DON'T RUSH TO DELIVERY
Two recent studies show that many patients are scheduling when their babies will be born, through elective induction of labor or early planned cesarean section, increasing the risk of medical complications to mother and baby. Induction is the artificial start of labor through the use of medications. A recent study looking at 17,000 induced Scottish births revealed that more than 25% were elective, showing no apparent medical reason. However, such unnatural initiation of labor has risks and should be reserved where there is a true need to deliver early or on a date certain. Risks of induction of labor include an increased need for cesarean delivery, increased risk of infection, prolonged labor and hospitalization, and increased chance of the newborn requiring additional medical treatment. There are medical reasons where inducing labor is recommened for the safety of mom and/or baby. However, without a medical indication, any benefit of delivering on a certain date is outweighed by the risks inherent with unnaturally starting labor. Induction of labor should be reserved for situations of necessity, not convenience.
Another rush to delivery relates to planned, repeat cesarean sections. A recent study found they were being performed too early. The U.S. study found that 36% of planned cesarean births were performed before 39 weeks gestation. Such early, planned deliveries are most likely being driven by convenience. However, like induction, research reveals risks associated with rushing to delivery without a medical need. Specifically, babies born before 39 weeks "are at increased risk for birth-related health problems." The American College of Obstetrics and Gynecology (ACOG) recommends that planned cesarean sections should not be performed before 39 weeks absent a medical need, unless there is evidence that the baby's lungs are sufficienty mature. As the author of the editoral accompanying the study noted, "many doctors and their patients are running a yellow light if not a red light" when electing to deliver before 39 weeks. Rather, the "window of safety" is now considered smaller, with the optimal time for planned C-section to be within a week of the due date.
