To ask if you'd accept or reject early caesarean

[Helpplease14]

I'm booked in for a caesarean at 39 weeks but my consultant has now suggested pushing the caesarean forward to 38+2 (tomorrow) due to me not currently being able to feel the baby move. On the monitor the baby is fine, but I've had an issue with movements since day one and an anterior placenta and go through periods of feeling the baby move lots and then some days, nothing.

The pros to pushing it forward are obviously the baby being here safely, but the cons are having steroid injections, the baby not quite being 39 weeks, and the whole situation feeling a lot more rushed and stressed whereas everything felt calm having a set date next week. I'm just really conflicted about what to do. I may well start feeling the baby move again tomorrow but if I didn't I would go to the ward twice daily until I do begin feeling him again, or my section next week, whichever.

Can I ask what anyone on here would do? I'm really conflicted, and obviously want to meet my baby ASAP and I feel like that's clouding my judgement.

Also questioning the steroid injections, at 38+2 I’d be asking why they are necessary as baby is full term and should be absolutely fine without them.

Separate to injections - another one voting to bring it forward.

I had one at 38w2 as well. Absolutely no need to have steroid injections unless theres a specific reason. And 38w isnt early it's fairly standard time for CS where I am.

@Helpplease14 - Yes! She was moving on the monitor and I couldn't feel her. It's just not worth the risk.

I'd listen to the health professionals and do it. They wouldn't suggest it for shits and giggles

I had reduced foetal movements but like you i went on the monitors and baby would be active.
I had a c section at 36 weeks and it turned out my placenta was not formed properly which caused the problems (but this can only be detected after birth)

I think it's definalty better to get baby here earlier if they are advising it.

And why wouldnt you listen to the actual professionals? They wont suggest it for fun .

I would have an earlier section
My son was born at 37 weeks+1 day
I was induced due to severe spd and I never had any steroid injections

I think you’re being irresponsible to ignore the medical advice. Don’t know why you’d want to chance it. I had a c-section at 37wks due to preeclampsia and didn’t need steroid injections.

Personally I would bring it forward.

The steriods are to help with lung function, as babies born by elective CS are at slightly more risk of respiratory distress, thought to be because the fluid on the lungs isn't 'squeezed out' in the same mechanism as a vaginal birth. However, its worth remembering if you were 38 weeks and in spontaneous labour and needed a CS they absolutely wouldn't delay it to give steroids!

Please don't dismiss your reduced fetal movements or dismiss their importance - it can be your baby telling you something is wrong.

Good luck OP, I hope you have a lovely birth!

Move forward

I had an elective c section at 38+4 I declined steroids as baby was at term. No medical reason that was just when they could fit me in.

I'm scheduled for a c section at 39+1; there's a chance the consultant may want to bring it forward to 38+1 which I would be absolutely fine with. I appreciate it is slightly different as I'm only 34 weeks now so have a bit more time to consider. I generally feel though that, once you get to 37 weeks, baby is safer out than in if there is any risk of complications.

Steroids speed up the maturation and development of prem babies lungs. By 37 weeks they’re are fully mature and so steroids are largely not needed. They don’t help with respiratory distress due to csection and gunk in the lungs.

Never heard of a baby born at this stage needing steroid injections or a baby born by ELCS needing them either!

You’re literally five days away from being 39 weeks. Babies are born at 38 weeks all of the time, it’s a normal time to be born. I’d do it personally without hesitation.

I work in a field that requires me to have a lot of knowledge about the evidence base for Maternity procedures though I am not a Midwife or doctor.

As your baby is moving, it's only that you can't feel it due to the position of the placenta, I'd be inclined to go with a watch and see approach, as 38+2 is quite early if this is the only concern.

How comfortable would you feel going in for regular monitoring if you don't feel movement? What's your gut instinct?

Only you can make this decision. What others think isn't really relevant. Caesarean birth is major surgery with downsides, but your baby's Health is vital.

Why not ask to chat with a consultant Midwife and go through your options in detail? They can show you the evidence for both courses of action and answer your questions.

If you do choose a caesarean, ask about options for personalising it, with delayed cord clamping, music, skin to skin immediately after birth, etc. It can still be a lovely experience.

Good luck.

I also had a 37 weeker (via c-sec but went into labour naturally beforehand) who was absolutely fine and although I know it is unsettling to have a c-sec earlier than you’d planned (I’ve been there!) you need to look at why the professionals would suggest it and trust their experience and judgement. It’s only a few days and better to be safe than sorry. Good luck and enjoy meeting your little one x

Bring it forward if that is wahat the conultant wants. Mine were both at 35+5

I had an emergency section at 35 weeks. I'd bring it forward in an instant. The drs know what they're doing.

Bring it forward! 37+ weeks is term, steroids are probably not needed (but won't harm your baby if they do use them to be overcautious so please don't worry).

The risk isn't worth taking.

I would take the consultants advice and move it forward.

I had steroids for my sections at 36 and 38 w I was told before 39 w they offer them just in case as a v small number of babies have breathing difficulties under 39 w

I think this is one of those situations where it just comes down to clinical judgment of your consultant. Nobody knows for sure which is the best course of action, but it seems to me that the risks of having a c section are little different now than they would be a few days later. However the worst-case scenario is that your baby becomes distressed in the meantime, regardless of monitoring in the interim. If you were trying to avoid a c section, then I could understand waiting a bit longer, but you're going to be having one regardless, so why not just get it over and done with?

NICE guidance recommends steroids for all planned caesareans prior to 39 weeks. Discuss this with your consultant, obviously the risk is much lower at this stage, but there is evidence of benefit even at 38 weeks.

Both my DCs were born at 36 weeks (births were years apart). One weighed 5lb 4oz, the other 4lb 15 oz. Both fine and no steroid injections.

Christ almighty. Why are you even asking? Please bring it forward. Please phone them right now.