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Original poster

Steroids for c section at 37+4…needed or not?

26 replies

Moominmiss · 29/08/2021 16:46

So I’m currently 36+6 with baby number 4 and booked in for a c section at 37+4.

This will be my fourth c section. My first was emergency, but my second and third were electives, both done at 38+2 and no steroids were given for either. Although my third was 7 years ago and I know things in my trust have changed over the years.

This pregnancy I developed GD at 28 weeks and since 30 weeks I have been insulin dependent.

Originally, before the GD my consultant wanted to do my section at 39 weeks, but because of how much insulin I’m now on she wants baby out sooner rather than later and booked me in for 37+4.

My trust now says that any section performed before 39 weeks requires 2 steroid injections given 24 hours apart.

I’m due to go in this week for my 2 injections and I’m actually petrified.

It sounds pathetic seeing as I’ve managed to get through elective sections, spinals etc. But I’m terrified of needles. It can take me up to an hour each evening to build up to injecting myself, and each time I do it doesn’t even hurt, I can barely feel it.

But of course I’ve done what nobody should ever do and google what the steroid injections are like and all I’m seeing are women saying how painful they are, the worst injections ever etc.

Even the midwife I saw that booked me in for them did tell me that they’re not pleasant. I always think when the actual medical professional tells you they’re not nice, then they must be bad!

It’s getting me so worked up that I’m starting to question whether I really need them. Of course I will get them if it’s what’s needed and what’s safest for baby, but it seems mad that the baby would be considered full term tomorrow, yet I’m having to have steroids for them being born on Friday.

Has anyone else got any experiences of having steroids, or of needing them over 37 weeks?

Thank you ☺️

OP posts:
RJnomore1 · 29/08/2021 16:49

I thought 37 weeks was term and didn’t need them - my 37 weeker is 21 though! - so no help - but I wanted to tell you I had them (at 29 weeks with my other child) and they were not that bad. No jag is fun but honestly nothing that awful to get stressed about.

Cobbsgirl92 · 29/08/2021 16:51

I had them as my section was done before 39 weeks, it wasn’t wonderful but over in a few seconds. They did to it in your bum/ upper thigh so they were behind you when your laying down so no chance of seeing the needle if that helps.
I just kept telling myself it was for babies sake and it would be over soon.
Good luck!

Original poster
Moominmiss · 29/08/2021 17:30

Thank you both. My consultant said that it’s only in the past 2 years that it’s changed and that the requirement is now to give them before 39 weeks.

I’ve also been told that the injections will be given in my bum. I’m literally dreading it!

OP posts:
PastMyBestBeforeDate · 29/08/2021 17:34

I had the steroids and tbh I can't remember being in pain afterwards so it can't have been that bad.

BuffySummersReportingforSanity · 29/08/2021 17:37

A baby is considered full term for vaginal birth at 37 weeks, yes, but a C-section delivery doesn't stimulate the lungs like labour does and there is a much greater risk of breathing difficulties if a baby is born by ELCS before 39 weeks that does not exist with a vaginal birth. Hence the steroid recommendation.

I would have them.

JumperooSue · 29/08/2021 17:38

At my trust all sections prior to 39 weeks require them to reduce the risk of RDS in the newborn, strong advise you to have them. Not nice but a necessary evil🙂

Also worth noting that steroids that really mess with your blood sugars, for diabetics at my trust the second steroid is giving as an inpatient and hourly blood glucose monitoring is taken, usually with the section the next morning!

Wowcherarestalkingme · 29/08/2021 17:38

My 37 weeker didn’t have steroids but my 32 weeker did. Before I had them they warned me how painful and uncomfortable they are. I didn’t experience anything unpleasant at all apart from my face went a bit flushed

Lifeandlemons · 29/08/2021 17:45

I had these with a c section two years ago. I remember the midwife saying they weren't pleasant. I didn't feel a thing, both injections were absolutely fine. I've had worse blood tests Smile

billiebeeme · 29/08/2021 17:45

I've got a 21 month old born at 37+5 and there was absolutely no mention of steroid injections. I was booked for section but waters broke and labour started. I still had the section but no injections.

She was absolutely fine and almost 7lbs. No breathing difficulties at all. We got home a day later.

Mustangsallyis · 29/08/2021 17:46

I had DC2 at 36 or 37 weeks by ELCS and my obstetrician didn't mention steroid injections.

notasillysausage · 29/08/2021 17:49

I had them for mine at 37 weeks. They were in my bum so I couldn’t see the needle, don’t know if that helps with your phobia. They really didn’t hurt very much either, just a short sting.

MissSmith80 · 29/08/2021 17:50

I had c-section in 2019. My Trusts policy was steroid injection at anything before 38 weeks. I was booked for an elective at 39+5 but my waters went at 37+6. I got one injection on admission (honestly didn't feel a thing) and then they said I'd get the next one the following day so 38+0 with my c-section happening on the day after (38+1) unless I went in to labour. They then changed their mind and decided to go for c-section at 38 weeks with only one steroid injection.
Anyway, I didn't feel a thing with the one I had. It's interesting that the policy gas changed (or has local differences) because your Trust are offering steroids quite close to term.
Good luck OP Thanks

MuchTooTired · 29/08/2021 17:51

I had my DTs at 36+5, and had the steroid injections just in case I had them before 37 weeks.

I hate jabs, and used to take over an hour to psych myself up to have the ivf injections done (ended up getting DH to do them, as I just couldn’t). The steroid injections really were not that bad. Honestly! I think the second one stung a little bit, but it really was no big deal - I was actually quite surprised how alright they were. Like a PP I’ve had way worse from blood tests.

MissSmith80 · 29/08/2021 17:52

Sorry, just read the thread properly and you explain the change in guidance in the last 2 years.

Original poster
Moominmiss · 29/08/2021 17:54

@JumperooSue yes, my diabetic consultant and nurses have given me an updated insulin plan for the days I’m having my steroids up until the section date.

I’m having to increase the units of insulin I have, and then have to monitor my bloods 2 hourly. 2 consecutive readings of 10 or above and I will be taken in and out on an insulin drip.

Hoping mine will stay stable enough for me to be at home.

Thank you all, I’m hoping they really won’t be as bad as I’ve read. I know that no amount of worrying will do any good. Im having them and that’s that, so might as well try to not think about them too much!

OP posts:
Garman · 29/08/2021 17:55

I had the first of two of these injections yesterday and it wasn't sore at all, you can't even see the needle because you're turned on your side anyway. She injected it kind of into my hip area not straight into my bum. I did have it straight into the muscle in my bum 6 years and that hurt alright, but only for a minute or so.

JumperooSue · 29/08/2021 17:59

@Moominmiss sounds like they’ve got a really good plan in place, good luck and it will be over before you know it!

Then to meet that lovely baby💕

HayB · 29/08/2021 21:53

Hey!
I had steroids when I had my twins, that was due to them being 29 weeks tho and obviously needed. I hate injections but I actually don’t think it was that bad when I had them!! Admittedly I was a bit overwhelmed by things happening but can honestly say it was fine.

I’m due to have my next baby via section and have been told this will be approx 38weeks. Steroids have been advised again and I queried why they are needed at 38+ and this is due to the brain signals of contractions not being sent to baby during section as you would in labour, and therefore not clearing lungs through birth canal etc, so steroids are recommended.
Hope this helps and please don’t worry about the steroids. Just look away and he’s done, sure it’s top of the leg they inject x

Sceptre86 · 30/08/2021 03:46

I have had them and they were uncomfortable but fine. Much better than the blood thinners we have to take after a section. Start preparing yourself mentally.

birdglasspen · 30/08/2021 04:55

Steroids are given to help babies lungs in particular to help baby remove mucus from lungs, during a section they don’t have the usual time to clear lungs that they would during labour. I’ve had two with mucus in lungs at birth, 1st was whipped off to neonatAl unit and spent 1.5 days there, felt like a month (vaginal birth ) , 2nd section with injections and had mucus but not bad enough for neonatal just needed watched and was checked over in ward a few times. Without injections may have been worse? So yes her injections as it’s not fun having a mucusy baby who is struggling to breath! I didn’t find injections bad at all, a slight stingy feeling afterwards from them lasted
Seconds and never noticed the other side affects that might happen, I would try not to worry they aren’t so bad at all and worth it if helps baby breathe easier on birth!

BunnytheFriendlyDragon · 30/08/2021 05:12

I had a c section at 37+1 and the consultant explained to us the risks either way ie baby made need oxygen after birth vs potential links to behavioural issues due to the steroids. She said the chance of baby needing oxygen after 37 weeks are low and if they did it would usually just be some oxygen. She didn't want to tell us what to do but made clear she fought they were bit necessary at that stage.

It's your decision but I would make it based on what's best for baby if possible.

Original poster
Moominmiss · 30/08/2021 09:29

@BunnytheFriendlyDragon this is the other thing that slightly worried me - the effects long term on the baby of me having the steroids.

My 2 babies that were born at 38+2 didn’t get steroids and neither needed any help with their breathing etc. I know this baby is going to be a little earlier than they were but there is a part of me that keeps wondering what’s best. I wish I’d thought to question it at the time with my consultant but I just sort of nodded along as I was sort of in shock and taking it in that she was bringing the section forward. It’s only been these last few days that the fear and anxiety has kicked in and got me questioning it all.

But with my first dose due tomorrow I don’t have much time to decide and my consultant isn’t easy to get hold of, certainly not by tomorrow.

My consultant definitely wants baby out earlier due to the GD, and obviously if that’s what she thinks safest for baby then I don’t want to risk that. I don’t know if I was to refuse the steroids she’d refuse to do the section until a later date. Ugh, wish I’d asked these things at the time as it’ll be near impossible to speak to her now.

OP posts:
BunnytheFriendlyDragon · 30/08/2021 10:48

I think if you've been advised to have baby sooner then I would do that.

Could you go to the appointment and ask to speak to a doctor?

Original poster
Moominmiss · 30/08/2021 11:30

@BunnytheFriendlyDragon I’m definitely happy to do whatever the consultant suggests in terms of delivering baby early. And if they say that steroids are also definitely necessary then I’m happy with that too.

But I’m nit going to get the chance to discuss it with anyone before my appointment. My appointment to have the steroid injections is at my local midwife led unit and the steroids will be given by one if the midwives there.
The consultants only come in for specific appointments so there won’t be anyone higher than the midwives for me to speak to.

It’s my own fault for leaving it until now to question anything.

OP posts:
BunnytheFriendlyDragon · 30/08/2021 11:56

It's your decision OP but I'm happy to share our experience on case it helps you. Because of a very late loss of DC1, with my DC2 (who is now 2 months old) we were very closely monitored by a fetal medical specialist.

It was always the plan to deliver baby early because we lost DC1 so late. The plan was induction at 38 weeks. I was then advised to have a c section at 37+1 due a low lying placenta. Consultant mentioned steroids and explained the issues babies can have if delivered early but said after 37 weeks this is not likely and even if it was an issue it would be a day or two on oxygen not a ventilator or worse. She said there is a connection between steroids and behaviour and that it's disproportionate in her opinion. Ie taking the risk of side effects is disproportionate to the risk of delivering baby by c section after 37 weeks. She didn't specifically say don't do it but we pushed a but and she made it clear she didn't think it was necessary. The risk after 37 weeks is something like 5% of needing oxygen, maybe less (can't remember exactly, sorry).

My DS did need some oxygen but it was related to something else discovered in the evening after he was born. He was fine when he was born.

I know people who saw a well known fetal specialist because they had losses like ours and he advised the same as our consultant.

I say this making clear I don't know all of your circumstances and this is just my experience but it may help you to know.