Delivering at 36 weeks

I had my 33 week check up today and I asked my doctor about possibly delivering at 36 weeks as I am almost to the point where I can't climb the stairs to get to the bathroom. I know its a bit selfish to want them to come out 2 weeks early so I want to make sure I make an informed decision.
He said that at my 36 week appointment he will do an amnio to check on their lungs and if they are developed then he would induce labour. Permitting that I haven't gone into labour on my own by then. I know an amnio can set off labour and break my water. But that is about it.
I just want to know if anyone has gone down this path and what are the pro's and con's? I am not looking for a lecture about keeping them in longer I just want other's personal experiences.

 

I had my girls at 36 weeks and some change. My OB didn't feel that an amnio was too reliable and said that he really didn't want to do one. We had a last ultrasound done a couple of days before the c-section and it looked fine so out they came. They had 2 hours of NICU time and about 5 days recovery time for me in the hospital. I'm not sure how it all changes if you're going to go through labour though

 

I think you are well aware of my thoughts on the issue.

I sincerely hope for the best for those little babies of yours!

 

My babies are at a good weight and my last ultrasound is on Oct. 15th. So its about 6 days before my 36 week mark. The steroids have kicked in as they are hiccuping which my doctor said is a good sign. I have complete trust in my doctor and know that there is no way he would induce me unless they are healthy!
I am just unsure which is why I want personal experiences. I know the pros and cons of an amnio and now I want to know if anyone has had long term NICU time with babies at 36 weeks. I just don't understand how its considered safe to deliver a single baby at 36 weeks but not twins. Except for the obvious which is a single baby is more then likely to be bigger then 2 babies.

 

You can justify your reasons for delivering them early all day, but for those of us that did everything we could to keep our babies in as long as possible and out of the NICU, it strikes a cord to see someone rushing to get their babies out as soon as possible. 35 weeks is still 5 weeks premature and there is no way that the Dr's can guarantee you that if they come that early everything will be 100% OK. I will never understand the rational behind it, but that's probably because my priorities above everything else was and is, the health and well being of my children.

 

I know you don't want a lecture.... I just wanted to say that my SINGLETON came at 35 weeks and 2 days due to PROM and spent 12 days in the NICU. She weighed 6 pounds. So, size doesn't neccesarily mean no NICU... you just never know if they are mature enough to come out yet. I was utterly miserable throughout my entire twin pregnancy, but I made it to 38 weeks and 2 days. My babies were 7 pounds and 5 pounds. The U/S had shown both to be in the high six pound range! My little girl was only 5 pounds! No NICU, but she has a tougher time with her digestion for sure.

Good luck with your decision. And I hope your babies are healthy and strong, no matter when they come out!

 

I had to deliver at 36w due to pre-e - my DD was 3.8 and my DS was 4.8 and had no breathing issues - they were a bit of lazy eaters but that was about it - they had no NICU time my OB didn't do the amnio per the peri who was fairly certain that at 36w there would be no lung problems - and there wasn't

now thats not to say that things don't go wrong but I've also been told that twins lungs do develop at a bit faster rate because they tend to deliver earlier.

 

I am not justifying anything. I want to make an informed decision. Its a very real possibilty at this point that I wont even make it that far. Irregardless its my decision and I won't do it unless I find it necessary. It's still just a possibilty at this point. That is what you don't read. If you seriously think I would endanger my children for no good reason other then to get them out then maybe you should take the time to ask the questions that matter. There are specific and good reasons as to taking them out 2 weeks early otherwise my doctor would never consider it. I asked for opinions not judgement. If you can't offer a personal experience then don't reply because I really don't need your crap.

 

I am all against early delivering without a medical reason. I agree with Molly (and Kyrstyn), mine measured more than 2 weeks ahead (lower 6lbs range at 34 weeks, however weight doesn't mean a thing when it comes to keeping body temps, lung maturity, etc.). Many of us have been there, I was uncomfortable believe you me. My one leg was swollen up to the point of 2 leg u/s because of possible blood clots (came back negative). I delivered at my scheduled induction date, 38w2d (my hospital will not deliver twins before 38 weeks unless there are medical reasons), they had a combined weight of 15 1/2 lbs, so again, I know what I am talking about, but I would never risk premature babies voluntarily.

Also everything before 37 weeks is considered premature, no matter how many babies. I've never heard why it's safe to deliver a 36 week baby? No doctor in the world can guarantee your babies won't need NICU, no matter when they're born, but especially when born premature. Of course, some babies do fine but not all. I am so grateful for being able to carry them for all those weeks. It's not easy but nature will tell you when it's time!

I know you didn't want a lecture, but what is 1 or 2 more weeks in the end?

 

I guess I didn't know that not being able to climb stairs was a good MEDICAL reason to take the babies early. :umm: Also, you said yourself that it was SELFISH reasons why you want to have them early. It seems as though almost every post your write is about wanting those babies out. I understand you are uncomfortable, but to me it just wouldn't be worth the risk to your children. And yes, having them 5 weeks early does not come without risk. I am not being judgmental, and I am sharing my experience as a mom of preemie's and how hard it is not only for them, but for you as well. That is the part that YOU are not reading.

 

We all try to do our best, and I am sure nobody would put their children at risk. But if you post on a public forum about voluntarily delivering your babies at 35 weeks, you can expect people to give their opinions. You're talking 5 weeks early that's the bottom line. Again, medical reasons, not a problem with, I am not a doctor, but getting up and down the stairs and being uncomfortable is not a medical reason.

I posted, to let you know, that no matter how crap you feel (regardless from medical issues) it can be done ... I did it, 12 days early, and they were big, very big.

 

Mine came at 36 weeks 2 days due to Pre-eclampsia. Looking back now, 36 weeks seemed fine. They were healthy, good weights, lungs were matured, didn't have any delays and are perfectly happy and thriving now.

BUT, I remember those first weeks being so hard and feeling so guilty I couldn't keep them in longer at the time. I was very stressed during the feedings because we couldn't keep my daughter awake long enough to finish a feeding - sometimes she barely ate at all. The hospital made us feel like it was imperative we get every ounce in her, because she was small and we needed to keep her weight up to take her home with us. Every feeding we were pleading with her, trying to get her to wake up, putting her under bright lights, unwrapping her blanket and undressing her, nudging her, forcing the bottle in her mouth while gently squeezing her mouth around it trying to get her to suck. There were so many times I ended up calling the nurse in tears wanting her to help us get her to finish eating, because the feeding was approaching an hour and we were supposed to be done by then in order for her to stay on schedule for the next one. She was just so little and sleepy and I kept thinking that she should still be sleeping inside of me. If she had stayed in a few more weeks she would have been more alert, and would have been better able to suck on her own without us basically having to teach and constantly remind her how. I never fed a newborn, or premie before. I just assumed you stick the bottle in and you're good to go. That so wasn't the case!

My son had bad reflux that lasted the whole first year. It was very stressful and hard on all of us - him especially. It means potentially having to feed him special (more expensive) formula, and propping him up for 30 minutes after each feeding. Which is a pain in the middle of the night when all you want to do is go back to sleep! I'm not an expert in this area, but I'm pretty sure premies are at a higher risk for reflux and other intestinal problems. I couldn't help but wonder if I kept him in a couple weeks longer, if we could have avoided it. This was another thing that brought me to tears in the early days, watching him suffer through this and blaming myself.

And the biggest and hardest part about the first month was when you're in the thick of it - all the crying, the sleep deprivation, and every day wondering when is it going to get better? and then you look at their adjusted age and they're still only in the negative - it's like you're starting at day one when they're 4 weeks old. So if you think ok, maybe I can start to get some sleep by 12 weeks or so, it's enough to put you over the edge when you realize those 12 weeks haven't even started yet!

And I always worried about them being exposed to germs moreso than other moms of full term babies, since things like RSV can be even more serious in premies.

So those are the biggest things at the time that were really hard, even though they were a great size for twins and just a little under 4 weeks early. Now everything is fine and I barely remember all that. But I think them being just a few weeks early makes a big difference in the beginning.

Good luck with your decision!

 

And hers isn't? Nothing guarantees that if she waits until she's 41 weeks everything will be ok either.

 

My post will be lengthy, so bear with me ... I have four children - four-year-old girl, two-year-old boy, four-week-old twins. They all have relevance to my story.

I had an elective c-section with my daughter - 100% elective. She was born in 2004 at 38 weeks and 1 day. At the time, 38 weeks was an acceptable gestation for a scheduled c-section. She weighed 7 lbs. 4 oz. and was perfectly healthy in every way.

I was due to have my second child - a boy - in July 2007. By that time the prevailing recommendation was 39 weeks before scheduling a c-section - lung development, yada, yada, yada. I thought it was absolutely cruel and unusual to have to be pregnant to 39 weeks in south Texas in July - I really, really wanted to go earlier. I had a track record of a big, healthy baby at 38 weeks, for crying out loud! But no, my mostly very accommodating OB would not go early - but 39 weeks DID fall on a Sunday, so he gave me the option of a Friday or Monday c-section. Of course I opted for Friday - did I mention it was July in south Texas?? Well guess what - my nearly 39 weeker, who was 6 lbs. 14 oz. had a horrendous NICU experience. He was fine at birth, but several hours later, was having trouble breathing - grunting, etc. It turned out that his lungs were not producing surfactant - a condition of lung immaturity - he ended up on an oscillator (big, scary ventillator) with a chest tube and we were asked if there was someone we'd like to call to give the baby last rites. YIKES. He spent five weeks in the NICU to the tune of $278K, not to mention the $40K worth of Synagis shots we had over two seasons to ward off RSV. Worth every penny, of course, but an experience I would not wish on my worst enemy. He is 100% recovered today - no residual problems whatsoever.

So I convinced my husband that only two children were boring, we really ought to have a third ... lo and behold, we are pregnant with TWINS! We now have four children ages four and under, in case you're keeping track. Anyway, my OB and I spent a significant amount of time discussing my second baby's NICU stay, whether or not the twins would be predisposed to a repeat performance, etc. My OB's opinion was that 38 weeks was ideal to deliver the twins if there were no complications. We discussed the rate of NICU admits for twins - he said that anything prior to 36 weeks was an automatic admission (not sure if it was just the hospital I delivered at or what), even if just for a few hours of observation, and that from 36 to 38 weeks, admission rates dropped to nearly zero, but that after 38 weeks, NICU admits begin to rise again (breakdown of the structure in there - placental, etc.). I was wary of delivering too early, based on our experience with our baby boy. In the end, he felt comfortable with anything between 38-39 weeks - and I had a weird obsession with having a September birthday - so we went with September 1 when I was 38 weeks and 5 days.

Although my OB had sworn I would never make it to September 1 - I was 90%+ effaced and a little dialated (2 cm) for more than a month - I did. With mono-di twins, I had been closely monitored for TTTS - lots and lots of ultrasounds. My final ultrasound, five days before delivery, guesstimated the babies at 6 lbs. 10 oz. and 6 lbs. 12 oz. The birth weights were 5 lbs. 0 oz., 19" and 6 lbs. 11 oz., 18" - there was a minor TTTS issue going on that had not been detected. Pretty big difference - and I went to a widely respected, very experienced OB who handles lots of high risk pregnancies and has the latest and greatest equipment. And we ended up with Baby A in the NICU - only three nights - because he was unable to maintain his body temp (B had been hogging the groceries and the blood, so A was pretty anemic). I sobbed and sobbed and was a complete mess when they admitted him - on DAY FOUR! I had thought we were good to go - I had worked so hard to keep the babies on the inside. Have I mentioned that I live in south Texas? And it was a particularly hot summer? And I normally wear and XS and had outgrown even XL in maternity clothes? And my cankles were as big as an elephants? I was in pure hell ...

So back to your questions related to NICU, weight and amnio - I guess my experience is a mixed bag. My two pregnancies that I gestated longer ended up with two NICU experiences - one way worse than the other. My birth weights were good, although my ultrasound weight guesstimate was significantly off for one baby. I did not have an amnio due to the GA of the twins, so I can't comment on that one. I agree with PP, you will not know whether NICU is necessary until the babies are born - there are no guarantees, but I do believe that getting closer to that 38 week mark reduces the odds from a statistical perspective.

Good luck as you make the decision that is best for you and your babies!

 

I certainly wasn't giving you crap, if this is directed at me. However, you DID post on a public forum, where LOTS of women have had their babies early and dealt with the NICU. If you haven't had a child in the NICU, then you have no idea how hard it is - no matter how short or long their stay is. And you really cannot know beforehand if your baby will need a stay in the NICU. If you deliver early do to preterm labor or a medical condition causes you to deliver early then I hope their NICU stay is short (if they need one) and they are home with you soon. I realize twins lungs develop faster, or so they say, HOWEVER, you still do cannot guarantee that a baby who is early will be fully developed. I hope you are able to hang in as long as you can and that your babies are healthy. Again, good luck to you.

 

My point exactly. Yours were three pounders and no NICU. My daughter was a six pounder one week earlier than yours, and needed 12 days. And, yes, her lungs were fine too.

 

Thank you to all that shared your experiences. That was what I was looking for. Not to be jumped all over and told I dont care about my children. I do not want NICU time but I can still have NICU time no matter when they come out. I was told this was suppose to be a good informative site and it is but at the same time I continuously feel like I am being attacked when I post a simple question on here.
With the reflux my son had that and I carried him to 41 weeks. Anything can happen. Stairs to me are important because I need to go to the bathroom and my bathroom is at the top of my house. I would rather not have to do my bodily functions in my pants thank you.
But there are other more specific reasons as to why we discussed the 36 week mark. I don't know why anyone would think I would induce labour at 35 weeks unless I made a typo. Irregardless they will come out at 38 weeks no matter what. My doctor won't let me go any further. There are medical reasons as to why we talked about 36 weeks also but I am still trying to wrap my head around those ones. Its not pure selfishness. No matter what anyone thinks.
I have listened to my doctor and the health nurses that come and check me and the babies everyday and we are all doing good. The contractions only come at night and they are not as strong as they were and they are no longer regular. That in itself is a big accomplishment with a very active 5 year old at home.

 

and you may not be selfish nut every reason you listed for having the csect early was selfish. If you don't want them to gripe at you then list the true medical ones and not the selfish ones. As a mother of 34 weekers I'd keep them in as long as possible unless the dr cited reason for an early birth

 

I can't say if those are her priorities or not. All I can tell you is that was my priority, and why I spent 4 long, UNCOMFORTABLE weeks laying flat on my back in a hospital bed, on every PTL med known to man kind to try and keep my babies in as long as possible. My comfort level was not of any importance to me, all I wanted was 2 healthy babies. Of course there are no Guarantee's, even if they are full term they won't endure the NICU, but I can tell you that the chances are significantly reduced.

As to the OP and not wanting to go to the bathroom in your pants, they make bedside commodes and bedpans that are a feasible solution to the problem.

Obviously, you only want to hear from people who agree with you and are going to tell you its OK to opt to deliver your babies early for your own selfish reasons. Unfortunately there are moms of preemie's who know how hard it is to see your kids in the NICU on this site, and there are also mom's that carried to term, incredibly uncomfortable but endured it all to ensure their babies safe and healthy arrival, and I don't see any of the aforementioned agreeing with you.

 

Sorry Damonsmummy,

I have to agree with most of the other posters here. I understand how uncomfortable you are getting and how tough it is to do regular things (I am already dreading the stairs daily at 29 weeks!) but I think unless your doctor specifies a medical reason on his/her own for you to NEED to deliver early, then maybe you should be looking for alternative options for your life to make one or two more weeks feasible for you. Such as a commode, or staying at a family member/friend's house where there is a bedroom and bathroom downstairs, etc. I'm sure we could help you come up with lots of options to help you make it through these last few weeks! You can do it!

You don't want to end up with some kind of guilt later on if god forbid one of your babies has a long term issue that results from being born too early.

 

I never asked for anyone to agree with me or not. In the original post I asked for personal experiences of moms who had twins at 36 weeks. I also asked for people not to sit there and judge and jump down my throat because its under consideration not set in stone. Since I am already extremely uncomfortable another 2 weeks would not make much of a difference to me. I haven't even gained as much weight with 2 babies as I did with my 1st child.
I am not fighting over it. In the end it will be up to me and my doctor. I could go through with the amnio and decide to not have them at all for the extra 2 weeks. There is so many different outcomes that I don't think anyone can really make an informed decision because you do not know what will happen. Waiting till 38 weeks may not even make much of a difference. There is no way of knowing for sure. Which is why I wanted to hear from other people. I am not having a c-section either unless the first baby who will come out is breech. I really don't know where that one came from either.
I watched what my sister went through when 2 out of 3 pregnancies ended up in NICU and I do not wish that upon anyone. I can only imagine how hard it is on parents. Even harder on those of us who are single parents with children at home and are torn about where to be. All I ask is that you don't judge me.
None of my previous posts were directed at anyone specifically. I thought I should clear that up.
And now I will say good bye and good luck to everyone!

 

if we want to be completely honest, the original post was asking about people that had delivered around the 36 week mark...it amazes me that if someone even asks about delivering before they're about to bust they get blasted by preemie moms that take it as a personal attack...I've seen it more than once...its made to sound like she's taking a knife to herself against medical advice to have her own c-section so she can go out and party...my peri wouldn't have let me go past 37 and a half weeks - by your (the general your) standards I probably should have changed hospitals and made formal complaints to the ACOG...

cut her some slack - pregnancy hormones make ya crazy!

 

Nobody is "blasting" anyone, and its not only mom's of Preemie's that have advised against having the babies early unless there is a Medical reason to do so. The rest of your post is just ridiculous, and I didn't say or infer anything of the sort. All I said is that there are many women on this site that endured being uncomfortable to ensure the safe arrival of their babies, that is a far cry from saying she is taking a knife to herself to go party.

 

I am no preemie mom by any means, though I still completely agree with Kyrstyn. I am on the complete other end ... I made it until 38w2d and delivered two almost 8lbs babies. So I've been there too, it's heavy, it's uncomfortable, but it's worth it. And you do what needs to be done, and that goes for all of us. I want to be able to look at myself in the mirror knowing that I did everything I could to give them the best possible start given the circumstances. For some of us that has resulted in preemies, for others in full term babies. But in the end we still know we couldn't have something different. If you medically intervene for non-medical reasons, you may regret it later. I think everybody agrees that the longer you carry your child (within the normal range) the better chances you give your child. Every scientific research will show you that. I am sure there are plenty of 34 weekers who didn't need NICU and I've seen full term babies in NICU, but don't let those exceptions (because it's still a smaller %) justify medical intervention because of non-medical reasons.

And there is, quite a difference between 36 and 38 weeks: http://www.ispub.com/journal/the_internet_journal_of_pediatrics_and_neonatology/volume_5_number_2_27/article_printable/what_is_the_optimal_gestational_age_for_twin_delivery.html

 

I think it is unfair to come onto this site, and ask people to share their most personal and intimate experiences with you and then rudly tell them not to judge you or that you don't as you have written "need their crap". You have written before that no one understands what you are going though, until they have walked in your shoes, well you have not been in the shoes of some of these women that you are complaining about, that have experienced the NICU and would have done anything to not have to have their children in there. In all of your posts you have been given so much support and understanding by the members here, and those that tell you things you don't want to hear are doing it with nothing but good intentions.

 

This is out of control. I asked a question that is it. No I don't want to be judged would you like to be judged by people who know nothing about you or the circumstances that even brought up the question in the first place? Yes some of its selfishness but at the same time there are medical reasons to. I would rather not discuss them but here goes since no one seems to really care about anything but making me out to be a horrible person.
With my last visit to labour and delivery the Chief Resident OB informed me that all the problems I had delivering my first one could very likely repeat itself. Anything that could wrong pretty much did go wrong. My son almost died and I almost died. Since he was partway out we were very lucky that after almost 20 minutes of trying the vacuum finally sucked him out. I was pretty much hemmoraging at this point. I had lost alot of blood. Way more then you should. I value my children's lives and my life thank you very much. I would rather not leave my children as orphans. So yes if taking them out early is a possibility I am willing to do it if my doctor is.
Its also very fair for someone I don't know to sit there and tell me that I don't care about my children? Would you like it if someone said that to you? More then likely not. Whether it was meant to sound like that or not that is exactly how it sounds like to me.
The people who did share their experiences weren't judging me if you go back and read it all. I appreciate what they said. Not a single one of them said anything rude about me or what I was asking. All I asked for was experiences. I appreciate the members who have given me support and understanding. I do not however appreciate being continously jumped all over for ASKING questions. Is this not a site where you should be able to come to and ask questions? I have never carried twins before so I do not know it all like everyone who has had twins. SO yes I ask questions its normal but believe me I will never ask another one on this site again.

 

I would like to add the only reason they could give me and my family for what happened with my son is because I am a very tiny person and my baby was very big. So yes I am terrified of having two 8lb babies because I couldn't even push out one 8.5lb baby.

 

I am sure that the doctors will take them early / earlier if they feel there is a need which is in your babies and/or your best interest. That just wasn't the impression I got from your original question. And I don't think I was the only one.

Good luck, and just focus on those babies now!

 

I haven't delivered yet, but I wanted to share whats going on with me -- maybe it will help. I am scheduled for a c-section next Tuesday at 37 weeks, 4 days. My doctor and I worked hard to strike a reasonable balance between taking them out too early and leaving them in too long. My little boy has not been growing well (he's dropped all the way down the the 3rd percentile for his abdomen size, compared to his sister who is nearly at 60%). If I didnt get good results at my last MFM visit (which was Tuesday), then he was going to take them today at 36 weeks, 6 days. If he had to do that, then he planned to give them the steroid shots for lung development just in case. I have to tell you that I was absolutely HYSTERICAL over the possibility of them having to come out before 37 weeks, even though its only a few days difference. I think that I'm worried because he's only measuring 4lbs 14 oz on the ultrasound (and I mean, this is the GOOOOOOD equipment) but I have absolutely no confidence that those numbers are correct and I am really afraid of having a tiny baby. In my mind, if he has that extra week, he may not get much bigger but at least he can spend that much longer trying to grow and develop the skills he's gonna need on the outside so that he can get out here and eat eat eat. Luckily for us, he did grow a bit so he's going to get that little bit of extra time. I'm not guaranteed that its going to make a difference, but I do think that I would have obsessed over him losing those 5 days or so inside.

Either way, :hug: to you, Mama. It sounds like you are really going through it. I hope that whatever happens, things work out for you and the little ones.

 

All you would have had to do was state this earlier. Hemoragging would have been a needed point in the first post.

 

Just wanted to say great news about your little boy! :hug:

 

Thanks!!! I'm pretty happy about being able to wait. Hopefully he's going to prove us all wrong and be a chubby little bruiser!! :aggressive:

 

I really hope that the ultrasounds are wrong and he is much bigger Sparkle!
As for what I wrote I haven't even told my own mother yet about that. I would rather not deal with that part of reality at the moment. I never thought it could factor in with this pregnancy. It's been 5 and a half years almost. Had the doctor never asked questions about my first labour I would be happily oblivious to the fact instead of wondering if I should be telling my 5 year old that mommy may not come back from the hospital.

 

My singleton was born at 35 weeks and spent 17 days in the NICU learning to breathe and eat on his own - it was not pleasant...

Keep in mind, there are medical devices you can have in your home to help you relieve your need to pee w/o using your bathroom (ask your doctor about this, he should be able to direct you to a medical supplier)... just an alternative.

I wish you luck and much health with your delivery!

 

I'm sorry, what????????