New guidelines redefine "full-term pregnancy." Understand the impact that your delivery date can have on your baby's health.
Your due date is in sight and you only have a few weeks to go. In fact, you're so close, you'd be happy to get the show on the road and have your baby now. What's the harm? Your doctor told you, after all, that at 37 weeks, you're close enough to your due date that its safe to have your baby. In fact, why not get your calendar out and book the date and make things easy? Why go through the last miserable couple weeks of pregnancy if you don't really have to?
That's what countless women were told during the 80s, 90s and 2000s when the induction craze was at its peak. As it turns out, those last few weeks are just as important as any other phase of pregnancy, and "close enough" doesn't always cut it.
The American Congress of Obstetricians and Gynecologists has redefined the meaning of "term pregnancy." Pregnancies used to be considered at term, and babies ready for delivery, any time after 37 weeks. If mom went past that, those last three weeks (or longer) were almost seen as a write-off. Now, however, after a couple of decades that have seen too many C-sections and record numbers of babies in the neonatal intensive care unit (NICU), those last few weeks of pregnancy are being taken seriously. That's why "term pregnancy" is now being broken down into distinct categories.
Term Pregnancy: Categories
• Early Term: Between 37 weeks 0 days and 38 weeks 6 days
• Late Term: Between 41 weeks 0 days and 41 weeks 6 days
• Poster: Between 42 weeks 0 days and beyond
Doctors and hospitals have learned so much from the mistakes made back in the day when inductions and C-sections were as easy to schedule as a haircut ,and were often done with mothers who were only 37 - 38 weeks pregnant. Many of these procedures were done not out of medical necessity, but for convenience sake--for example, to make sure grandma could be at the birth, or so mom could be sure her own doctor would be on-call during her labor. But because due dates are often miscalculated, especially by ultrasound, doctors were frequently delivering premature babies who wound up spending time in the NICU. And many of these inductions were unsuccessful because mom's body was not ready to go into labor. These women wound up with C-sections they most likely wouldn't have needed if they'd waited for labor to start on its own.
Slowly but surely the birth culture of "induction or C-section on demand" has changed. Now, most doctors have received the memo that unnecessary inductions are potentially dangerous for moms and babies. If there are solid, compelling medical reasons to induce or schedule a C-section, then, by all means, that's what those procedures are there for. However, if the medical reason can wait until a baby is full term, mothers and babies both fare better. If there's no reason to induce or do surgery, then for heaven's sake–don't do it. That's why these guidelines were developed, because finally, FINALLY, the medical community understands that "close enough to the due date" isn't always good enough. Lots of essential "finish work" is done in the last few weeks of pregnancy and we're learning more every day about the negative consequences we're inflicting on babies when we cut short their time in the uterus.
Another great thing about these guidelines is that it spells out that a woman isn't really "over due" when she goes past her due date a week or two. For a long time now, doctors have been fixed on that 40-week mark as if a timer will go off and all hell's going to break loose if the baby isn't born lickety-split. Their concern is about babies growing too big for mom's pelvis, or a placenta growing too old to sustain baby. While those things do occasionally happen, they don't happen very often. Since post due date pregnancies put doctors on the defense (legally speaking) however, the birth culture pressed hard for women to accept medical interventions to push them into labor once the buzzer went off.
The thing is that prior to when all those crazy inductions took over the birth industry in the 80s and well into the 2000s, women delivered safely a week or two past their due dates all the time and it was no big deal. Sure, they were crazy uncomfortable and frustrated, but nobody considered that there was anything wrong with them. These new guidelines send the message that women and their doctors need to hear: So what if the baby's a little late? No biggie. He or she will come when really, truly ready to be born. Frankly, we think mom's body knows when that time is far better than anybody else.
Jeanne Faulkner, R.N., lives in Portland, Oregon with her husband and five children. Got a question for Jeanne? E-mail it to firstname.lastname@example.org.
This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.