The Case Against Elective C-Sections and Inductions

What moms can do

While most babies arrive on their own timetable, it's important for every expectant mom to take these steps based on these new findings.

Never push for an early delivery. Women sometimes ask to schedule their delivery ahead of time in order to book their favorite ob-gyn or to accommodate a family member's travel plans. "A woman might say, 'My mom's coming in from California for the birth,' " explains Alan Fleischman, M.D., medical director of the March of Dimes. "It isn't unusual for doctors to perform a cesarean or an induction on request." His advice? Don't even ask. Unless there's a compelling medical reason to rush, a healthier baby is worth the wait.

Better your odds of going to term. Preventing preterm labor starts before you're pregnant. "That means making sure you're ready for pregnancy by not smoking, drinking, or doing drugs and by managing your weight," says Dr. Fleischman. "If you don't take care of those things before you conceive, then you need to do so as early in your pregnancy as possible." New research also shows that taking folate, a B-vitamin, for a year or longer before becoming pregnant may reduce your risk of having an unplanned preterm birth by 50 to 70 percent.

Consider an earlier maternity leave. A recently published study from the University of California Berkeley found that women who were clerical, managerial, manufacturing, and service workers and who felt their efforts on the job outweighed their compensation were less likely to deliver early if they took maternity leave before giving birth rather than waiting until after the baby's arrival. Several international studies have shown a similar connection. If you have a demanding job or you're under a lot of stress for any reason, experts recommend following your instincts: Schedule breaks or time off whenever you feel the need, and seek out plenty of emotional and physical support from the people around you.

Understand the risks. Most babies who arrive early do so because the mom is having complications with her pregnancy. Problems such as preeclampsia (pregnancy-induced high blood pressure) or placenta previa (when the placenta blocks all or part of the opening to the cervix) may be mild enough that you can safely wait to deliver at term or severe enough that you'll need to deliver right away. For situations that fall somewhere in between, you and your doctor will need to weigh the pros and cons of delivering sooner rather than later. The reassuring news is that thanks to all of this new research, your baby's pediatrician will be better prepared to give her any extra care she might need if an early birth turns out to be unavoidable.

Get Your Due Date Straight

Your due date plays a big role in the conversation about whether to schedule an induction or a C-section. And the best way to learn the most precise date is to have an ultrasound in your first trimester. "If you're going to be induced at 38 weeks and your date is off by two weeks, you'll have a 36-week baby," says Dr. Alan Fleischman, medical director of the March of Dimes. A first-trimester ultrasound is accurate to within five to seven days. Unfortunately, many women wait to have an ultrasound until the second trimester, when the test is better at detecting abnormalities but much less dependable for dating purposes. While your doctor will also calculate based on the first day of your last period, those results are less reliable if you can't pinpoint that day or have an irregular cycle.

Originally published in the August 2009 issue of Parents magazine.

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