Why the last few weeks matter

Monday, 19 May 2014

Unless you've had a history of premature labour, the majority of woman wish to avoid going overdue like the plague.  Yes we're blessed, grateful and happy and on cloud fucking nine to be pregnant but generally by your magical mystical due date, and often before, you're fed up.  Beyond fed up.

Sometimes we get to 37 weeks and we hear the phrase bandied about that 'baby is fully cooked, you can come out now!' because pregnancy is 'term', yet your due date is a mere estimate, there's no exact science.  A healthy pregnancy can go up to 42 weeks (occasionally beyond)  Are we to believe that in those extra 3-5 weeks baby is just chilling out in there packing on the weight?  Surely that would be utterly churlish of us to presume these weeks are not important.   Your babies brain, lungs and liver are still developing at 37 weeks and will continue to do so.  They're not 'done'.

Did you know that a baby's brain at 35 weeks only weighs 2/3 of what it will at 39-40 weeks, that's quite a difference.

The problem with statistics is that we can manipulate them to fit to our own agenda.  Whilst  being petrified of a premature birth we placate ourselves with the rising statistics of survival rates yet there is a darker side to this, as the stats increase week by week many anxious and fed up mums convince themselves that the final weeks don't count.  That they're superfluous.  That just because babies can survive being born early, that it's okay to aim for that leading to alarming statistics such as that found by an American Watchdog who discovered that 75% of mothers believe 34-36 weeks is full term.

I know the inforgraphic below is American but it does a pretty good job of outlining exactly why you should, if possible, wait until at least 39 weeks gestation, because the last weeks matter.

Title is “Let Baby Set the Delivery Date”
Babies need at least 39 weeks to grow before they are born.
Illustration of a pregnant woman in profile says “39 weeks? But I’m ready to deliver now!”
Between 37 and 39 weeks, the baby goes through critical development of the brain, lungs, and liver.
Your baby’s brain at 35 weeks weighs only 2/3 of what it will weigh at 39 to 40 weeks. Adapted from material developed by the March of Dimes.
Babies born before 39 weeks have a 20% greater risk of complications than babies born later, including problems with breathing, temperature, and feeding.
One more reason to wait: your due date could be off by 2 weeks, which means if you have your baby before 39 weeks you could be delivering early!
Elective delivery prior to 39 weeks increases the mom’s risk of postpartum depression, stronger and more frequent contractions, and the need for a cesarean delivery.
National Child and Maternal Health Education Program
A program of the National Institutes of Health
Learn more at http://www.nichd.nih.gov/ncmhep/isitworthit
Information provided by the National Child and Maternal Health Education Program within the Eunice Kennedy Shriver National Institute of Child Health & Human Development.
US Department of Health and Human Services
NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development

Yes, generally and statistically speaking babies born after 37 weeks need minimal extra care and I'm sure the almighty internet forums will be full of positive anecdotal stories of positive outcomes, but, they're still developing.  Their lungs, liver, brains, sucking and swallowing reflexes etc are immature, they're more likely to have breathing difficulties, may struggle to maintain body temperature and have a higher risk of hearing and vision problems.  Unless medically necessary to give birth this early is it fair or even right to voluntarily evict babies this early from the womb?  To play roulette with their early days?  Many woman who've been through the harrowing experience of having an involuntary spontaneous premature birth would give an arm and a leg to have kept their babies in for as many weeks as possible.  Yet in America, up to 40% of deliveries are scheduled pre 39 weeks, for no medical reason with no accountability.

The American college of Obstetrics and Gynecology have redefined 'term' so that 37+0-38+6 is now considered 'early term' with 39+0-40+6 being considered 'term'. *

Granted, over here in the uk, it does seem more difficult to electively give birth without medical reason before your due date.  In some parts of the country you can't even receive a membrane sweep until 41+0.  It doesn't alter the mindset though ingrained in many pregnant womans minds that because 37weeks is considered 'term', it's okay or even optimal to choose to start the labour process then.  That by the magical 37weeks you don't 'need' to be pregnant any longer.

Don't get me wrong, I've been overdue.  Twice.  The first time by ten days and the second by 3 or 4 (Bad mummy moment, I can't even remember!) So I get it.  I absolutely get it.  I've been there fat, miserable and uncomfortable scoffing pineapples and curry whilst giving The Husband an early birthday present of offering to 'swallow' to encourage labour.  Yet i'd never request an induction before due date at bare minimum.  I'll admit with The Preschooler I had a successful sweep at around 39+3 however this was due to high BP and crippling pain from a trapped spinal muscle and SPD and as such was recommended by a consultant.

Sometimes, preterm delivery is unavoidable be it spontaneous labour or a managed medically necessary induction, this post however is about the unavoidable none necessary elective births before 39/40 weeks.

Forget the 37 weeks.  Banish it from your mind.  40 weeks is only an extra three weeks, even if you go to 42 it's only an extra five weeks.  In the grand scheme of things, it's just an extra month.  Your baby is worth it.  As ridiculous as it seems when you're nearing term and beyond fed up, one day you'll miss being pregnant.

So sure, try the none invasive old wive tales of natural induction.  Have some fun.  It really is true that in a healthy pregnancy, baby will only come when baby is ready anyway.  If it helps you pass the last few weeks, go for it.  Just remember, sometimes your baby simply needs that extra time, to not be rushed and to be 'ready'.



  1. Great post! I was overdue with two as well - they just wanted extra time to cook. For my second pregnancy I had to really stand my ground to try for a Vbac and to not have a section at 38 weeks (no medical reason really, I have just had a section with my first so the doctor wanted me to just schedule a section automatically) It wasn't a comfortable few weeks and I had a section in the end but I know my little guy did well for having an extra 4 weeks to get ready for the world!

  2. I went to 42 both times with mine! guess they come when they are ready ;-)

  3. Here here! My first was born at 42+2 and although i was induced, my labour happened a lot quicker than they expected and she was only 6lb15. I believe that 42 weeks was her 'time' and she would not have been ready any earlier. Likewise my 2nd was 41+6 and a healthy7lb7. Both were emcs though so my 3rd was an elective and delivered at 38+6- a tiny 5lb15. I think she would've been better staying put a couple of weeks longer too.
    This time around I want another go at a vbac and I have loosely agreed that an elective can be booked at 41 weeks, since they don't want to induce me. Thing is, I am not sure I will go into labour before 41 weeks at all, esepcially as they have moved my due date forward by another 3 days at my scan. We shall see!
    x x


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