As early elective births increase, so do health risks for mother and baby

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A dramatic increase in the number of U.S. women and physicians choosing an early childbirth comes with new health risks for mothers and newborns ...

The average time a fetus spends in the womb has fallen seven days in the United States since 1992 ...

Researchers see an "evolutionarily dramatic event" in the trend, and perinatal health experts see dangers. Shortening gestation could affect lung development and some fine-tuning of brain functions ...

... Babies born too early often sleep longer than normal and have trouble learning how to breast-feed, causing dehydration and jaundice

"For every day and every week before 39 weeks, it's an increasing risk to the baby," ...

... women are significantly more likely to experience C-sections at for-profit hospitals across the state. ... the number of women in the state who die each year from causes directly related to childbirth had more than doubled since 1996.

The rise in deaths during childbirth indicates that obstetric health has deteriorated in many important ways ...

... A normal pregnancy lasts 40 weeks, although researchers believe it probably is safe to induce delivery at a full 39 weeks. Women often naturally give birth earlier than this, and in some cases medical problems call for an early delivery. The problem comes when babies are forced out of the womb.

Of all births from 1990 to 2006, the number of babies born at 36 weeks increased by about 30 percent, and babies born at 37 and 38 weeks rose more than 40 percent, according to national statistics. There was a corresponding drop in the number of babies born in later weeks. Now, more babies are born at 39 weeks than at full term.

The data examined is considered fresh by academic standards and covers such a long period of time -- 16 years -- that experts say the trend is unmistakable

... Some early births are scheduled for the convenience of the mother or doctor ...

... One mother, Michelle Van Norman, gave birth to her second child ... 11 days early in 2006, with no need for urgency ... Van Norman, a 31-year old mom living in Las Vegas, said her doctor didn't seem worried about the date.

"There were no medical reasons for the delivery being early," Van Norman said. "He told me the week he could do it and asked me to choose which day was best for us."

None of those days was best for the baby. After his birth by C-section, one of Christian's lungs collapsed. He spent three weeks in intensive care and 10 days on a ventilator with six tubes going into his chest.

"The whole experience was horrific," Van Norman said. "It didn't end with the birth, it continued for the first year of his life, and we still don't know if the oxygen deprivation has had any affect on him." When Van Norman's surgeon cut the cord, Christian seemed robust. The doctor declined to comment about the case.

"The doctor came in the day after and asked where the baby was," Van Norman said. "When I told him, he asked me if I was joking. "... I swore from that day on I would never put another baby through that kind of torture for any reason."

In California, the state Department of Public Health, March of Dimes and California Maternal Quality Care Collaborative have released what its authors call "the Toolkit." The authors note that deliveries at 37 and 38 weeks account for about 17.5 percent of total births in the United States

Babies born early through induction or C-section without a medical reason are nearly twice as likely to spend time in the neonatal intensive care unit ... They also are more likely to contract infections and need breathing machines ...

"We are finding out that the last weeks of pregnancy really do count" ...

"At 35 weeks, the brain is only two-thirds of what it will weigh at 40 weeks." Many organizations are responding with programs designed to eliminate early elective deliveries ...

Melissa Maimann, Essential Birth Consulting 0400 418 448