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We've certainly come along way when it comes to saving mothers and babies during childbirth. But we still have a lot to learn.
In the March 1st issue of the Wall Street Journal, Laura Landro, the Informed Patient columnist, writes a piece that in some ways seems silly to have to have been written at all. Emerging evidence, she writes, suggests that when the pregnancy is going along smoothly, the birth should not be induced before 39 weeks.
So-called elective inductions (inducing for no other reason but that you or your doctor wants that baby out already), accounts for a quarter of all births nowadays, up from less than 10 percent in the 1990s, Landro reports.
Why would anyone want to tinker with nature? Well, it seems that sometimes this date or that one fits a mother's hectic schedule. Or maybe it's just more convenient for the obstetrician. The thinking has been that 37 weeks is enough time in the womb, so it could not hurt to get the baby out shortly thereafter.
Part of the problem is the fixation on due dates. Years ago, a group of obstetricians writing in The Lancet, suggested that their colleagues forgo the specific date and instead tell their patients that the baby will be born some time within a four week period. That way, if the pregnancy goes past that arbitrary date, women will not worry. But somehow we all want one date. It's a fun gimmick. We all hear women refer to their baby being born a day early, or two days late, when in fact that baby came out right on time.
Human babies gestate for some 38 to 42 weeks. The problem with elective induction, as Landro writes, is that emerging studies suggest babies born at 37 weeks-which many physicians have considered full time-are more likely to have defective brain development, potentially upping the odds of emotional issues later on, according to the National Institute of Child Health and Development.
I think there is a difference between a baby who comes out naturally at 37 weeks and one that is encouraged to come out at the same time, nudged by modern technology. Those last few weeks of pregnancy and even labor may stimulate some of the final touches necessary for proper brain and body function.
There are signs of hope. Some hospitals, according to the Wall Street Journal, have new policies to prohibit doctors from scheduling deliveries before 39 weeks if there is not medical reason to do so. Also, some birth classes are trying to teach women about the risks of inducing early.
There are so many wonderful mysteries about the entire birth process. We can now watch sperm meet egg; we can place the embryo into the womb; and then we can measure our hormones and watch the baby with ultrasound along the way. But let's not overestimate our know-how. Sometimes, babies know when they are ready for the outside world-or at least our bodies seem to know. Our children have so many healthy years outside of the womb, let's not make hasty decisions. We owe it to them to let them get the best preparation inside the womb so they can be the best they can outside.
