MARYSVILLE — Krickett Claphan was nearing the end of her third pregnancy.
Wracked from the pains of both early, ongoing contractions and kidney stones that eventually sent her to the hospital, she could barely wait for her baby’s birth.
“I was in so much pain,” she said. “I was ready
to be done.”
Wanting the pregnancy to be done is a sentiment shared by many expectant moms. Some, like Claphan, cite medical reasons. For others, it’s the increasing physical discomfort as the pregnancy reaches its end.
“I hear it all the time,” said Dr. Matt Banfield, an obstetrician at The Everett Clinic. “Can we just get this over with? Can we induce?”
Physicians and groups such as the March of Dimes say medical evidence underscores the importance of avoiding induced births before the 39th week of pregnancy.
Such births, unless done for medical reasons, put the baby at higher risk of medical complications or being hospitalized in neonatal intensive care units, medical studies show.
The last few weeks of a typical 40-week pregnancy are critical to a baby’s development. The brain will increase in weight by a third in the last five weeks of pregnancy, according to a 2010 study by the March of Dimes and the California Maternal Quality Care Collaborative.
About half of the areas of the brain associated with memory, attention, thought, language and consciousness develop in the last six weeks of a pregnancy, said Kathy Nelson, spokeswoman for Washington chapter of the March of Dimes. And about one-quarter of the parts of the brain that regulate movement and balance develops after 37 weeks.
Banfield said about half of his pregnant patients joke about being induced at the end of their pregnancies. But 5 to 10 percent “really do pressure me,” he said. “It doesn’t take very much with most of my patients to convince them that it’s not safe.”
Doctors are holding off on inducing even those pregnant women with high blood pressure or diabetes. These are conditions which in the past doctors routinely induced pregnant women before 39 weeks to avoid medical complications, he said. Now, they monitor these women carefully.
Dr. Kevin Pieper, medical director for women’s services at Providence Physician Group, said he sometimes gets requests from military families to induce a birth.
“The dad or boyfriend is headed out on the Lincoln in a week and they want to be delivered,” he said.
Providence Regional Medical Center Everett, like other hospitals across the nation, have policies trying to prevent elective, or non-medical inductions, before the 39th week of pregnancy, Pieper said.
Typically, just explaining that policy and the reasoning behind it is enough to halt the discussion, he said.
Even with increasing national attention on reducing elective labor inductions and cesarean sections, they are still relatively common. Exact percentages are hard to come by because some patients have conditions for which they are considered for induction for medical reasons.
About 6.4 percent of births at a Pennsylvania hospital were elective inductions before the 39th week of pregnancy, according to a 2009 study in the medical journal Obstetrics & Gynecology.
And inductions are still being done more frequently than the rates of pregnancy complications for which the procedure would be required, according to the findings of two other medical journals studies published in 2009.
Claphan, 25, who lives in Marysville, was about 34 weeks into her pregnancy when her contractions became so frequent and uncomfortable that her doctor ordered bed rest.
“We tried a couple of medications, but they didn’t do very much,” Banfield said.
Then, a little more than three weeks later, she was hospitalized with a kidney stone attack.
“I said, ‘What if we get you delivered? It could be a good way to solve all these problems,'” Banfield said.
Banfield knew that the sooner Claphan’s baby was born, the sooner the pressure would be relieved in her pelvis. “With kidney stones, the pain can go away,” he said.
But before they took steps to trigger the delivery, a test was conducted to test the maturity of her baby’s lungs.
The results showed the lungs were not fully matured. So if the baby’s birth was induced, or medically triggered, it could put the infant at risk for respiratory problems.
“It was scary,” Claphan said of the test results, worrying just how much more her baby’s lungs could develop in the final days before birth.
Banfield reassured her. “There’s a lot of changes in that last two weeks that allow most babies to be delivered at 39 weeks and beyond,” he said.
Sure enough, when 8-pound, 1-ounce baby Cheyenne was delivered by cesarean section 10 days later on Jan. 10, “the baby turned out just great,” he said.
“I get uncomfortable, suffering patients begging to be induced,” Banfield said. “Usually if I describe some of the things that can go wrong with respiratory distress, they realize another week or two is very small in the grand scheme of things.”
Normal labor doesn’t start with the woman, he added. “The signals come from the baby that it’s time to come.”
Sharon Salyer: 425-339-3486 or salyer@heraldnet.com
Everett March of Dimes Walk
The annual March of Dimes walk in Snohomish County is scheduled for May 7 at American Legion Memorial Park, 145 Alverson Blvd., in Everett. Registration for the event begins at 7:30 a.m. The 3.5-mile walk starts at 9 a.m. For more information, call 800-291-3463 or check the website: www.marchforbabies.org/wd_regp01.asp
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