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37 Weeks is No Longer a Full Term Pregnancy According to ACOG

post #1 of 20
Thread Starter 

In hopes of reducing elective inductions, increase spontaneous labor, and set better expectations for pregnant women, the American College of Obstetricians and Gynecologists have redefined and relabeled the ending weeks of pregnancy. At 37 weeks women are no longer considered "full term." Find the new term categories here.

 

Quote:

In the past, the period from 3 weeks before until 2 weeks after the estimated date of delivery was considered “term,” with the expectation that neonatal outcomes from deliveries in this interval were uniform and good. Increasingly, however, research has shown that neonatal outcomes, especially respiratory morbidity, vary depending on the timing of delivery within this 5-week gestational age range. To address this lack of uniformity, a work group was convened in late 2012, which recommended that the label “term” be replaced with the designations early term (37 0/7 weeks of gestation through 38 6/7 weeks of gestation), full term (39 0/7 weeks of gestation through 40 6/7 weeks of gestation), late term (41 0/7 weeks of gestation through 41 6/7 weeks of gestation), and postterm (42 0/7 weeks of gestation and beyond) to more accurately describe deliveries occurring at or beyond 37 0/7 weeks of gestation. The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine endorse and encourage the uniform use of the work group’s recommended new gestational age designations by all clinicians, researchers, and public health officials to facilitate data reporting, delivery of quality health care, and clinical research.

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As we all know healthy babies are born on both sides of the due date bell curve - 37 weeks and 43 weeks - and it really doesn't matter what label of "term" these weeks are given. However, I do believe that this redefinition will help mother's prepare to reach and go past their due date without feeling like their pregnancies should be "over" and ask for an induction, and/or her providers will be less likely to oblige.

 

What do you think about ACOG's decision to redefine 'term' pregnancy?

post #2 of 20

WOOOHOOOO!

ACOG doing something that makes sense and its actually all about the health of moms and babies? NO WAY! hahha!

 

This is fantastic. I get SO sad when I hear my friends say, "Well, I'm 37 weeks now! Baby can come anytime!" Or, "My doc is waiting until 38 weeks to schedule the c/s because then I'll be full-term".

Its just sad. This is great news.

post #3 of 20

I like this - but, I had a 37 week totally spontaneous and natural delivery and my baby boy was healthy - but certainly not as done as others. He did great - but - I wouldn't classify 37 weeks 0/7 term ... he didn't look completed fully for a few weeks. That said - he and his birth were perfect - so what do I know?

post #4 of 20

My first born was 10 days late.  He was 9,9 with a huge head, and I am a 5,2, 100 pound woman.  He had to be pulled and pryed with forceps, and has neurological problems.  I will alway wonder if he should have been a C section, on time.  My daughter, same size as me, went in labor a week early, and after a long labor, she had to have an emergency C section to deliver her 8,9 baby.  The baby also had to be pulled out of the pelvic.  Now she can't plan her next C section until 39 weeks, and she would like to do it at 38 weeks.

So, I think it depends on the size of baby and mother.

post #5 of 20
Quote:
 

My first born was 10 days late.  He was 9,9 with a huge head, and I am a 5,2, 100 pound woman.  He had to be pulled and pryed with forceps, and has neurological problems.  I will alway wonder if he should have been a C section, on time.  My daughter, same size as me, went in labor a week early, and after a long labor, she had to have an emergency C section to deliver her 8,9 baby.  The baby also had to be pulled out of the pelvic.  Now she can't plan her next C section until 39 weeks, and she would like to do it at 38 weeks.

So, I think it depends on the size of baby and mother.

I think size of the baby should be secondary to lung maturity.  

post #6 of 20
I also noted this:
Quote:
In order to facilitate data reporting, delivery of quality health care, and clinical research, it is important that all clinicians, researchers, and public health officials use both uniform labels when describing deliveries in this period and a uniform approach to determining gestational age.

I have always poo-pooed the idea of dating ultrasounds as unnecessary, but if it helps the medical community as a whole get a firmer grasp of what outcomes can be expected at what gestations, then I think that would be great. All of my kids have been born (spontaneously) in the time frames that are now defined as "late term" and "postterm," and I would love to have solid science on just how risky it is to go past 42 weeks. The first step in that, obviously, would be having a better idea of who is actually going to 42 weeks, and whose dates are just a bit off.
post #7 of 20
Quote:
Originally Posted by peggybehnke View Post

My first born was 10 days late.  He was 9,9 with a huge head, and I am a 5,2, 100 pound woman.  He had to be pulled and pryed with forceps, and has neurological problems.  I will alway wonder if he should have been a C section, on time.  My daughter, same size as me, went in labor a week early, and after a long labor, she had to have an emergency C section to deliver her 8,9 baby.  The baby also had to be pulled out of the pelvic.  Now she can't plan her next C section until 39 weeks, and she would like to do it at 38 weeks.
So, I think it depends on the size of baby and mother.

I don't fully understand the problem here. If it's a planned c-section, and they aren't going to wait until the baby is already stuck in the pelvis before going to surgery -- even if she went into labor spontaneously, they'd take her in for the c-section right away and not wait until things went badly -- why does the size of the baby matter? If the baby is going to be born by c-section no matter what, and therefore won't be getting stuck in the pelvis, it seems like the only consideration left is making sure the baby is as mature as possible before the surgery.
post #8 of 20

I think this is wonderful! So many mothers think that 38 weeks is the max they should have to carry their baby.  Just because they are "full term" on paper doesn't mean baby is ready to come out.  My last two were born spontaneously at 35 weeks and 37 weeks and thankfully they were both completely and absolutely healthy but they also came on their own with no interventions.  My first two children came on their own at 38w5d and 39w.  My 39 weeker was my largest baby, she was a 1 lb. 4 oz. heavier than my 38w5d baby, 1 lb. 7 oz. heavier than my 37 weeker and 3 lbs. 6 oz. larger than my 35 weeker.  Babies need that extra time to mature and develop.

post #9 of 20

Agreed!  There's plenty of time from when your water breaks/contractions start to have a c-section for whatever the reason is.  My child was born via c-section because he was frank breech (and that's a topic for another day, because I still believe he could have come out vaginally), and from the time my water broke, to when he was actually born, only 5 hours passed.  Now if the person is one of those who have children 30 minutes after contractions start, that may be a problem, but for most this isn't the case, and that's where baby-led c-sections are best.  Also, not only are you sure the baby is mature enough to be born, but the contractions themselves help prepare the lungs for life on the outside.  IMO, baby led c-sections are a much better option then scheduled sections.

post #10 of 20

The number of weeks of gestation does not mean a baby will be too big to birth. I am 5'2" and was tiny before pregnant and went over 42 weeks and my baby was only 6 pounds 6 ounces. Healthy pregnancy, easy vaginal delivery. My next pregnancy went 38 weeks before I went into labor and the baby was 7 pounds 6 ounces (4 less weeks and the baby weighed a pound more). I knew when I got pregnant because I was keeping ovulation charts so my dates were accuate. 

 

Lung development is usually not an issue after 36 weeks. What is important after 36 weeks is brain development. Every week the baby can stay in the womb is very important and can't be duplicated outside the womb. If a woman and her doctor got the due date wrong and do a planned C-section when the baby is really 36-37 weeks, the baby's lungs will be okay but the baby will have been born too soon for brain development. This can have lifelong consequences for the baby and the family. 

post #11 of 20
Lung development can be an issue. It's part of the reason the babies born by c/s are more likely to have respiratory issues. The other part of that equation is that the miss out on the chest squeezing which vaginally-born babies get and therefore may not have drained all the fluid from their lungs.
post #12 of 20
I think they HAVE to start using U/S & *gasp* trusting women's own O date over LMP dating also. I think a good portion of LMP dating is not accurate.
post #13 of 20

It's not as common at 36 weeks, but yes, lung development is still an issue.  My now 6 month old was in the NICU for nearly 2 weeks with immature lungs when he was spontaneously born at 36 weeks.  My first baby was spontaneously born at 35 weeks with very minimal lung issues (just some fluid at birth) and only stayed in the NICU for 35 weeks to gain some weight and get over a little jaundice.  My middle 2 babies were 38 and 39 week deliveries and were perfectly healthy and came home within 48 hours.  There are a lot of variables and there is nothing negative that can come with changing the standard of term to mean 39 weeks.  The longer a baby can "bake", the better.

post #14 of 20
Quote:
Originally Posted by dinahx View Post

I think they HAVE to start using U/S & *gasp* trusting women's own O date over LMP dating also. I think a good portion of LMP dating is not accurate.

 

Who are these providers who go solely by LMP dating and don't do a dating ultrasound? I think that practice has gone or is going the way of the dodo bird. (And where it isn't, it should.) Though the first midwife office I saw, who refused to accept my O date, demanded a LMP date, and then said they needed a dating ultrasound because LMP dates aren't very accurate... they can go hang. I did get the dating ultrasound with my second one, though I could have declined it for the same reason, but I wanted to see the baby. :) 

post #15 of 20
Refusing to accept O dates is still VERY common. IMO it is ridiculous because women have access to better & better O dating technology. A lot of OBs also still 'change' due dates through the pregnancy. Just not very scientific . . . LMP IMO still gets overmuch weight . . .
post #16 of 20
I was lucky this time b/c my U/S confirmed my O date which was 7 days off from my LMP date. But if it hadn't, they wouldn't have accepted my O date which was backed up by OPKs, charting/temping AND the date of my first + test.

In my last pregnancy, my very cool OB still tried to change my date to one that was *impossible* & 7 days before my actual date. It would have had me ovulating on like day 7!
post #17 of 20

I thought everyone was compensating for LMP dating being inaccurate by doing more ultrasounds. I don't know why the idea that someone might know their O date is so bizarre to some providers. :dizzy

post #18 of 20
Quote:
Originally Posted by dinahx View Post

Refusing to accept O dates is still VERY common. IMO it is ridiculous because women have access to better & better O dating technology. A lot of OBs also still 'change' due dates through the pregnancy. Just not very scientific . . . LMP IMO still gets overmuch weight . . .
I agree! In my experience most providers reject the concept of a woman knowing when she O'd. They go on LMP very heavily. I had a hard time refusing an early dating ultrasound bc my LMP didn't match my dates, and and had to argue the rest of the pregancy about due dates. I now just give my LMP as 2 weeks before I O'd, but I shouldn't have to.
post #19 of 20
I agree: I have contemplated just lying (subtracting 14 from my actual O date) but I tell the truth in all its complexity to advance science & womankind. wink1.gif

IDK why they have trouble accepting something that I have evidence for (Charts & OPKs) but readily accept something I just 'recall' & could totally make up.
post #20 of 20
So just what I am saying is that a good percentage of babies we call 37 weeks could actually be 36 or 35w4 even.
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