C section dates why so early

[LadyPug]

Hi everyone,

Just wondering why all elective c sections are booked before 40 weeks? I’m going for VBAC so if do end up with an elective c section it won’t be until 42 weeks. Is there a reason everyone has electives early? Thanks!

To reduce the chance of going into labour?

But most c sections are booked for around 39 weeks. I wouldn’t class that as ‘so early’

Balance of reducing the likelihood of going into labour before section date and therefore having to do emergence section, with risk to baby (negligible at 39 weeks). Also risk of stillbirth increases from around that time, whilst there is no benefit to baby to staying inside longer.

Oh I see! Makes sense to reduce chances of going into labour (if you don’t want labour, hadn’t thought about it from that perspective). I know quite a few electives booked around 38 weeks as well as 39 and since week 40 is best week for reduced still birth rate I just figured everyone would get booked in for 40 weeks. Really just wondered why I never hear of electives at 41 weeks, must happen though! Thanks guys

I'm not in the UK. My elcs was booked for 40 weeks but when I went in for pre op assessment they decided to do it there and then so it was 39&4 I think but on my second 16 months later they did it at 37 .I had a faster and better recovery then.

Wow that’s so interesting mrsnec thanks for sharing! 37 weeks has about the same stillbirth risk I think as 41 weeks so I’m guessing it must be down to individual circumstances when they choose to do it. I just want to go as long as I can to give myself best chance of natural labour but obviously within reason! Ha!

since week 40 is best week for reduced still birth rate eh? If a baby is still born, then waiting til 40 weeks won't change that. Having a c section at 39 weeks doesn't increase a risk of still birth.

If you want / need a c sec then you're going to get it booked in before the really high chance of spontaneous labour

I think they used to try and book them for around 37-38 weeks, as that was technically 'full term' but there was a lower risk of going into labour spontaneously (which could be dangerous, depending on the reason for the c-section).

Then a few years ago, a study showed much fewer breathing problems after birth if they waited until 38, preferably 39 weeks (IIRC) so they would try and book it that bit later. I was told this when I was booked in for my second section as I was surprised they wanted to wait until 39 weeks then.

Also - they have to book them into a free theatre slot, and they may not have much choice about when that is. I had to be added onto the end of a general gynae surgery list instead of the c-section lists, as there were no free slots in theatre until I was 43+ weeks!

Sorry sleeping not being very clear! Haha. What I mean is that the stillbirth rate improves eg decreases week on week from 37 to 40 weeks then it starts to increase again so the best time to have the baby (however you have it, not that we can control it) but statistically is 40 weeks so I just presumed c sections would be booked for then. Hope this makes better sense!

Thanks Roomba that’s so interesting. I didn’t even think about them being booked up either!

First was an emergency c at bang on 37 weeks, 2nd was a c section due breech baby, I asked it to be at 40 weeks because my first child birthday was very close to when they wanted to do c section. Explained this and there were no problems.

Yes my second one was about how busy they were too. I was worried it was too early but I had had enough of being pg by then. When they bought the date forward they guaranteed I was first. If I had gone for later they were doing another 6 that day.

I was just glad they didn't do it on his actual due date as that was leap day.

I had elective CS at 37 weeks ( 21yrs ago) as I'd had an emcs at 40+3 following induction
Was booked in for another elective CS for 3rd dc at 38 weeks (18 yrs ago) but he decided to arrive early at 35 weeks and I had a VBAC!!
( he was 7lbs, and perfectly healthy - I had steroid injection- just grateful I was able to deliver him naturally , goodness knows what weight he'd have been if I'd gone to term

LadyPug
What I mean is that the stillbirth rate decreases week on week from 37 to 40 weeks then it starts to increase again so the best time to have the baby (however you have it, not that we can control it) but statistically is 40 weeks so I just presumed c sections would be booked for then

But that doesn't work. If statically the chance of still birth is 4/100 at 37 weeks, 3/100 at 38 weeks, 2/100 at 39 weeks and 1/100 at 40 weeks then 2/100 at 41 weeks etc (obviously vastly distorted numbers) then it still doesn't make any difference when those babies are delivered as unfortunately those 4/100 babies will still die in the womb at 37 weeks. Keeping them in til 40 doesn't change that.

It might be that there are more still birth deliveries at 37 weeks but that's not the same as saying being born at 37 weeks has higher fatalities.

Are you suggesting that a 37 weeks delivery of a previously healthy foetus results in higher rate or infant mortality, dying during the process of birth? And to what statistical significance?
If the planned delivery of a healthy baby by csec at 37 weeks Foote no medical reason resulted in a higher risk of death I can't see that hospitals would allow it as it affects their scores so to speak

Ah yes sleeping I see what you’re saying. No I’m not saying that, I’m talking about stillbirth only (stats from AIMS) and so it makes sense what you’re saying because it’s about stillbirth and not post birth mortality. I just figured 40 weeks is the optimum time that baby is ready to face the world but I’m guessing maybe not. There must be reasons that c sections are delivered sooner (that’s what I’m here to find out!) for me, the reason these stats are so relevant is because I’m looking at going to 42 weeks and so I am considering these risks. What you are saying seems correct though!

Ok on agreement about me being right ;) that's what's confusing isn't it, so many stats saying apposite things and you just want to know what is best.

40 is deemed best because it's what's "normal" but in reality everyone its different.

If you want a planned c sec then you don't want to risk going into the "due, ready to push" stage so they plan before 40 weeks. Early term is 37 so they will aim from then onwards.

If it isn't too personal, why do you want to go to 42 and have a planned c sec?

The best you can do is remain vigilant. If baby's movements slow down a lot of stop, speak to someone. Don't think well it's fine, he's running out of space - he won't. You need to see someone and just get him checked. If everything else is good and he's good then I assume it's simply about when to for you in and remember that the chances of something going wrong are very very low with a straight forward pregnancy / baby

Haha so confusing sleeping you’re right! Oh no, I want a VBAC but if it doesn’t happen then we go to elective (no induction) so the reason for waiting till 42 weeks is to give the best chance of spontaneous labour. However I then started worrying as everyone is having their sections so early!

Ah that makes sense. Hopefully you'll go pop, agh, squeeze, ooh bang in time 😄😄😄

Ah that makes sense. Hopefully you'll go pop, agh, squeeze, ooh" bang on time 😄😄"😄

I had my first elective at 37weeks. This was solely to reduce the chances of me going into labour, due to previous complications it would of been dangerous to go into labour. This time im hoping to go a little longer hopefully to 39 weeks.

39weeks is optimum time to reduce risks to Baby of respiratory distress at birth but less likely to go in to labour. If you want a VBAC, Then you would book a section date later (if you don’t want an induction) to allow time for that

I'm actually concerned about how late electives are booked for! I went in to spontaneous labour with DS 1 at 37+6 (by hospital dates, 36+6 by my dates) and I'm worried that next DC I'll go into labor before they even book me in for my section!

Wellthisunexpected the problem is where else would you do them? Anything before 37 is officially prem. Spontaneous labour here at 35 weeks although I did end up with EMCS

sleeping there isn't an answer really as I won't necessarily go early with DC2, but in my circumstances having any amount of labour before my c section would be bad and due to my last experience I don't trust them not to act if I do go in to labour before my c section date. To be honest I'm actually talking myself out of TTC as I don't want to give birth again!

😢