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News from Wyoming Department of Health

It’s Best for Babies to Wait

5/13/2014

The Wyoming Department of Health is reminding families who may be expecting babies that it is best to wait for labor to begin on its own with most healthy pregnancies.

Health care experts say babies should not be delivered before at least 39 weeks unless there is a valid health reason or labor starts on its own. “We know babies do best overall when they get at least 39 weeks to grow and develop before they greet the world,” said Dr. Wendy Braund, state health officer and Public Health Division senior administrator with the Wyoming Department of Health.

In Wyoming, the death rate among young infants is highest for those born “preterm” (less than 37 weeks). The increased risk persists among births considered to be “early term” (37-38 weeks). Compared to babies born at 39-41 weeks or more, the risk of young infant death is nearly two times for those born at 37-38 weeks. About 30 percent of Wyoming babies are born at 37-38 weeks.

Braund noted that many people do not realize that it takes 39 weeks for a baby to be considered “full term.”

Dr. James Bush, Wyoming Medicaid medical director with the Wyoming Department of Health, said, “Most of the time, baby naturally sets the schedule for delivery. Other times, labor is induced (scheduled and started with medications) or caesarean sections are planned. It’s the early elective deliveries we hope women avoid.”

Bush said Wyoming Medicaid does not reimburse doctors or healthcare facilities for elective inductions or caesarean sections before 39 weeks.

Nationwide, up to 10 percent of all babies are scheduled for delivery before 39 weeks without a medical reason. Non-medical reasons for early delivery may include provider preference, convenience, distance to delivery hospital and symptom relief.

A pregnancy that lasts at least 39 weeks gives the baby’s brain and body the time needed to grow. “At 35 weeks, a baby’s brain weighs only two-thirds of what it will weigh at 39-40 weeks. The part of the brain that controls awareness, perception, reason and movement does not fully develop until 39-40 weeks,” Braund said. “Babies need time for the full development of other important organs such as the liver and lungs. A full-term pregnancy also allows more time for babies to learn how to suck and swallow, and gain weight, which help keeps them warm.”

Scott Matthews, director of program services at the March of Dimes Colorado/Wyoming Chapter, said “We know babies born prematurely are at greater risk for health problems such as brain and lung development, vision or hearing loss, and difficulties eating after birth. Many of these can be lifelong problems so if the pregnancy is healthy, we urge women and practitioners to let labor start on its own or, if possible, wait until at least 39 weeks of pregnancy.”

Early elective deliveries, or deliveries occurring before 39 weeks, have been associated with increased risk of lower brain mass, low birth weight, feeding problems and respiratory distress syndrome for babies. Moms may face an increased risk of postpartum depression and complications requiring longer hospital stays.

Bush acknowledged that it is not always better for a pregnancy to continue to 39 weeks or more. “There are times when important medical reasons make early delivery the best choice for the baby and mother. These situations should be discussed and decided with a doctor.” Wyoming Medicaid covers early delivery procedures before 39 weeks when there is a valid and documented medical reason.

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