Let Them Grow

Written by Bakersfield Magazine

Here’s something you probably didn’t know about babies: a baby’s brain at 35 weeks gestation weighs only two-thirds of what it will weigh when it’s at full term (39-40 weeks).

That’s because the last few weeks of pregnancy are critical for the development of a baby’s brian, lungs, and liver.

It’s the main reason why premature births are a big concern in our area. It’s also the main reason why the March of Dimes has started reaching out to health organizations, hospitals, and women in our community—because, believe it or not, some women and their doctors are choosing to deliver early.

The March of Dimes research indicates that in 2009, 1,788 babies were born too soon in Kern County. Of those, some were elective births, meaning the mother and doctor have scheduled to either deliver via cesarean section or to induce labor.

The March of Dimes teamed up with a number of organizations, including the California Maternal Quality Care Collaborative and the California Department of Public Health, to investigate the growing number of elective deliveries in California and, together, are urging not only those in the medical community, but local mothers, to understand the risk factors that come from delivering before 39 weeks.

According to their report, “Research has shown that early elective delivery without medical or obstetrical indication is linked to neonatal morbidities with no benefit to the mother or infant...yet rates of labor induction have increased dramatically, from 9 percent in 1989 to 21.2 percent in 2004.”

And, unfortunately, those elective deliveries between 37 and 39 weeks come with a list of complications including increased chance of NICU admission, increased respiratory distress syndrome, increased need for ventilator support, increased chance of sepsis, and increased feeding problems.

These are problems associated with “early term” delivery or “late preterm,” which is defined as delivery between 37 and 38 weeks, six days. Babies born during this time are generally healthy, but they are at a higher risk for medical problems compared to babies who are born at full term, which is 39 to 40 weeks.

That’s because a baby’s lungs and brain are still growing late in a pregnancy. And, during the final weeks of pregnancy, a baby will gain a majority of its weight. Babies who are born early tend to have less fat on their body and are, therefore, unable to retain heat. Unfortunately, that means they need to spend time in an incubator to help keep the body safely warm. That means less time with mom and dad right after birth.

Research is also showing that a baby born early has increased chances of having vision and hearing problems.

“It’s important to realize that if you are wanting to schedule an induction, that your due date may not be exactly right,” said Vicki Lombardo, March of Dimes’ Associate State Director of Program Services. “For most women, it’s hard to know the exact date you conceived and, if your cycle is irregular, it’s hard to judge based on your last menstrual cycle. So an estimated due date could be a week or more off. That means a scheduled induction one week early, could, in fact, be two weeks early, which increases the chances that the baby could have complications.”

And, oftentimes, trying to induce labor when it’s not

beginning naturally, will lead to a c-section, which is a major surgery for the mother.

Some women may prefer to be induced for convenience, even without medical need, because it allows them to plan for their baby. Some of the most common reasons for wanting to induce preterm are because of doctor’s schedules, wanting to make sure family can be present for the birth, and wanting to pick the date of their baby’s birth.

“Additionally, some physicians will recommend induction preterm because of the possibility of macrosomia (abnormally large baby) or because of prior c-sections,” Lombardo continued. “People have gotten comfortable with prematurity because we have made advances in neonatal medicine that allow physicians to keep premies alive. People think that their baby will be fine as long as it’s born after 34 weeks.”

In many cases, the baby will be fine, but there are the risks.

“The American Congress of OB/GYNs has always stated that it’s not wise to deliver electively before 39 weeks. Thirty years ago, that was the norm,” Lombardo explained. But doctors realized that even if the baby was born before that, medical advances were available and could keep the baby alive. People became less nervous about premature births and, when mothers complained of sore backs, leg cramps, and other late pregnancy conditions, doctors became willing to induce.

“This initiative has put the focus back on the importance of waiting until at least the 39th week of pregnancy before inducing, if necessary,” Lombardo continued. “We’ve teamed up with local hospitals including CHW (Mercy and Memorial), San Joaquin Community Hospital, and Kern Medical Center to encourage hospitals to dissuade patients from requesting preterm births. It’s really about education at this point...parents need to know what risks they’re taking with their child’s health when they decide to induce labor before term.”

Additionally, the March of Dimes has reached out to the Kern County Department of Public Health to help educate mothers through information sessions, classes, and more. But there has to be a way to support that type of eduction. That’s why the Central Valley Division of the March of Dimes will be holding their 5th annual March for Babies this April 9 at Liberty Park.

“More than 1,700 babies are born too soon in Kern County each year—that’s 12 precent of all babies born here,” said Renee Nuanes, Director of Fundraising for the Central Valley Division of the March of Dimes. “The good news is that literally everyone can make a difference. As more and more companies, friends, and families join the March of Dimes in the fight against prematurity, we are able to make a greater impact. The more money we raise, the more we can invest in research, programs, education, and advocacy...and believe me, every dollar helps! Those investments lead to miracles. March for Babies is a great way to join our efforts and help save babies.”

And it’s fun, too.

If you would like more information on this year’s walk or to learn more about March of Dimes programs, visit marchofdimes.com/ca or call (661) 369-1181.

Illustration ©March of Dimes Foundation

Article appeared in our 27-6 Issue - February 2011