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Elective Early Deliveries Pose Risks for Babies
Date:12/18/2008

at the conference. They include more surveillance to prevent stillbirths; changes in maternal demographics, including the fact that women weigh more; a rise in elective deliveries; and a presumption that after 34 weeks of gestation, there is little risk, he said.

But Oshiro and the other doctors said that, while many early C-sections are medically necessary for the health and safety of both the baby and the mother, families opting to deliver early for personal reasons need to know these early deliveries could put their babies at risk.

Oshiro said the pressure for elective deliveries can often come from families. "I find it hard when a woman wants to deliver before her husband goes to Iraq," he said. And obstetricians are busy and usually lack the time often needed to persuade a family that a full gestation is in the best interests of the baby.

"It's hard, because the odds are that the babies will be fine. Nine out of 10 are OK," he said. "But for medical issues, that's not good enough."

According to the March of Dimes, a baby's brain at 35 weeks' gestation weighs only two-thirds of what it will weigh at 39 weeks, and other organs like the lungs and liver are still growing late in pregnancy. Babies born at full term are also less likely to have vision and hearing problems. They also weigh more, making it easier for them to stay warm, the doctors said.

The doctors emphasized the importance of having a correct due date, especially if making a decision to deliver early. Try to remember the date of onset of the last menstrual period and have an ultrasound during the first 13 weeks of pregnancy. An early ultrasound will allow a doctor to predict an accurate delivery date, Oshiro said.

Oshiro pilots a program based in Utah that reduced preterm and early term C-sections from 27 percent to 5 percent from 1999 to 2005.

Key to the program's success, he said, has been discussing with doctors why they
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