ELCS looming - doc says 38 weeks, but should I push to go to 39?

[gherkins]

Hi,

I am going to have an ELCS next month, after my last delivery just over a year ago ended up in an EMCS.

At my hospital, doctors like to perform ELCS surgery at 38 weeks, I imagine to minimise chances of women going into labour early.

However, I've since been reading lots of things online that suggest ELCS at 37/38 weeks are now no longer recommended, and that it's better to wait until 39 weeks, as the baby has less chance of suffering breathing problems. There seems to be quite a lot of data to support 39 weeks as being preferable for the baby.

My doctor is pushing for 38 weeks, seems rather unconcerned about the potential breathing problems issue, and isn't really into having long discussions with me about it (we are overseas, it's very much 'doctor knows best' in this part of the world). She says that as long as the baby is not too big, and that there are no signs of me going into early labour, she doesn't mind waiting until I am closer to, or at, 39 weeks though.

So - should I push to go to 39 weeks? Has anyone got any views on whether a 38 or 39 week delivery is better? Has anyone had an ELCS at 38 weeks who, with hindsight, thought it was too early? I'm of the view that every day inside helps, and want to do what's best for the baby.

PS: I know each birth is different, but last time I was hopelessly overdue, so I'm not expecting to go into labour early. Doctor says if I do go into labour between 38 and 39 weeks, I just need to get myself down to the hospital pronto!

I would say try to go for 39 weeks,espeicially if your first was late. I think there is evidence to suggest that before 39 weeks there can be breathing problems, like transient tachypnoea. Mine were and are going to be done at 39+2 and 39+3 because of my dates and the days they perform elcs in my hospital. Perhaps have a google and see if you can go armed with the hard evidence, they might be more amenable that way. I dont thing there is a huge issue with going in to labour beforehand, my hosp said just ring them and go in and they would check and do the cs as a sort of emergency case. HTH.

Thanks ClockingOut, that's very useful to hear.

I definitely would feel more comfortable waiting until nearer 39 weeks.

Anyone else have more info on this?

Take a look at the NICE/RCOG guidelines, they say planned CS should not routinely be undertaken before 39 weeks. I gogled c section guidelines.

I'd go for at least 39 weeks if you can. Here in the UK I managed to get mine put back to 40 weeks, dd's due date, and am very glad I did - babies put on weight more efficiently on the inside than on the outside to start with, and dd was smallish even at her due date. I begged for an extension as I didn't feel she was ready to be born/didn't feel anywhere near labour when it was booked when I was 37 weeks (dd was breech). They pointed out that by doing that I could end up with an 'emergency' cs and had to accept the risks of that (in their words, there are statistically more complications from surgery done in the middle of the night, it could be more rushed, etc.). All was fine though.

Sorry for mini hijack - could anyone link to the guidelines/information on breathing problems for pre 39 week sections? My elcs will be 37 weeks at the latest (am only 16 weeks atm). Thank you.

Had my CS at 39wks even thoughDD1 was a month early. They talked about potential breathing probs before 39wks and weren't concerned about labour beginning earlier. They ensured I knew all symptoms of early labour and would go straight in if I had any signs. DD2 is now 6wks

I had my ELCS at 38+2 for various reasons and DD was fine and a reasonable size.

The risks of breathing difficulties are slightly higher at 38 than 39 weeks though at 39 weeks is considered around the optimal time at present
--- but the risks are really very low at 38 or 39 weeks so don't worry too much about this

Thanks so much for all the advice and info.

It seems that - although any risks are tiny - it might well be worth waiting until week 39, unless if there is any complication that means the baby needs to be born earlier.

Not sure how much sway British medical guidelines will have in this part of the world, but it's good to know what ideally should happen under British guidelines.

Thanks again. Appointment with doctor next week - fingers crossed!

Just thought I'd say DD1 was born by CS at 36wks and had no related probs so I'm sure you'll be fine either way. Good luck x