The magic number is 39 weeks.
MedPage Today reports on a NEJM study that looked at women who underwent a repeat Caesarean delivery. It found that infants who delivered early, defined as less than 39 weeks, had a markedly increased risk of adverse outcomes, which included “adverse respiratory outcomes, need for mechanical ventilation, newborn sepsis, hypoglycemia, admission to the neonatal ICU, and hospitalization for five days or longer.”
40 percent of elective Caesarean deliveries are repeat procedures, and this number is sure to go up as the rate of initial C-sections rises due to malpractice fears and a physician payment system that favors procedures.
You can’t wait too long however, as the study also found the rate of stillbirth increases if delivery is delayed past 40 weeks.
So when counseling expectant mothers anticipating a C-section, 39 weeks seems to be the ideal delivery time.
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{ 2 comments }
we do get paid the same for c/s versus vaginal, at least I do so there is no desire to do c/s if you don’t have to because they are in the hospital more days for more days of rounding which is uncompensated or included in the delivery.
so i don’t think people just do c/s for ease that much but it’s hard to tell a patient who states she absolutely wants a c/s that she can’t have one, just like if a person walks into the pcps office and says for the 100th time that he has chest pain, are you going to not do an EKG this time?
“40 percent of elective Caesarean deliveries are repeat procedures, and this number is sure to go up as the rate of initial C-sections rises due to malpractice fears”
Kevin, why do make up this cr–p?
There is no evidence that defensive medicine increases C-section rates. Indeed, there is good evidence that they are not related. See Beomsoo Kim, The Impact of Malpractice Risk on the Use of Obstetrics Procedures, The Journal of Legal Studies, vol. 36 (June 2007)(finding no increase between C-section rate and increased likelihood of being suied).
btw, Kim’s an economist, not a lawyer
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