Follow the directions on the box: Early elective induction is not a good idea


The Pediatric Insider

© 2011 Roy Benaroch, MD

Doting Dad: “So, how do you like your birthday cake?”

Dubious Daughter: “Um….it’s OK, I guess. Why is it so runny?”

Doting Dad: “Oh, the box said cook it for 30 minutes, but since we’re in a hurry I took it out of the oven early. Here, have a spoon!”

Dubious Daughter: “Um….mom??”

Pregnancy is a mysterious process. We’re pretty sure we know how it begins, but we honestly have no idea why women go into labor at 40 weeks. How the baby (or mom) knows it’s time to begin labor, we don’t know.  But it seems to work out if we let labor begin on its own without second-guess the timing. Of course, there are some circumstances where for the health of baby or mother, it’s best to start labor early. But most of the time, a hands-off policy (remember, we’re talking about the end of the pregnancy here) works out just fine.

But what if you’re in a hurry, or you want a colorful 11-11-11 birthday for Junior?

Leave it to humanity to not leave well enough alone. A growing number of pregnancies seem to be ending in “elective inductions” on dates chosen for all kinds of reasons. That might be OK, if the baby’s allowed to stay in the oven long enough. But many of these pregnancies are being electively induced prior to 39 weeks gestation. And it turns out that babies born even a little too early may have some serious (and preventable) health problems.

As reported in the Wall Street Journal, growing evidence of the harm of the not-quite-term elective delivery is leading to a push back against these early inductions of convenience. Babies born prior to the natural gestation of 39 weeks have more problems with feeding, and are more likely to have difficulty breathing. They’re more likely to need a prolonged hospital stay, and more likely to have permanent health consequences of their complications such as hearing or vision loss. They have an increased risk of psychological and learning issues, perhaps stemming from inadequate prenatal brain development. While most babies born a week or two early will do fine in the long run, many will not—and we can’t tell before the baby is born if these problems are likely to surface.

There are sometimes legitimate health reasons to delivery a baby early. But without a specific medical reason, early elective induction prior to 39 weeks poses an unacceptable risk to the long-term health of your baby. It’s better to follow the directions on the box. You’ve waited 37 weeks–another few weeks is worth the wait for a healthy baby. Let the pregnancy end when it’s supposed to, and enjoy years of tasty, well-baked birthday cake together.

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