38 weeks -Should I ask for a later C section?

[Saz909]

Hello, I am just looking for advice and to see what others would do in this situation.

I am currently 36 weeks with my third baby (third CS) previous 2 were both a week overdue, small for gestation but otherwise fine.

my due date is 16th April and I have been given a ELCS date of 2nd April when I will only be 38+0. When I asked why so early she told me the info she had said ‘between 38-39 weeks, but this was based on a doctor I met once at 20ish weeks before growth was even plotted.

She also said there aren’t many available slots because of bank holiday weekend.

I saw a consultant today who seemed surprised that it was so early but didn’t say it would be a problem, only that it could result in NICU stay due to immature lungs. He also mentioned it may not be the worst idea as my BP is creeping up. It’s not high enough to have been put on medication though.

I just can’t help feeling uneasy about this though as there doesn’t seem to be a good clinical reason to have a c section a week earlier than the guidelines suggest at 39 weeks.

Would you push for a later date or is 38 weeks fine?

I'm not an expert and not given birth yet but I'd feel the same concerns as you and would probably push for later.

I’d push for later (due to the lungs too). Anything past 39 I’d be happy with

My twins were born by C-section at just under 36 weeks. No problems with their lungs. I think 38 is considered full-term. You should be fine.

Going by my recent experience, I would push for later. I was high risk due to gestational diabetes, previous late loss, advanced age etc so my section was booked for 38+1. Baby was born a good healthy size but she was very sleepy from the start and had issues feeding. (No breathing issues thankfully) We ended up staying in hospital for 2 weeks as she lost a lot of weight whilst she was getting the hang of feeding. I had to stop breastfeeding and put her on formula so she could gain weight which was very upsetting. We got discharged from hospital on her due date and on reflection I just think she wasn't ready to be born at 38 weeks. Although it's considered 'term' I think a lot of babies aren't actually ready at that point, especially if it's a planned c section. Bit different if you go into labour naturally though

Definitely push for 39. 38 should only be done with a clinical indication. Recent evidence suggests that 'early term biryh' (37-38 weeks) is associated with higher likelihood of special educational needs and lowered school attainment, so national guidelines strongly encourage planned CS done no earlier than 39. Perhaps they suggested 38 to reduce chance of you labouring, but risk of uterine rupture is no higher than with just 1 previous CS (1 in 500) so it's not common practice for the reason of 2 previous CS alone. I would push back and cite RCOG guidelines.

Thanks all for your replies. What has made me more uneasy is that this seems to have been decided without even a doctor having evaluated it. I hadn’t seen a consultant since the 20 week mark, at which point there were no issues except my sons both previously being small - however baby is not measuring small, she’s 40th percentile.

I have had very on and off care throughout seeing a different midwife every appt, so it doesn’t really feel like anyone knows what’s going on. I’m not even sure who to contact to try and get the date moved back, but I think I will start by calling triage tomorrow and go from there.

There are SEN risk factors associated with earlier c sections, even as late as 38 weeks. There is new research coming out and also why would you want to risk a NICU stay. Push layer