State health officials and their allies launched a campaign Monday to convince pregnant women to leave the bun in the oven a bit longer.
State Health Director Will Humble said that having women go at least 39 weeks — if not a bit longer — would go a long way to reducing birth defects. And obstetrician B.J. Johnson, a board member of the Arizona Perinatal Trust, said 40 of the state’s 46 hospitals already have policies in place to prevent inducing labor or performing a C-section for non-medical reasons before that point.
But Johnson said women continue to exert pressure on their doctors. And he said that doctors can always find some medical reason to act early.
“Too often we have women who want to have their baby on a certain day because the grandparents are in town,” Johnson said. And they even request to set the birth date to match the number on a sports jersey.
He said medical professionals share some of the blame.
“Basically, the issue is caving in to peer pressure,” Johnson said. There’s also the desire not to have to deal with an unhappy woman in the late stages of pregnancy.
“There’s fear of litigation,” he continued. “There’s fear of being reported to the medical board.”
And then, he said, there are training issues for medical professionals.
He said there is a medical definition of what is “labor,” which involves both regular contractions and progressive dilation of the cervix.
But Johnson said that, particularly in a place like Arizona, lack of fluid intake coupled with heat can result in symptoms that mimic labor.
“Basically, we have a hard time recognizing true pre-term labor,” he said, something Johnson said may be reduced with work being done with hospitals.
Johnson said it also would be wrong to think that those last few weeks don’t make much of a difference. He said a baby’s brain at 35 weeks is two-thirds the size of what it would be just four weeks later.
Humble said women also need to have a better understanding of what a “normal” pregnancy involves. He said the whole concept of nine months to make a baby is a misconception.
At the very least, Humble said 39 weeks comes out to be more than that. So a woman who gets pregnant now, in mid June, should not presume the baby will come the same time in March.
And a birth calculator used by obstetricians actually suggests 40 weeks is full term, though 39 has become the accepted minimum for what that includes.
Humble said the problem of about one birth in seven in Arizona being premature is not limited to issues of convenience or preference. He said maternal health also plays a big role, with women who are in less than peak physical condition more likely to carry a baby who insists on being born early.
He said lots of women insist they’re going to get in shape before they get pregnant. But he said that’s just not realistic.
“Half of pregnancies are unplanned,” he said. The message his agency wants to get out in cooperation with the March of Dimes is that women in their child-bearing years should stay in good shape.
“Then, when you do have that unplanned pregnancy, you’ll be in a good position to have a good outcome,” Humble said.
Sheila Sjolander, the health department’s chief of the Bureau of Women’s and Children’s Health, said education also will make a difference. She said many women are unaware of their own health factors and habits that put a child at risk of being born early.
Some may be more obvious, like smoking and even the mother’s obesity. But Sjolander said there is no level of alcohol intake by a pregnant woman that is considered safe.