Dr. Marjorie Greenfield
Specializing in pregnancy and birth.
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 Ask Dr. Greenfield
Scheduling a C-section | | | QUESTION | | | Dear Dr. Greenfield,
I am currently 26 weeks pregnant and because I suffered a separated pelvis in my first pregnancy, I will be scheduled for a c-section. My question is "when is a c-section scheduled for?" I assume before the 40th week. Is it a week before? Or two? Thank You.
— Lorriaponte | | | ANSWER |
February 28, 2002 | | | Dear Lorriaponte,
This is a great question, and it depends a bit on some specifics of your situation as well as your doctor's schedule and both of your preferences.
Doctors usually aim to schedule a repeat cesarean for when the baby would be expected to do well outside of the uterus. Any time that the baby is going to be delivered before 39 completed weeks, amniocentesis is recommended to be sure the baby is ready. Substances can be measured in the amniotic fluid that indicate whether the baby is out of the risk zone for respiratory distress syndrome or RDS, the breathing problem that preemies get. It is worthwhile to note that amniocentesis near term like this doesn't have the same risks as second trimester amnio and is considered a very safe procedure.
In situations where there are medical reasons to avoid the possibility of a few hours of labor, doctors try to schedule the cesarean for as early as possible, and amniocentesis may be done as early as 36 or 37 weeks. More typically, amnio is done around 38 weeks, and the cesarean is scheduled for either later that day or the next day. The c-section is cancelled if it turns out the baby's lungs are not yet mature.
If you are relatively low risk and don't want an amnio, cesarean is usually scheduled for around 39 completed weeks. Your doctor will look at all your dating parameters, like when you had a positive pregnancy test as well as any ultrasound results, and assess the certainty of your due date. They try to balance the chances of going into labor (and having an unscheduled cesarean), against accidentally delivering a premature baby, which used to happen fairly often before these strict rules were followed.
When you talk to your doctor about potential dates for your baby's birthday, you can see if, for your particular situation, he recommends amniocentesis or just picking a date around 39 weeks. I hope this answers your questions. And congratulations on your upcoming birth!— by Marjorie Greenfield, M.D. |
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