Elective early childbirth may increase risk of complications

In recent years, more moms-to-be are choosing elective early childbirth for non-medical reasons. Perhaps they want to plan the delivery around their busy schedule or relieve uncomfortable late-pregnancy symptoms.

However, a new article in the journal Mayo Clinic Proceedings cautions women about the increased risk of complications that can occur during the early-term period, defined as between 37 and 38 weeks, six days. A full-term pregnancy is 40 weeks.

“I see many patients who want to deliver their baby in the early-term period,” says Dr. Brad Epstein, obstetrician and gynecologist on staff at Advocate Sherman Hospital in Elgin, Ill. “They are experiencing considerable pain and discomfort and mentally feel ready to deliver the baby at 37 weeks, which has been classically defined as a ‘term pregnancy.’ However, the reality is that the baby is still maturing even in the last couple weeks of pregnancy.”

According to the article, approximately 10-15 percent of all childbirths in the U.S. take place before 39 weeks without a solid medical reason. Compared to deliveries performed between 39 and 40 weeks, elective early-term deliveries are associated with an increased risk of complications for both mom and baby.

The potential complications for a baby delivered earlier than 39 weeks without a medical reason include breathing problems, feeding difficulties, increased infection risk and even death in a small number of cases, Dr. Epstein says. They are also more likely to experience a prolonged hospital stay and be admitted into the neonatal intensive care unit, he says.

Since an early elective delivery requires the woman to be induced via medications or procedures, this can often lead to prolonged labor, notes Dr. Stephen Gladdin, obstetrician and gynecologist on staff at Sherman Hospital.

Additionally, there is an increased risk of infections or bleeding complications from the instruments used to delivery the baby such as forceps or a vacuum, he says. Women who opt for an elective early-term delivery are also more likely to have a cesarean section delivery.

“If there is a medical reason that requires a woman to deliver early, such as preeclampsia or high blood pressure, then there is absolutely indication for an early delivery,” Dr. Gladdin says. “But for an otherwise uncomplicated pregnancy, there is no reason to induce someone before 39 weeks. The risks associated with an elective early-term delivery without a medical reason simply do not outweigh any benefit.”