Thinking of refusing steroid injections at 38 weeks - unsure, what would you do?

[Unsure1045]

I’m currently 36 weeks pregnant and due to have a C-section in two weeks time due to severe pains caused by a hernia in my pregnancy. Baby is 99th centile and as well as HG I also have gestational diabetes. I am a high risk pregnancy but baby is doing really well.

My consultant agreed to a 38 week C-section but told me I must come in a week before to have two lots of steroid injections. After a lot of thought and research I’m considering declining these.

has anyone else been in this situation and what did you do?

What is your reason for declining?

Aren't the injections to help the baby?
What are your reasons for declining?

I almost went into early labour at 36 weeks and the consultant wanted to give me the steroids. The midwife told me to look at some studies before accepting. There are studies which indicate that steroids in pregnancy may cause behavioral problems in children. I declined the steroids but in the end my labour didn’t progress and I went to term. At 38 weeks the steroids should not be necessary but read the peer reviewed studies and discuss with your midwife before making a decision

This doesn’t make sense OP, the baby is full term and steroid injections aren’t routinely offered at this point, and they slowly wear off after having them and after a week they will have fully worn off anyway. I’d speak to the consultant again and double check what they are suggesting and it sounds pointless.

I would be very wary of thinking I know better than a consultant obstetrician because I know how to use Google.

This!

Why would you need steroid injections for a term baby? Did they explain the need to you?

I’ve had two premature babies. The first died, the second came at 33+1 and I had two rounds of steroids. I had two preterm birth scares with the second pregnancy before he arrived at 33+1 and they held off both times as they didn’t think birth was imminent. Both hospitals I was under, including a specialist one for preterm birth, said they could only give the two rounds of steroids once and would not be able to repeat them, and that they are only beneficial if given within 24 hours before birth.

So a doctor saying they want you to have them for a term birth and a week before delivery sounds very bizarre to me.

As a side note, my 33 weeker is, thus far, doing very well and is ahead in some areas of development.

@canthavetoomanylights to be fair in this instance what the consultant is suggesting, based on what information the OP has provided, is bizarre... unless there's a massive bit of info missing it does seem a strange suggestion.

In fact, editing to add as just re read the OP and see you have gestational diabetes (which puts the baby at risk of hypoglycemia- low blood sugars) as does antenatal steroids so to raise the risk of hypoglycemia unnecessarily seems bizarre

My consultant warned me both times that the steroid injection is linked to adhd ? I still insisted on going ahead (36w and 34W) they said they only like to give them from babies under 34 w now

I was advised to have a steroid injection for my 38+5 c section baby. I did as they said it would help DC lungs finish developing. I had the injection. DC was in Nicu after birth with breathing issues.

Babies born by c section at less than 39 wks have a higher chance of experiencing respiratory difficulties, hence the advice given to have the steroids.

Yes I would have the steroids - have they said that they will help to support your baby’s lung development? You are having a medically managed birth anyway so I would just go along with whatever is best for you and your baby.

Some Trusts do like to give steroids for c-sections at 38 weeks, it’s not unheard of depending on various risk factors. I had an ELCS at 39 weeks and DS struggled with breathing initially I would probably take them but there’s much less benefit than when they’re given for earlier labour.

Big baby, gestational diabetes, c-section birth without labour - the risk of wet lungs is higher. A lot of NICU admissions are either premature or big c-section 38 weekers.

My consultant said she had to offer me them for my 37 week section, I asked for her recommendation and she said she wouldn’t as the research was iffy longterm. She didn’t say iffy but I can’t recall her word. That child is now 3 so it was fairly recent.

I had steroids st 30 weeks and DS was born soon after. He wouldn't have survived without them. No neurodiversity, just a beloved, wonderful boy who I am massively grateful for. Why would you refuse them?

If you’ve already done your research then you’ll know more than most people responding. It’s great that you’ve identified and read the RCTs and were already educated in how to interpret the statistical methods during your undergrad/masters, and that you were already across the role of surfactant and the mechanisms by which glucocorticoids stimulate it.

With that knowledge you don’t need random opinions on MN.

What did I do?
took the steroid at 38 weeks of course 🙄
DS is ten now with no issues.

Having worked in NICU, I would have taken the steroids. I didn't even think about it at 35 weeks, but I still would, personally, at 38 if it was a C-section. Natural labour involves the release of surfactant, and there's a reason that babies are squeezed down a birth canal in typical labour and birth, part of which is getting the gunk out of the lungs. A planned c-section happens before that process, so the steroids give the baby a kick start for their breathing apparatus.

The steroids are to help baby’s lungs develop enough to breathe on their own when born early.

Why would you refuse this?

Well the baby isn’t being born early so she’s doing her own research, not difficult to understand really

This.

I had twins at 36 weeks and had the steroid injections. I would say the smaller twin still suffered a lot with respiratory infections ( requiring hospitalisation) that bigger twin shook off. I always assumed it’d of been worse had I not. 11 now and no issues.

Just to point out, I’d obviously take them at 30 weeks as well. I’m not saying I’d refuse steroids for a premature baby 10 weeks before due date.

Your situation is incredibly different to mine and I’m glad your little boy had the injections

Steroid injections are generally offered up to 37 weeks to help strengthen babies lungs. Op I would seek advice from a medical professional not mums net