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Unless medically indicated, labor inductions or cesarean deliveries should not be performed before 39 weeks’ gestation, according to The American College of Obstetricians and Gynecologists.
Unless medically indicated, labor inductions or cesarean deliveries should not be performed before 39 weeks’ gestation, according to The American College of Obstetricians and Gynecologists (The College).1 A full-term pregnancy is 40 weeks, and most spontaneous labor begins between 37 and 42 weeks. All newborns born before 37 weeks’ gestation are considered premature. In the United States, 1 in 8 babies are born prematurely, a rate that is higher than that of most other developed countries.2
According to the 2011 March of Dimes Premature Birth Report Card, the United States earns a “C,” and this is after a 3-year improvement in preterm birth rates was noted in almost every state from 2006 to 2009.2 Three states (Louisiana, Mississippi, and Alabama) and Puerto Rico earned an “F,” and only one state-Vermont-earned an “A.” These grades were derived by comparing the nation’s 2009 preliminary preterm birth rate of 12.2% with the March of Dimes new 2020 goal of 9.6% of all live births.
Most newborn deaths are caused by premature birth. If premature newborns survive, they often experience complications that include problems with vision, hearing, respiration, and nervous system development. Premature birth is also associated with learning and behavioral problems later in life.
“After 37 weeks of pregnancy, there’s still significant fetal development occurring until a woman’s due date. The remaining weeks are the time when the lungs and brain mature and the fetus gains body fat,” said Sindhu K. Srinivas, MD, a Committee on Practice Bulletins-Obstetrics member.1
The College encourages women to familiarize themselves with the signs of preterm labor and reminds women and their obstetricians to make delivery at or after 39 weeks’ gestation their goal to achieve the best health outcomes for newborns. Obstetricians should remind patients to report any regular uterine contractions, even painless ones. Patients should also notify their obstetricians of any unusual changes in vaginal discharge; leaking amniotic fluid; vaginal bleeding; pelvic or lower abdominal pressure; mild abdominal cramps; or a constant, low, dull backache.
In addition to preexisting maternal health conditions, other risk factors for preterm labor are a previous pregnancy in which preterm labor or delivery occurred, smoking, illicit drug use, multiple pregnancy, a shortened or abnormal cervix, an abnormal uterus, problems with the placenta, bleeding in the second or third trimester, and little or no prenatal care.
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1. The American College of Obstetricians and Gynecologists. Fight prematurity with awareness, longer pregnancies Ob-Gyns say.Â Accessed November 2, 2011.
2. March of Dimes. Preterm birth rate shows three year improvement in most states. Accessed November 5, 2011.