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What Are Early Elective Deliveries?

Elective early deliveries (EED) are cesarean deliveries or labor inductions performed before 39 weeks of pregnancy, specifically between 37-38 weeks

Elective early deliveries (EED) are cesarean deliveries or labor inductions performed before 39 weeks of pregnancy with no medical necessity.

Doctors usually recommend early elective delivery when the mother or baby has a medical condition. When done for nonmedical reasons such as scheduling, it can bring health risks to both mother and baby.

What are the risks of early elective deliveries?

Risks for the baby

  • Oxygen supply may be compromised if the umbilical cord is damaged.
  • May be more prone to suffer visual and hearing issues in the future.
  • May be less likely to be able to suck, swallow, and stay awake long enough to eat.
  • If preterm induction fails, cesarean delivery may be required, which can increase chances of breathing problems and other issues.
  • Organs may not be fully developed, which can lead to complications.
  • 20% increased risk of birth difficulties such as:
  • Neonatal intensive care unit admission
  • Transient tachypnea 
  • Respiratory distress syndrome
  • Ventilator support
  • Suspected or proven sepsis
  • Feeding problems and other transition issues
  • Pulmonary hypertension

Risks for the mother

  • Risk of infection due to lengthy labor that requires equipment such as forceps or a vacuum
  • Risk of serious and prolonged bleeding
  • If preterm induction fails, cesarean delivery may be required, which can lead to issues in subsequent pregnancies and raises the likelihood of future cesarean deliveries.
  • Longer recovery time (2-4 days in the hospital followed by 4-6 weeks recovery at home).
  • Stronger and more frequent contractions.
  • Increased risk for postpartum depression.

When is early elective delivery recommended?

The most common medical reasons to induce labor early include the following:

  • Intrauterine growth restriction (baby is not growing)
  • Premature rupture of membranes
  • Gestational diabetes 
  • Preeclampsia (high blood pressure)
  • Fetal heart condition that warrants immediate medical attention 

In such cases, the benefits of an early induction outweigh the drawbacks. If there are no medical risks, however, it is recommended to let labor begin naturally.

Can you request early delivery?

Putting pressure on your doctor to have your baby delivered early when it is not medically required could be hazardous to both you and your baby. While the last 1-2 months of pregnancy can be quite difficult, inducing for any of the following reasons is not recommended:

  • Baby is too big
  • You have trouble sleeping
  • Family or work event you want to schedule around
  • You want your baby to have a certain birth date

Early in your pregnancy, talk to your doctor about when and why they might propose an early delivery. If there is no medical reason, however, your doctor may refuse your request to do an early elective delivery.

Why is it good to wait for a full-term pregnancy?

Pregnancy can be stressful and uncomfortable, and you may want it to be over as soon as possible. However, delivery before 39 weeks puts your baby at risk for a variety of health and developmental issues.

Physicians used to assume that when pregnancy reaches 37 weeks, most of the baby’s main organs are fully developed. However, new evidence indicates that it may take longer than that. Vital organs, such as the lung and brain, do not fully develop until 39 weeks in some cases. At 38 weeks, your baby is building the digestive system and training the lungs to breathe by continuing to breathe in and digest amniotic fluid. At 39 weeks, your baby’s brain is still developing. They may be exercising reflexes to help them suck, swallow, breathe and control body temperature.

According to studies, babies born via cesarean delivery at 37 weeks are 4 times more likely to spend time in the newborn intensive care unit (NICU) and suffer from respiratory difficulties. Inducing labor involves several medical treatments that may or may not be beneficial to you or your baby.

So while you may want to hurry the process, it’s best to sit back and allow nature to take its course.

SLIDESHOW

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Medically Reviewed on 4/4/2022

References

Image Source: iStock Images

Union Hospital. Early Elective Delivery. https://my.clevelandclinic.org/-/scassets/files/org/locations/union-hospital/about/quality-accreditation/early-elective-delivery.pdf?la=en

Ashton DM. Elective delivery at less than 39 weeks. Curr Opin Obstet Gynecol. 2010 Dec;22(6):506-10. https://pubmed.ncbi.nlm.nih.gov/20978440/

The University of Texas. Early Elective Delivery (EED). https://med.uth.edu/pediatricsurgery/safer-culture-roadmap/inside-the-project/lessons-learned/early-elective-delivery-eed/

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