Poll: What is your doctor's goal? 34 weeks? 36 weeks?

[Angela]

I've talked to quite a few women lately who have said that their doctors won't stop labor once they have reached 34 weeks. One of the doctors at my OB/GYN's office said the same thing  (because their "NICU outcomes were so favorable," he said), but my usual doctor said to continue with bed rest and nifeipine until 37 weeks. Developmentally speaking, there is a world of difference between 34 weeks and 36 weeks, and even a big jump between 36 and 37.

Had anyone's doctor said that they won't stop labor after 34 weeks? And why would this be the standard protocol?

We have a right to medical intervention when it is in the best interest of our babies, and if it is not a risk to ourselves (as with preeclampsia, gestational diabetes, etc.). Shouldn't our goal be 40 weeks? With my first pregnancy I didn't know what the treatment options were. With my second pregnancy, I did, and I was able to ask the right questions and keep my little guy cookin'. I want that for EVERY pregnant women. If you haven't had a chance already, please take a look at the most current treatment options here: www.keepemcookin.com/prevention.aspx

I look forward to hearing what you ladies think...

[firedancertat]

My doctor will not stop labor after 34 weeks.  My 1st child was born at 34 weeks, completely healthy, by the way.  They hope to make it to 34 weeks with this one also, but my preterm labor started at 13 wks this time instead of 20. 

[flowerpot77]

Hi Angela

I am from the UK and do you know they don't believe in stopping labour here?!  (well not in this hospital).  I am always reading latest research etc so i know in America they always use all these drugs to halt an early labour.  I asked my doctora bout this and she said they only use it here if a lady needed transported to another hospital for a NICU bed.  All very strange.  Why would the UK not use these drugs?

I came into hospital at 21 weeks.  If I went into labour now (24 weeks) they would not stop it.  They said they will be pleased if I make 26 weeks.

The differences in UK and USA medicine are quite huge in obstetrics.  I am very lucky to have got the Fetal Fibronectin test, only one hospital in the UK routinely use it whereas I know you all have it in the USA, is that so?

i guess a lot of the differences are in the fact that we have the NHS system and you all have to pay out there?

Anyway, just thought I would mention it! 

Flowerpot

[Elizabethsmom]

Hi!  I'm new to the forum and love it so far.  My doctor also said he won't stop labor after 34 weeks because the drugs given do have risks to mom and baby and if the baby is healthy and will most likely do well in NICU, it's not worth the risks. 

-Stacy

[plmommy]

My doctor won't stop labor after 34 weeks also. Because my current issues I will be scheduling a csection at 37 weeks with this baby. My doctor feels like it might be dangerous for me to into labor on my own.

[Fyreflye]

Hooray! 34 weeks today!  I know my Dr's dream goal is a scheduled c section at 39weeks, but right now we are taking things week by week.  She suggested that we find a way for someone to be home with me and my 4 yr old during the day and I do as strict bedrest as we can manage to keep baby in there as long as possible.  I will be having an ultrasound probably next week to check things out.  I had my daughter at 37 weeks and have felt the whole time that this baby would come around then, we will see how it goes.  Baby is fine and active, and my cervix is thick and closed, but having a lot of discomfort and intense pain. If I go into labor, will be rushed to surgery for c section.  Today is a big goal day!     Fyreflye

[mihindimindy]

my doctor wants me to get as far as possible.  He hasn't said whether he would try to stop labor or not, since historically that hasn't been an option for me - I don't go into labor, my water just breaks pretty much w/o notice.  I think he will be satisfied if I get to 34 weeks.  That's how far I was with my daughter when she was born and she is fine healthy and wonderful.  She had great apgar scores.

[mommy-ready]

that's a very good question!  I've been on bed rest since wk 25, when my cervix measured 1.08 cm.  I was on hospital bed rest for 2 weeks and then released to modifed bed rest at home.  I was too late for a cerclage, but they did put in a pessary which has been very helpful as my cervix has reached 2.7 cm.  HOWEVER...  on Monday my dr did an exam and said I was 3-4 cm dilated and 50% effaced.  And, although my cervix is longer and very high, they repeated the steriods for the baby's lungs and put me on procardia, indocin, and progesterone.

Upon my release from the hospital yesterday my dr told me that we would leave the pessary in and continue meds until 36 or 37 weeks; he feels very strongly that I won't stay pregnant much longer once we stop the meds and take the pessary out.  HOWEVER...  my husband and I are really on the fence about how long we want to continue medications and interventions.  Especially since we are quite certain our little princess is very healthy and strong.  We have decided that we will not allow an increase in meds or any additional meds or interventions that are not natural.

Thoughts?

[drapkowicz]

My Perinatologists told me that with all the medical advances today, that there is not a miracle drug to stop labor.  He said we have a few options, (all of the same that most women in this situation take) but that if the baby wants to come the baby wants to come and drugs may buy you a little bit of time but thats it.  It seems from hearing some stories that they do work in certain circumstances and for certain people.  In my case with ruptured membranes, they are concerned about infection and risks to the baby and his cord, so they prefer not to keep women pregnant longer than 34 wks.  My doc said, the risk is not worth it at that point.  I was a bit shocked myself! I asked if at 34 weeks if i could go home and deliver with my regular doctor and they didn't recommend that at all! So i am going to take their word for it and hope for the best!

[LadyMtBiker]

I'm working with midwives (that work at a hospital) and their goal is to keep the baby 'cookin' until I am no longer 'high-risk'.  (Guessing 37 weeks)  Otherwise, I would need an OB... and we all really want a midwife to deliver our baby (using The Bradley Method).

[AboutPreemies]

I love Fyreflye's comment that her doctor's dream goal is 39 weeks :-) Between 34 and 36 weeks babies are considered late preterm babies - usually fine, but sometimes with sugar, temperature, or more likely, feeding issues. Breastfeeding can be hard for these little guys because they're not strong enough to bring in a good milk supply in mama - so stay vigilant with feeding times and weight gain! As a NICU nurse, I've seen a lot of these little guys come out fighters with absolutely no issues at all - and I've seen some who have serious respiratory trouble from the start and need a 2- to 3- week NICU stay to learn how to breathe and eat.

All that said, there are a lot of good points brought up in your posts. If you're ruptured, than infection risk really is a major concern. And the interventions we use to stop preterm labor aren't very effective, but they do have side effects. If we're talking about the best time to take out a nice, stable cerclage, than the later the better - but if we're looking at a mom who's standing on her head, ruptured, on 3 different drips, than 34 weeks is a great goal.

[autoimmunelife]

We haven't been given an answer as to when they won't stop labor.... they do want to see us at 37 weeks or more, but at this point (especially since mag doesn't stop my labor or cervix changes... it just makes us sick) they haven't given an actual point where they would or wouldn't stop labor... the main goal at this point is "as far as we can get the pregnancy to continue"....

[JacErnst]

My doctor would prefer to get to 38 weeks, but depending on his size we're going to be really happy with 36 weeks. If i go before 34 weeks, we will try and stop it and hold off until 36 weeks. But it will all depend on him.

My OB is brand new - just finished med school - so she's coming at it from a new perspective. not as old school as some of the older docs. she'd rather see him in there growing then outside.

[Reaganh3]

Just got the answer to this question last week.  My doctor's goal is 36.5 weeks, which just happens to equal Valentine's Day.   

[Yvonne]

The words my doctor used were ". We'll be thrilled if you make it to 34 weeks.  If you make it to 36 weeks, we'll do a happy dance".

Given, we are expecting twins, so perhaps that changes the situation a little...I'll have to remember to ask if they will try to stop labour after 34 weeks at my next appointment.

Yvonne