REPOST: In Healthy Pregnancies, Let the Baby Set the Delivery Date

In a recent article in The Huffington Post, Dr. Guttmacher describes his experience of becoming a new grandfather within the context of his training as a pediatrician. His column presents the scientific evidence that, in a healthy pregnancy, waiting until at least 39 weeks to deliver improves outcomes for the mother and the baby.

A few months ago, I became a grandfather, and I love it. In the final weeks leading up to my grandson's birth, I didn't think he could get here fast enough. My step-daughter, too, had grown impatient, in anticipation not only of the new baby, but of the end of the discomfort and exhaustion of that final month.

But while my grandfatherly instincts made me eager for my first grandchild's arrival, as a pediatrician, I knew that in a normal, healthy pregnancy it's the baby, not a grandfather, or even the mother, who best sets the delivery date. The outcomes for mom and baby are best when delivery occurs after 39 weeks. Obstetricians recognize this as a best practice.

Yet some families still request delivery, or their doctors may even suggest it for scheduling purposes, before 39 weeks. In these instances, labor is initiated even though the pregnancy could progress further with less risk to the mom and the baby.

Of course, for some pregnancies, there is a medical need for delivery before 39 weeks. This need may arise from any number of health problems affecting mom, baby, or both. In such cases, the mom's health care provider will recommend an early delivery.

But for most pregnancies, it's best to wait.

Why?

Much of a baby's development happens in the final weeks.

At 35 weeks, a baby's brain weighs only two-thirds of what it will weigh at 39 to 40 weeks. During this time, brain growth surges to accommodate such important functions as balance, coordination, learning, and social functioning. The lungs, liver, and other internal organs undergo important development in the final weeks, too.

Later deliveries bring fewer health risks for babies.

Babies delivered at 39 weeks or later have fewer health risks than babies delivered earlier. In the short term, babies delivered before this time have more trouble breathing, feeding, and keeping warm, so they're more likely to require medical attention and a stay in a neonatal intensive care unit. Deliveries before 39 weeks also carry a higher risk of cerebral palsy, vision and hearing loss, learning difficulties, and even death. Forgoing elective delivery in the final weeks may reduce these risks.

Later deliveries mean fewer complications for moms, too.

Elective early delivery increases the risk of cesarean delivery. And C-sections, while common, carry risks for the mother, such as wound infection and anemia, and require longer recovery time. Having a C-section also makes C-sections more likely for subsequent pregnancies. Mothers who deliver after 39 weeks typically have better outcomes.

Of course, because the estimated due date may be off by even two weeks, some women who think they are delivering on time are actually delivering early. So, unless there's a medical need to induce labor, it's usually best to wait for labor to begin on its own.

Right now, many dads and moms eagerly are awaiting the birth of their babies. Parents worry about enough things during pregnancy -- avoidable risks shouldn't be among them.

My family was fortunate. The delivery went smoothly, and both my stepdaughter and grandson are healthy and doing well.

All families want the same for their loved ones. That's why it's best -- unless the health of a mom or her baby is in danger -- to wait to deliver until at least 39 weeks of pregnancy.


Dr. Cristian Andronic specializes in advanced gynecologic and robotic pelvic reconstructive surgery. Follow this Twitter page for more updates.