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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

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

70 replies

Unsure1045 · 20/06/2026 20:40

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?

OP posts:
aurpod1980 · 21/06/2026 15:19

I had GD had to have first baby at 37 she ended up on respiratory distress in NICU for two weeks - the hospital apologised and said she should have been given steorids

for baby 2 got steroids around 36 weeks had her at 38 weeks - she was in scbu respiratory distress again. I think with GD lungs don’t develop so well. Her lungs not as bad as baby 1 who needed surfactant and intubation .

so I’d say have them.

Beachbeachbaby · 21/06/2026 15:26

I’ve had all 3 babies at 38 weeks and none needed steroids. I would have been sceptical after baby one and refused personally

38+4
38+5
38 + 0

all c sections, all births I was in labour naturally before the section. No indication. EMC EMC and then planned C but baby arrived before the date they gave me (a week 39 date which was bloody stupid)

Lougle · 21/06/2026 15:50

Batties · 21/06/2026 14:54

That doesn’t change the fact that the baby is full term and so lungs are fully developed.

Some has gotten lost during the conversation with the DR. Either he hasn’t explained is well or OP has misunderstood.

The difficulty lies with the fact that @Unsure1045 has gestational diabetes. The mother has high blood glucose levels due to diabetes, but the baby doesn't have diabetes, so responds to the increased glucose by producing higher levels of insulin. Higher levels of insulin inhibit the production of surfactant, making babies of mothers with gestational diabetes have a later lung maturation.

Additionally, surfactant levels normally trigger labour, so the fact that a woman is in labour (in normal physiology, not with labour triggered by infection, etc) means that the baby's lungs are ready.

When a baby is born by C-section without labour, they are being born before their lung development has triggered labour. In other words, their lungs haven't said 'I'm ready'.

Finally, alongside surfactant (which makes the lungs slippery and able to inflate easily), the baby has gunk in their lungs. Natural labour involves contractions, which squeezes the gunk out of the lungs. A c-section overrides this process.

Therefore, a 38 week baby whose mother has gestational diabetes may have underdeveloped lungs, reduced surfactant, and increased gunk, which increases the chance of Neonatal Respiratory Distress Syndrome.

Some babies will be just fine, others won't. You only find out when a baby goes into respiratory distress. You will never know if a baby whose mother received steroids would have been fine without them. Similarly, you will never know if a baby whose mother didn't have steroids and that goes into distress would have been fine if they had steroids. And you'll never know if the baby whose mother had steroids and still went into distress would have been worse or better without them. So you can only work on statistics.

ToKittyornottoKitty · 21/06/2026 16:02

Lougle · 21/06/2026 15:50

The difficulty lies with the fact that @Unsure1045 has gestational diabetes. The mother has high blood glucose levels due to diabetes, but the baby doesn't have diabetes, so responds to the increased glucose by producing higher levels of insulin. Higher levels of insulin inhibit the production of surfactant, making babies of mothers with gestational diabetes have a later lung maturation.

Additionally, surfactant levels normally trigger labour, so the fact that a woman is in labour (in normal physiology, not with labour triggered by infection, etc) means that the baby's lungs are ready.

When a baby is born by C-section without labour, they are being born before their lung development has triggered labour. In other words, their lungs haven't said 'I'm ready'.

Finally, alongside surfactant (which makes the lungs slippery and able to inflate easily), the baby has gunk in their lungs. Natural labour involves contractions, which squeezes the gunk out of the lungs. A c-section overrides this process.

Therefore, a 38 week baby whose mother has gestational diabetes may have underdeveloped lungs, reduced surfactant, and increased gunk, which increases the chance of Neonatal Respiratory Distress Syndrome.

Some babies will be just fine, others won't. You only find out when a baby goes into respiratory distress. You will never know if a baby whose mother received steroids would have been fine without them. Similarly, you will never know if a baby whose mother didn't have steroids and that goes into distress would have been fine if they had steroids. And you'll never know if the baby whose mother had steroids and still went into distress would have been worse or better without them. So you can only work on statistics.

Did you get AI to write that for you?

Lougle · 21/06/2026 16:51

ToKittyornottoKitty · 21/06/2026 16:02

Did you get AI to write that for you?

No, I watched 38 week babies struggle to breathe in NICU when I worked there.

What made you think it was AI? People can still use words, I hope.

Rubuxus · 21/06/2026 16:59

I would do your research then go to them and have a big discussion. Ask for a second opinion aswell.

It doesn’t sound good re the low blood pressure your right but I am sure if you have one problem you can deal with it. Maybe it’s that they are foreseeing a baby who can’t breath plus has low blood pressure like previously and in those circumstances maybe it’s a world of trouble? I don’t know but obviously they have reasons so ask.

ToKittyornottoKitty · 21/06/2026 17:37

Lougle · 21/06/2026 16:51

No, I watched 38 week babies struggle to breathe in NICU when I worked there.

What made you think it was AI? People can still use words, I hope.

Edited

Long and overly detailed, written like AI in essay style. So why do you think they want to give steroid injections a week before when they will have worn off by the time the baby is delivered? That would probably be helpful info for OP

Yetanotherone12 · 21/06/2026 17:47

It sound like you have a complicated medical history,o/p, that without access or an obs specialty none of us can say which decision is best.

mine were born at 38w(emcs) and 38 w- elective this time as they didn’t want me to go past the date it all went to shit with the first. Steroids were not suggested in either.

however i had very normal, low risk pregnancies. So my experience is different to yours. From pp it does sound like your gestestional diabetes and large baby would mean steroids are indicated.

i would go back and ask the consultant why. If the baby is nearly term, why are steroids indicated? Then you may get some balance as to the reasons and what the risks would be if you decline.

if you do decline then what? Would they delay or cancel the section? Would the benefit or more mature lungs in that case outweigh the risks of the GD etc?

DontBuyAnotherBook · 21/06/2026 17:53

MrsPatrickDempsey · 20/06/2026 20:55

What is your reason for declining?

Let me guess..OP thinks it causes autism? 🙄

Caffeinepleasenow · 21/06/2026 17:59

DontBuyAnotherBook · 21/06/2026 17:53

Let me guess..OP thinks it causes autism? 🙄

Edited

Maybe if you read the thread and all the OPs posts, you'd see why. There is a documented link between steroids and ADHD and it's not standard practice at 38 weeks. Good reasons to question it, in my opinion.

Lougle · 21/06/2026 18:13

ToKittyornottoKitty · 21/06/2026 17:37

Long and overly detailed, written like AI in essay style. So why do you think they want to give steroid injections a week before when they will have worn off by the time the baby is delivered? That would probably be helpful info for OP

You're very rude. They won't have worn off. If the OP is being called in for her first steroid injection at 37 weeks, the second dose will be be at 37+1 or 37+2. The C-section is planned for 38 weeks, 5/6 days later. Optimal timing is 24 hours to one week after the second dose.

It's better to give them at term, so that if the OP goes into labour prior to the planned date, the baby still benefits from the steroids.

DontBuyAnotherBook · 21/06/2026 18:17

Caffeinepleasenow · 21/06/2026 17:59

Maybe if you read the thread and all the OPs posts, you'd see why. There is a documented link between steroids and ADHD and it's not standard practice at 38 weeks. Good reasons to question it, in my opinion.

Edited

ADHD and autism mostly happen due to genetics. It is why I roll my eyes at comments about this or that causing autism.

Lougle · 21/06/2026 18:17

ToKittyornottoKitty · 21/06/2026 17:37

Long and overly detailed, written like AI in essay style. So why do you think they want to give steroid injections a week before when they will have worn off by the time the baby is delivered? That would probably be helpful info for OP

It's not overly detailed. The birth process is complicated. The reasons for using steroids is complicated. The reasons for complications are complicated.

I mean, I suppose I could have said 'Without steroids Bubba might struggle to breathe', but I think @Unsure1045 gathered that before she posted.

ToKittyornottoKitty · 21/06/2026 18:21

Lougle · 21/06/2026 18:13

You're very rude. They won't have worn off. If the OP is being called in for her first steroid injection at 37 weeks, the second dose will be be at 37+1 or 37+2. The C-section is planned for 38 weeks, 5/6 days later. Optimal timing is 24 hours to one week after the second dose.

It's better to give them at term, so that if the OP goes into labour prior to the planned date, the baby still benefits from the steroids.

Im not being ‘very rude’ I answered your question and asked you one… this is how discussions work. OP was looking for advice and questions to ask her medical team tomorrow. Not sure why you’ve now quoted and replied to my same post twice though.

ToKittyornottoKitty · 21/06/2026 18:24

DontBuyAnotherBook · 21/06/2026 18:17

ADHD and autism mostly happen due to genetics. It is why I roll my eyes at comments about this or that causing autism.

There are studies showing potential links between the steroids and ADHD though and plenty of people on here have said their doctors even pointed this out to them. I don’t think it’s totally invalid that people are worrying about this. I had the steroid injections with my DD who was born at 29 weeks, she’s now 9 and doesn’t have ADHD, so I can’t agree with that research based on experience, but it’s out there and people are talking about it so it’s not really fair to eye roll at it.

Yetanotherone12 · 21/06/2026 18:30

ToKittyornottoKitty · 21/06/2026 18:24

There are studies showing potential links between the steroids and ADHD though and plenty of people on here have said their doctors even pointed this out to them. I don’t think it’s totally invalid that people are worrying about this. I had the steroid injections with my DD who was born at 29 weeks, she’s now 9 and doesn’t have ADHD, so I can’t agree with that research based on experience, but it’s out there and people are talking about it so it’s not really fair to eye roll at it.

you can agree with research even if you don’t experience it.

research is population based, not individual. So for example in your case the research may well show that steroids increase your risk of adhd- the point being increase the risk, not guarantee it.

my dd got chicken pox despite being vaccinated. Doesn’t mean I don’t agree with the research that shows vaccinations prevent it.

ToKittyornottoKitty · 21/06/2026 18:36

Yetanotherone12 · 21/06/2026 18:30

you can agree with research even if you don’t experience it.

research is population based, not individual. So for example in your case the research may well show that steroids increase your risk of adhd- the point being increase the risk, not guarantee it.

my dd got chicken pox despite being vaccinated. Doesn’t mean I don’t agree with the research that shows vaccinations prevent it.

I didn’t say I don’t agree with the research. I was saying that I’m not saying the research matches my
own experience… because I don’t want to scare OP into thinking I’m saying the steroids caused ADHD in my child’s case, because they didn’t. I understand how research works, that’s why I was saying it’s understandable that people read it.

aurpod1980 · 21/06/2026 18:54

My second daughter who had the steroids has Autism, her anxiety is so high we’re unable to do an assessment for ADHD … but it’s likely she has ADHD.

Lougle · 21/06/2026 20:01

aurpod1980 · 21/06/2026 18:54

My second daughter who had the steroids has Autism, her anxiety is so high we’re unable to do an assessment for ADHD … but it’s likely she has ADHD.

All 3 of my girls have ASD and 2 have ADHD diagnoses, with 1 pending (but the clearest of them all). I only had steroids with the one born at 35+2.

hyggetyggedotorg · 21/06/2026 20:06

I had DS1 at 37 weeks - no steroids offered. DS2 at 40+1. DD at 38 weeks & offered steroids for her lungs.

I declined as I felt 38 weeks was pretty much term anyway. Had the Consultant recommended it rather than just offered I would have accepted. As others have said, amateur research is no match for an actual Obstetrician qualification.

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