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.

Are there really long term peer reviewed studies of 37 weekers suggesting strongly that what you say is true?

Yes, I agonised for weeks over this decision and did a lot of research.

The differences between 37 weekers and 40 weekers are noticeable throughout life.

There will always be individuals who buck the trend, but at population level, there isn't really much room for debate.

I think the doctors want you to make the decision, because of this "sue" culture that we live in now. When I was 39 weeks with my DD, I had a hind water leak, and the doctor asked whether I'd like inducing or just to wait until I went in to labour naturally. I had no clue what was best, and he didn't seem to want to advise. In the end I asked him "what would you tell me to do, if I was your daughter", and he said "I'd tell you to get the baby out now", to which I replied "let's do it".

It's hard for you though, as you are getting conflicting advice!!

Until recently in the UK elective lscs were done from 37 weeks. Then research showed an increased risk of RDS so now not done till 39 week unless medical need. But you've had steroids which reduces chance of RDS. I'm not sure evidence for adhd or autism link is strong.

This was the study that made the final decision for me

TL:DR

We observed a gradual increase in IQ from 37 to 40 weeks of gestation

Darling the best outcome is a safe baby and a safe mother. If this is what your doctors have suggested, how are you being unreasonable? I have had three babies from two c-sections under general anaesthetic. They are 13 and 11 now - all healthy and happy and I do not feel like less of a woman for not having given birth the "natural" way. (In fact, now that I am at an age where my friends who did give birth naturally are having reconstructive surgery on their bits and incontinence issues, I feel quite pleased that things worked out the way they did!)

37 is when c sections are planned for twin pregnancies (I had one). It is not a premature anymore after 37w.

I have a pair of 37 weekers they're fine.

Do you know the sex of baby? A 37 week girl is more "term like" than a 37 week boy IME. Boy was sleepy with a poor latch but overcame it quickly.

GP here. Had my twins at 36+4 because twin1 had stopped growing. I was desperate to get them out while the placenta was still functioning as once it stops working there's no going back.

It's always a judgement call but at such a late stage of pregnancy I'd listen to the Dr who wants to get baby out. It's safe to deliver at 37 weeks and if there is any concern about placental failure then I would say let's get moving.

All the best OP and enjoy those delicious milky cuddles 😊

i had an ivf planned c section at 37 weeks - high risk pregnancy.
baby & me fine & healthy. 5 years on no problems with my child and would do the same again.
the early section was for my health not for baby who was fine.

Just wanted to send hugs OP, I have been where you are and know exactly how terrifying it is. My situation was slightly different in that it was to do with being super overdue but the fear of stillbirth/placenta failure was almost unbearable. I still remember it as one of the most stressful times of my life and hated the fact it seemed like ‘my’ decision. Hang in there and look after yourself.

Oh and try and stay off Google! That way madness lies.

My first was born at 38+0. I went into labour spontaneously at 37+5. I felt pretty much from the beginning that actually he'd have needed to be in longer. He was sleepy, had jaundice needing phototherapy, and we had a nightmare getting bf established as he refused to feed for the first few weeks (I topped up/expressed/persevered and we got there after a month). He was very light and skinny, but then he still is. My second and third were born at 40+8 and 40+10 respectively and they just seemed a lot readier for the world. That said, I a) can't corroborate the 'lower IQ' thing at all - my 38-weeker is a very bright boy - and b) don't want to discount the risks associated with your pre-eclampsia. The difficulties with my first pale into insignificance compared to some of the potential outcomes there. I think IIWY I would be feeling I'd try and hang on to 39 weeks if, and only if, I felt completely assured of close and robust monitoring and immediate access to care if I felt something was going wrong. And I think before making that call I would want to speak to someone specialised in pre-eclampsia first.

Whatever you decide, good luck.

thank you everyone. I really am driving myself mad here. IT's weird how having a little bit of control is actually more stressful than letting someone else just decide. I just looked at the study on SEN. It looks as though 6 out of every hundred 37 weekers go on to have a diagnosed SEN as opposed to 5 (approx) of every 100 38 weekers and 4.5 out of every 100 40 weekers. Which in a way doesn't seem that different. But even just reading the stuff is making my blood pressure go up!

Thank you so much to everyone for your lovely supportive words.

I had an ELCS at 37 weeks. I asked my consultant and she agreed readily. I was going through ante-natal depression and an in patient at a mother and baby unit. Had been in same unit with severe PND with my first baby.

Great birth. No problems with the baby.

Oh sweetie
I hope you and baby are well. Some very good advice above.

If I were you I would
(1) Book elective c-section ASAP. If any doctor / midwife / nurse etc challenges it, say that it was recommended and that you are following that recommendation because of the risk of still birth.
(2) Once you have made that decision, just be happy with it. Tell yourself that anxiety is not good for you or the baby or your partner (if you have one).
(3) Enjoy your birth. I have given birth both ways and the elective c-section is a fabulous option.

FWIW I almost lost my eldest due to doctors giving me choices at the end of the pregnancy. (I was stressed and declined a c-section and regretted it deeply.)

Don't take a risk on losing your baby.

Also, I just read the end of your post. What poor advice from that second doctor. Yes, 'early' birth is clearly associated with (very minor, totally manageable) lung issues. My third child had this (c-section at 37 plus a bit days). They are kept in the nursery for 2 days while you have a good sleep.

But the rest (autism, ADHD) is pure speculation.

Sending you a hug and best wishes for a healthy baby.

With all 3 of my pregnancies I was not permitted to go beyond 38 weeks. My eldest was due 21 April and I went into labour

That is so unfair of them to put that decision on you and give you conflicting information. They are the professionals and should be guiding you with consistent advice and best practice.

The information the doctor is giving you about learning disorders etc. is not evidenced based. There would not be enough to say that would cause it and FWIW all of my DC were drug free Waterbirths at term. One is a high achiever with great marks. Two have dyslexia and struggle at school. A friends DC was a 23/40 twin and is dux of year 7. Another friend didn't know she was pregnant. Drank a lot of alcohol in the first trimester and that DC who is 7 has a reading age of 13, and her other DC where she did "everything right" find school difficult.

No one knows what causes LD, autism ADHD ect. We get what we get, of course there are things you can do to help reduce the risk but sometimes you do everything right and it still happens. And some people do everything wrong and have no problems. Please try not to stress, tell the doctor you want consistent advice and information from one provider.

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. I'd go with the Dr who said
benefits will outweigh the risks/ there is a risk of stillbirth etc because there is NO proof what so ever that c-sections cause fucking autism (not mad at you) or ADHD.

Incidentally, my 36 weeker is NT and my 39 weeker is autistic.

I'd have a section at 37 weeks.

Sorry, spotted mistake..

NO proof what so ever that c-sections, or early births, cause fucking autism (not mad at you) or ADHD

430 in that study (unless I’m reading it wrong) the confidence intervals include zero so it’s not stasticly significant

I’ve been in a similar situation OP. I developed pre-eclampsia at the very end of my first pregnancy (picked up when I went into labour at 39 weeks). When I had my second child last year, my blood pressure went up dramatically at 36 week antenatal appointment and I also had some protein in urine. They were going to deliver that day, but they managed to control the BP with meds and decided to try and hold on until 37 weeks, if BP remained stable. I got to 37 weeks and they decided to keep monitoring over the following week. I was told that I would probably be induced sometime during that week, but they were happy with BP and scans so they let me continue until 38 weeks. I saw a few different doctors during that period and they all seemed happy to deliver at 37 weeks, but all thought going beyond 38 weeks would be a risk, even though placenta/BP was fine at that point. One very experienced consultant said that he wouldn’t recommend going beyond 38 weeks as things could easily change (considering my history) and it wasn’t worth taking the risk.

I was induced at 38 weeks and son was fine. He was smaller than the scans had predicted (7lb rather than 9lb, so still a good weight nevertheless) and had hypothermia/low blood sugar when he was born (due to the BP medication I had been on during the last couple of weeks apparently). He was taken to the baby unit to warm up and they let him out again within a few hours.

I had severe PE but waited until 38 weeks to deliver on the proviso I was on hourly observations and if I deteriorated I'd go straight to theatre. I was hospitalised at 37 weeks but had it "mild" earlier than that. Several times I started being prepped and it settled a bit/baby started moving more so we waited.