Early birth without medical indications: Just say no

Suspecting that a baby might be large baby is not a medical reason to deliver before 39 weeks, according to two major professional organizations of physicians specializing in pregnancy and birth care.

The recommendations were issued jointly by the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM).

adorable Newborn Kai

Professional guidelines for labor induction & birth

In response to the rise in early-term births in the US, the ACOG reemphasized its position against deliveries before 39 weeks, unless there is a valid medical indication, because of the health risks to infants and mothers.

ACOG and SMFM have long recommended that doctors not induce labor or perform cesareans before 39 weeks of pregnancy without a clear medical reason. A full-term pregnancy lasts 40 weeks, and “early-term” deliveries are those that occur between 37 and 39 weeks of gestation.

There are certain medical indications that require early delivery, including preeclampsia/eclampsia, fetal growth restriction, placental abruption, multiple fetuses, and poorly controlled diabetes. However, suspecting that a baby is macrosomic (large) is not an indication to induce or deliver by cesarean before 39 weeks.

Early-term infants have higher rates of respiratory distress, respiratory failure, pneumonia, and admission to neonatal intensive care units compared with infants born at 39 to 40 weeks gestation. Infants born at 37 to 38 weeks also have a higher mortality rate than those born later.

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Reducing the number of non-medically indicated early-term births and improving newborn outcomes is possible, according to ACOG and SMFM. Hospitals around the country have successfully lowered their rates of non-medically indicated early-term births by implementing policies to prevent them.

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