Delivery at 37 weeks?

Hi lovely knowledgeable ladies,

My sister's SIL is 34 weeks pregnant with baby number 1, coming up to 35 weeks. She has had a really rough trot since about 32 weeks with seemingly non-pregnancy related issues: headaches that turn into migraines accompanied with vomiting leading to dehydration. She was in and out of the Mercy and Austin getting rehydrated and medicated to try and ease the pain and the vomiting. Sent her home and she was back quickly with more of the same. She's had tests and scans and they can't seem to pinpoint what it is and she has been basically sent home with strict instructions to rest.

There's nothing wrong with the baby. She's had monitoring and all seems fine. She is still suffering from headaches and vomiting but she seems able to keep things down so she's not getting dehydrated. They think that while it doesn't seem to be pregnancy-related, the pregnancy is probably either making it worse or preventing her from getting appropriate treatment.

Sister has just told me that SIL's neurologist has told her that she just needs to get to 37 weeks then baby will be full term and they'll be sending her off for a c-section.

SIL is not happy about a c-section but will do it if that is what she is told is happening. Apparently they have also discussion possible induction. My sister has told her about the "cascade of intervention" etc but doesn't think it's sinking in.

I've told my sister that SIL needs to talk to an Obstetrician about the optimal delivery time because a neurologist is surely not the best person to be making decisions about delivering a baby.

My sister has asked me about benefits of delivering a baby at 37 weeks versus leaving it to bake a bit longer, until she goes into labour naturally. Does anyone have any ideas??

What about benefits of induction vs natural labour?

All I know is that my Ob would not schedule my c-section till I was past 38wks as they run the risk of dates being out and they actually end up with a premmie, unless there was something wrong with baby or me, OR I went into labour. I was a scheduled c-section and DS2 was born at 38wk5d. The Ob only operated on certain days and the week before I would have been 37wk2d and he would not schedule me that early. HTH

My ob is delivering me at 37weeks and said he doesn't expect any problems.

My DD was born via emergency c-section at 36 +5 as my placenta has started to calcify. She was born healthy but small. Her Apgars were 9 and 10 and she didn't need to go into special care at all. However- she suffered severe silent reflux for the first 6 months of life and the doc put it down to her stomach valve being under developed due to premature birth. We also had A LOT of trouble breast feeding as she had no suck reflex at all.

I don't have any experience with induction but my c-section experience was fine. I got skin to skin and bub with me in recovery. I would guess that they will be concerned about what is going on with SIl's health and can't run tests ect while she is pregnant. Neurological issues can happen quickly and there may be a big difference in getting her diagnosed earlier (even if only 3 weeks earlier)

Ultimately its SIL's decision and she should be discussing her options in collaboration with both her Neurologist and her Obstertrician.

Obviously its not a life or death situation otherwise Babe would have been born by now. Its more of a "hinderance" situation due to the vomiting and dehydration.

I'm no Dr but its sounds to me like it probably is pregnancy related IF the condition wasn't pre-existing.

We all know that term is considered 37 weeks for 42 weeks but thats not to say that by delivering a baby at 37 weeks isnt without risks. Each baby is different. Although considered term at 37 weeks the babe can still be at risk for Respiratory Distress aswell as Small for Gestational Age as well as other issues that can come with having a pre-term baby.

The longer that babe stays in the better. Simple.

As for the delivery. I'm in 2 minds. Being a nuerological issue, going through the "stress" of labour might aggrivate the issue causing more stress for mum and therefore baby. However, if its believed that SIL's migraines can be controlled throughout labour and this is SIL's preference, then a vaginal birth would be an ideal option.

Again though...SIL needs to sit down with all involved to be able to come to a safe, educated decision.

All the best!
xx

There are always going to be benefits of a naturally started labour v induction v c/section - that's a given.
But saying that. This girl sounds like she's going through hell.

They will have to send her to an Ob to have any sort of intervention. There will be a team of doctors trying to help that mum and bub but they will also weigh up the health benefits of the mother. Sometimes for mum earlier is necessary not just better.
I'm having a (necessary) planned section later this month, but after today I might be looking at one this week. At 37 weeks. I'd rather do that than have a stroke/have my kidneys fail. I need to be able to function. It's not always the way we plan.
I hope SIL finds herself a great team to get the optimal outcome for both of them.

I was induced at 37 and 36 weeks respectively. Both times bub was fine and didn't need SCN at all. However both were very sleepy and the first had jaundice. These both made breast feeding very challenging.

I'd go an induction over c-section anytime but that's my choice. I felt very strong going into both deliveries. Inductions are very intense and if she's not 100% then she might not be able to cope.

Let us know how she goes.

Thanks for all the replies, ladies. I really appreciate it!

She is going through hell. She just wants it to be over. Sister and I had discussed the fact that headaches and vomiting do not make for a life-threatening condition but Sara makes a good point, sometimes neuro conditions can come on quickly... :think:

Also, the neuro has indicated exactly that - they are not sure how she will cope with natural labour, given how much stress her body is under, not to mention the mental stress.

She's going public - can she request an appointment with an Ob?

I would think it all depended on the individual baby. Some babies need to bake longer than others which is why "full term" tends to go from 37-42ish weeks. For me I'm sure that my bub would be fine at 37 weeks as both my previous babies made their entrance naturally at 37 1/2 weeks and both rather large (8lb10oz and 8lb3oz) and have had no gestation related issues. But then you hear of others going "over due" and still having small babies that require a little help to adjust to life on the outside.

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She's going public - can she request an appointment with an Ob?

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She sure can if they are discussing inducing or c section at 37 weeks. To make this decision, she needs to be provided with information on her options.

Babies born at 37 weeks often have more difficulty getting breastfeeding established.