Why You Should Wait Until At Least 39 Weeks Before a Planned Induction or Cesarean

***I'm going to post a little disclaimer here and now before continuing: This post does not include medically indicated/necessary early inductions or cesareans. I am only covering elective inductions and cesareans (and RCS) in this post. Please keep that in mind as you read. Thank you.***

The end of pregnancy is a trial. You're exhausted, you feel horrible (no matter how easy a pregnancy you've had), and you want nothing more than to meet your baby and get it over with. That's normal, understandable, and totally okay. But if you're considering inducing or having a c-section (repeat or primary), there are a lot of good reasons to wait until you are at least 39 weeks.

Did you know that some experts estimate that at least 50% of deliveries between 36-39 weeks are scheduled? Is this evidence based? Does this include medically necessary inductions and c-sections? No, not really.

Did you know that at least 1 in 3 first-time moms is induced? Did you know that inducing increases your chances of having a cesarean birth? Do you know by how much? Do you know what crucial developments happen for your baby in the last few weeks of pregnancy? Here are some statistics:

• At least one-third of these inductions have no medical indication. First-time mothers who are induced at term for no medical reason have a C-section rate of approximately 24%, with the largest percentage of these Cesareans being performed in early labor—before the woman reaches 6 cm. 
• The average gestation of a first-time pregnancy worldwide is 41 weeks, 1 day.
• First-time mothers who undergo elective induction of labor are twice as likely to have a C-section as those who go into labor on their own.
• A significant percentage increase in both C-section deliveries (67% increased risk—that’s big), and NICU care (64% increased risk), for women and their babies who undergo non-medically necessitated inductions.

So, if induction itself, even at term, presents such risks, why are women so quick to request an early induction? And what are the risks associated with inducing prior to 39-40 weeks' gestation, and why is this happening?

• Your baby’s brain grows 35 percent between 34-41 weeks.
• A full-term pregnancy lasts 40 weeks, but elective deliveries are often planned for two or three weeks earlier. And even though 37 weeks is also still considered full term, studies show that babies born even a few weeks too early are at greater risk for health problems than those who are born later. That has some doctors campaigning to curb the trend of scheduled labor and delivery.
• More than 25 percent of infants born electively between 37 and 39 weeks required admission to the neonatal intensive care unit (NICU) for an average of 4.5 days, compared with fewer than 5 percent of infants who were delivered at 39 weeks or later, according to a recent study published in the American Journal of Obstetrics & Gynecology.
•  Labor inductions can set in motion a chain of events that ultimately make a C-section more likely. First-time mothers who have had their labor induced double their risk of requiring an emergency C-section, which typically results in a longer recovery period for mom, according to a recent study in Obstetrics & Gynecology.
•  A recent study by the March of Dimes, National Institutes of Health and the Food and Drug Administration found the risk of death -- however small -- more than doubles for infants born at 37 weeks compared to those carried to a full 40-week term.
•  Most women give birth between 38 and 42 weeks of pregnancy. But very few babies are born on their due dates. It is normal to give birth as much as 3 weeks before or 2 weeks after your due date 
• 10 to 15 percent of all births in the U.S. are "early elective" deliveries (meaning prior to 39 weeks' gestation, via cesarean section or induction, without a clear medical reason), two new studies find -- and some hospitals report that number is as high as 44 percent. But, the American College of Obstetricians and Gynecologists (ACOG) staunchly advises against elective deliveries before 39 weeks.
•  Most recently, a study published in the journal Pediatrics in early July, involving more than 100,000 New York schoolchildren, found that children born at 37 or 38 weeks did worse on third grade math and reading tests than kids born just a week or so later. The study showed that 2.3 percent of the children born at 37 weeks had severely poor reading skills, compared with just 1.8 percent of children born at 41 weeks; that's a 33 percent increased chance of severe reading difficulty. They also had a 19 percent greater chance of having moderate problems in math.
•  The last few weeks of pregnancy are critical to both lung and brain development. Complications of elective deliveries between 37 and 39 weeks include:
  
• Increased NICU admissions
• Increased respiratory distress and TTN
• Increased need for ventilator support
• Increased rate of sepsis
• Increased feeding problems 

• Babies born too early may have more health problems at birth and later in life than babies born later. Being pregnant 39 weeks gives your baby's body all the time it needs to grow.
  Here's why your baby needs 39 weeks:
• Important organs, like his brain, lungs and liver, get the time they need to develop.
• He is less likely to have vision and hearing problems after birth.
• He has time to gain more weight in the womb. Babies born at a healthy weight have an easier time staying warm than babies born too small.
• He can suck and swallow and stay awake long enough to eat after he's born. Babies born early sometimes can't do these things.

Those are some pretty good, science-based, reasons to wait (at the very least) 39 weeks before scheduling your child's birth. If you're considering inducing or scheduling a cesarean, these are definitely some points to consider when it comes to timing.