. Nothing wrong with her at all she's incredibly smart and advanced in fact. Of course someone else may have the same story but their baby does suffer from a number of issues. Personally I'd do it op yes there may be risks but they will be low- also of course you don't want to put your baby at risk but surely anything is better than the alternative? A dear friend of mine had a still birth and I'd never wish that fate on anyone. Good luck op I'm sorry you have to go through this stress

What is your gut instinct telling you? Do you feel he's safer in or out?

My first baby was an emergency section at 35 weeks due to foetal distress, was being monitored for worsening pre eclampsia. Month NICU stay for grade 4 IVH. Worst time of my life.

Second baby was always going to be an ELSCS, pre eclampsia symptoms started again circa 34 weeks, was regularly monitored, and at 37 weeks my symptoms started to worsen and I felt very instinctively he needed to come out. Begged, pleased, argued, sobbed hysterically at day unit, until someone rang the senior obgyn on the golf course and he agreed I could go in the section book for the Tuesday. Saw my own consultant on the Monday who just said "You're really worried now, aren't you? Ok, see you in the morning."

DS was fished out at 37+3, was 2.5lb heavier than scan a week previous indicated (he was 10lb12!), my placenta was fucked, and his blood sugar levels dipped to the absolute minimum allowable before NICU admission before starting to rise again. He did develop jaundice so we were readmitted for 24hrs when he was 4 days old, but he was fine. He's now nearly 8, completely healthy and wonderful.

But I'll never forget my consultant coming onto postnatal afterwards and saying "you told them, didn't you Welsh? You knew". And I did, I knew he needed out.

So what do you think? Does your baby need to come out, or is he ok to cook a bit longer?

^^ Not everyone's instincts are right.

Basing it on what you've said, I'd go with the c section at 37 weeks.

My DS was born at 37 weeks and wasn't considered preterm.

He was sleepy and a bit jaundiced but it cleared up at home within a week.

I had an ECS on New Year's Day. If there is a risk of an emergency on Christmas Day I'd go for having the section this week. US might be different but New Year's Day was chaos and I can't imagine Christmas Day being any better. No Consultants around, no physio when I had problems, they were even short of clean sheets.

I do hope it goes well whatever you decide.

I had to deliver at 37 weeks and was told that it's considered full term. No problems whatsoever

The reality is that there are risks either way and so which feels right to you? I agree with a PP that I'd get more medical opinions.

I had a planned c section at 37 weeks. I was given steroid injections 2 days before to develop babies lungs but when he was born he struggled to breath. He was transferred to NICU for a week. He was also always a very sleepy baby.

He is now 2 and a half and has significant development delay and is currently being assessed by pardiatricians. Of course I will never know if the early birth had an impact on his development but if I could reset the clock I would try to wait til 39 weeks.

That being said I didn’t have pre eclampsia or any other pregnancy conditions that would have increased the risk of still birth so baby would have been “safe” to stay in a little longer.

I've had pre eclampsia twice personally of be in for the c section now.It's unpredictable and potentially serious to both of you

thank you everyone for all your experiences/ thoughts. I guess the truth is that there really are pros and cons of each. I don't know if I can trust my instinct because it keeps changing- one minute I'm convinced he needs to come out ASAP, the next I feel like I'm failing him by not giving him the best chance to stay in as long as possible. Plus the pregnancy hormones etc, this really is so hard. thank you again for all the support

(I was in a similar boat btw, and opted for c section at 39 weeks on the nose)

...and there is a big difference between birth at 37 weeks, and 40 weeks, despite both being considered 'term'

430West I have to disagree. My son was born at 36.5 weeks. He passed all of his exams (standard grades/Highers and Advanced Highers) at A Grade. He is currently at Uni studying an extremely difficult degree and doing well. He is extremely academic, to the point that I can't quite believe that he's mine!

430 this baby may be born at 37 weeks, not 27... Are there really long term peer reviewed studies of 37 weekers suggesting strongly that what you say is true? I suspect any difference by 37 weeks is miniscule, not to mention that the environment in the womb leading to early delivery may be a factor, and cannot be altered.

Ha, 430, you might want to say that in front of my cousin who was born at 28 weeks and is a Cambridge-educated barrister...

I really feel for you OP, what a tough decision to make. Like previous posters, I think you need to ask for another medical opinion.

I had a baby in NICU for three weeks, he was full term but needed surgery. NICU is a really full on, intense, awful experience that has a permanent effect on you.

I would be concerned about a baby born at 37 weeks but I am not qualified to balance the risks.