Editor’s note: This story was originally published on momaha’s sister site, LiveWellNebraska.com
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By Bob Glissmann
WORLD-HERALD STAFF WRITER
Moms offer their doctors plenty of reasons for wanting to deliver their babies before their due dates.
And physicians often accommodate them.
“They’re saying ‘Come on, Doc. My mother-in-law’s coming. She’s going to help take care of my other kids,’” said Dr. Robert Bonebrake, a perinatologist at Methodist Women’s Hospital. “And a really tough one: ‘My husband’s going to be shipped out’” for military service.
But unless there is a medical reason for delivering before 39 weeks of pregnancy, he said, doctors need to get tough.
“Sometimes, well-intentioned, we end up doing some things that may not be completely the best for the entire situation,” he said.
Bonebrake noted that rates of neonatal and infant mortality, respiratory problems, jaundice and admissions to neonatal intensive care units are lowest when a pregnancy reaches 39 to 40 weeks.
Convenience, he and others said at a Monday press conference, is not a good reason for delivering a baby early.
The March of Dimes, which advocates for pregnancy and baby health, is leading a nationwide initiative to lower the preterm birth rate. The goal in Nebraska is to lower the rate from 11.5 percent to 10.6 percent by 2014.
Addressing early elective deliveries is one part of that effort, as is educating mothers about the risks of smoking and alcohol use during pregnancy and controlling expectant moms’ high blood pressure and diabetes.
Sometimes a medical reason arises either with the mother or the baby that requires an early delivery, said Dr. Joann Schaefer, Nebraska’s chief medical officer. She said, however, that “there are a lot of inductions that are occurring in moms that don’t have a medical reason to occur. That’s a behavior that we want to stop.”
Allowing a baby to come to term, Schaefer said, gives the baby more time to grow and increases the likelihood of a healthy baby.
“A baby’s brain, lungs and liver are still developing in those last few weeks,” Schaefer said, “and we need that baby to come out when Mother Nature says it’s time.”
Of the 1,177 Nebraska babies whose births were induced from 37 through 38 weeks’ gestation in 2011, about two-thirds were elective, state figures show.
Preterm birth — before 37 weeks of pregnancy — is a serious health problem that costs the United States more than $26 billion annually, according to a 2006 Institute of Medicine report. But deliveries that are considered “late preterm” and “early term” also can be problematic, Bonebrake said.
Monica Seeland, a Nebraska Hospital Association official, said her group would encourage physicians, nurses and administrators to make sure they have a birth-scheduling policy that addresses early delivery without a medical reason.
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