Normal Practice to Induce AMA Mom's at 39 Weeks?
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Anonymous
No, absolutely not: http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Nonmedically-Indicated-Early-Term-Deliveries American College of Obstetricians and Gynecologists clinical guidelines : Nonmedically indicated early-term deliveries. Committee Opinion No. 561. American College of Obstetricians and Gynecologists. Obstet Gynecol 2013;121:911–5. "The differences between 37 weeks of gestation and 39 weeks of gestation are consistent, larger, and statistically significant across multiple studies. Even comparing neonates and infants delivered at 38 weeks of gestation with those delivered at 39 weeks of gestation there is still an increased (albeit clinically small) risk of adverse outcomes." That strongly advises waiting until 39 - but doesn't seem to say anything about waiting beyond 39 weeks. |
Anonymous
I'm so very sorry pp. The theory that placental insufficiency is more common with AMA moms is unproven at last in medical research. Stillbirth risks do rise at the end of pregnancy but researchers have not figured out exactly why on a population level. https://evidencebasedbirth.com/advanced-maternal-age/ |
Anonymous
It's actually about 1% of all pregnancies if you include "early" stillbirth (after 20 weeks). https://www.cdc.gov/ncbddd/stillbirth/facts.html Stillbirth at term is high for mothers over 40 like PP. It's about 1-2%. |
Anonymous
Sadly it may be even higher. CDC says stillbirth affects 1% of pregnancies. https://www.cdc.gov/ncbddd/stillbirth/facts.html |
Anonymous
Right. PP was your mom actually an OB? When she said she only "lost" 2 babies, she was likely referring to intrapartum deaths (where the baby dies during delivery). That's actually very rare in the US because we monitor babies during delivery and do c-sections if they get into trouble. That's a kind of stillbirth, but not the only kind. |
Anonymous
So sorry for your loss, PP. I had an induction at 37 weeks for medical reasons and, while it was certainly no walk in the park, was successful and I delivered vaginally. I will try like hell (though I may not have much choice) to avoid an early term induction next time, but think that inductions closer to 40 weeks are generally MUCH easier because your body is already gearing up for labor. OP, you should be able to find a practice that allows you to go later with extra monitoring. Think about if you want to do that though. I had extra monitoring the last few weeks for the medical issues, and it was a PITA to miss work and go to all of those extra appointments. Also, how sure are you about your dates? I was tracking ovulation, so I knew I was 37 weeks and not 35.5-36 weeks, so felt more comfortable that my LO was actually full term. She was definitely fully cooked - over 8 pounds, strong, and able to latch right away. I may push back more if I wasn't totally sure about dates. |
Anonymous
| You mentioned that you are interested in a low intervention delivery - but does that mean no c-section or non-medicated delivery? I would just manage your expectations...so much about birth is out of your control. Everyone hopes to not need a c-section, but if told your baby is in danger, what would you do? All you can do is try to find an OB or midwife who most closely is compatible with your views, but don't invest all your hopes and dreams into what the birth will be like. It's a moment in time and you'll have your child for a lifetime. If you end up having a c-section you are not a failure. |
Anonymous
It's kind of scary to me how uninformed people are about stillbirth. |
Anonymous
Inform us, please. |
Anonymous
Many stats have been calculated on stillbirth using different calculations. A 2013 study using California data from 2005 found for women age 35 or older, stillbirth rates increase from 5 per 10,000 in week 39 to 10 in week 40 to 15 in week 41 and to 32.5 at week 42 or more (in the under 35 set it was 4, 7, 8.5, and 28 respectively). That's more like 1 in 2,000 (week 39), then 1 in 1,000 (week 40), then 1 in 650 (week 41), then 1 in 300 by the 42nd week (Source: https://www.ncbi.nlm.nih.gov/pubmed/23707677) But anecdotally it seems there are more stillbirths than that. Maybe because there are more older moms concentrated in DC? So who the hell really knows. |
Anonymous
^^oops, I meant to say using different data, models, and methods. (hence the discrepancy in the true rate) |
Anonymous
| PP with the neonatal loss here. Thanks so much for everyone's kind words, I appreciate it and I'm sorry to have brought up the upsetting worst case scenario. Mine was not a stillbirth - he died after a day in the NICU due to brain damage from oxygen deprivation from a VCI rupture - I had an EMCS but it was too late. I have never posted on a thread like this before because I don't want to be the downer one who freaks out expectant mothers. I hated horror stories when I was pregnant and then I became one myself. I guess there's just so much shame and grief around stillbirth, and so little research into it, that people don't talk about it. I may well have a skewed view of this because I now know several women who've had term losses, because I'm also in the club noone wants to be part of. I guess I just wanted to offer a different perspective because I wish more than anything that I could go back in time myself. |
Anonymous
| i was 46 and my OB had me scheduled for an induction at 40w4d. (i wound up inducing a day sooner b/c i was high risk for preeclampsia and my BP got high.) |
Anonymous
| Yes, they wanted me scheduled by 39 weeks for both of my pregnancies. |
Anonymous
| 41 went into labor at 39 weeks...and maybe 2d?, can't remember. My Kaiser ob was going to let me go to 41 weeks. Everything was fine. Very healthy baby and placenta was in good shape too! |