As much as she enjoyed being preggers, Janice Koh, 32, couldn’t wait for her baby’s arrival. She was desperate to give birth before 40 weeks because she had been suffering from symphysis pubis dysfunction, a severe form of pelvic pain, since her seventh month.
“Somebody told me that delivery will happen early with first pregnancies, so right after 37 weeks, which I knew is the medical definition for full-term, I was literally counting down the days to going into labour,” Koh says.
Her pelvic pain had only worsened over time, despite getting regular physiotherapy and being put on bed rest. “The bigger the baby got, the more pressure he put on my pelvis, which made things worse,” Koh recalls. “I asked to be induced after 37 weeks, but my gynae gave me a big, fat no. She said as long as I can hang in there I should because the last few weeks are the most crucial for baby.”
Surfactant ― a substance in the lungs that keeps the tiny air sacs open ― helps baby to breathe independently. Produced in greater amounts during the last few weeks of pregnancy, this compound is vital to baby’s overall well-being
In the medical world, pre-term labour is defined as giving birth before 37 weeks of gestation and the reasons vary. Often, it’s due to the water bag bursting from trauma or an infection, cervical incompetence, placenta abruption or bleeding from low lying placenta (placenta praevia), notes SmartParents expert and Gleneagles Hospital’s consultant ob-gyn, Dr Christopher Chong.
In other cases, your doctor might decide to advance your baby’s delivery because of complications such as pre-eclampsia, characterised by high blood pressure and signs of damage to your liver and kidneys. Not doing so can be fatal for both mummy and baby.
Medical reasons aside, a number of women do request an early delivery for personal reasons. “Some do it for horoscopic reasons and some want it because their husband works overseas and has limited time at home,” Dr Chong explains. “And in one patient of mine, when she noticed her first stretch mark! Fortunately, she was already past 36 weeks!”
Less than one per cent of Dr Chong’s patients ask for an early elective delivery that is non-medical. Nor will he consent to just any request. “I don’t allow any deliveries before 36 weeks. After 36 weeks, it is on a case-by-case basis after assessment, discussion and counselling.” This assessment includes:
* Scans to show that the foetus is of a good growth, size and weight.
* The water level in the water bag is normal.
* The heart beat check via a CTG (cardiotocography) machine is normal.
* The injections given to mature the foetal lungs are all on track.
Like Dr Chong, most doctors have plenty of reasons to be strict before they consent to early deliveries. This is despite the pregnancy having passed the 37-week mark, and everything looks good with mum and baby.
Though you have three short weeks to go before 40 weeks, this is when the most crucial development happens for your little one. Here are six reasons why it’s beneficial to hang in there…
1. Surfactant is being produced in greater amounts
Surfactant ― a substance in the lungs that keeps the tiny air sacs open ― helps baby to breathe independently. Produced in greater amounts during the last few weeks of pregnancy, this compound is vital to baby’s overall well-being. “Otherwise, the baby will have respiratory difficulty and may need intubation and ICU care, which can be very costly,” adds Dr Chong.
2. Their organs are maturing
While a baby’s organs are fully formed by 37 weeks, they continue to mature after that. The development of the brain and nerve connections ensures that bubba won’t have any issues with sucking and swallowing after birth or behavioural problems in the future. As for the liver, “the more it matures, the lower the risk of jaundice after birth,” Dr Chong explains.
“If you go into natural labour, the cervix is often ripe. An unripe cervix takes a longer time to soften and ripen and are slower to dilate, hence, resulting in a longer labour or even a C-section.”
3. They are producing more body fat
Is there anything cuter than a chubby baby? Great to tweak, these way-pinchable rolls of fat, which multiply during the last weeks, are actually a sign that your bambino is growing healthily. Her skin is thickening and the more body fat she accumulates, the better she’ll cbe able to maintain her body temperature after birth. Bub’s fat also acts as a nutritional reserve, giving baby enough energy to sustain herself as she waits for mummy’s milk to come in. Good news for you because you’ll less stressed about your milk production, and possibly, enjoy a smoother breastfeeding experience.
4. Babies born early may end up in the neonatal intensive care unit (NICU)
Babies who don’t hit the official full-term mark have a higher risk of health and birth complications. “They may end up in the NICU for respiratory help and drip or tube feeding,” Dr Chong notes. This means you might have to forgo your first cuddles and skin-to-skin contact with bubba during that all-important Golden Hour right after birth, which will help your bond while boosting breastmilk production.
5. Mummy is more prepared
Waiting the 40 weeks isn’t only helpful for bub, but also for the mother, whose body is made to deliver vaginally at full term. “With natural labour, you have a better chance of normal delivery ― all else being equal ― and also a shorter labour,” Dr Chong notes. “If you go into natural labour, the cervix is often ripe. An unripe cervix takes a longer time to soften and ripen and are slower to dilate, hence, resulting in a longer labour or even a C-section.”
6. Fewer delivery complications
Indeed, it’s true that your chances of needing a Caesarean are higher when you go into labour earlier. But this also depends on other factors, says Dr Chong, including the mum’s pelvic bones (how wide or narrow they are) and whether the water bag has broken prematurely. If you decide to be induced, like Koh did, you stand a higher risk of having a longer labour which may have a negative impact on baby and you. “A longer labour means more stress to the foetus and an increase the risk of foetal distress,” Dr Chong warns.
Luckily for Koh, after a 10 hour-long labour, she had a smooth delivery at exactly 40 weeks. However, now that she knows the benefits of a full-term birth, the mum, who is expecting baby #2, has decided to wait it out even when the going gets tough.
“It’s beneficial for everyone, so I’m just going to have to ‘tahan’ my aches and swelling. It will be worth it in the end!” she adds.
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