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Letter from Dr. Alan Guttmacher, Director of NICHD

Last Updated on Thursday, November 01, 2012

Editor's Note: As many or our supporters know, the rate of premature births is a growing issue in the US. In recent years, health care providers are emphasizing the distinction between "medically-indicated" premature delivery, such as in patients with hypertensive discorders, and elective premature delivery. Dr. Alan E. Guttmacher shares this letter in the context of the "ideal time of delivery" under normal circumstances. ACOG's Prematurity Awareness Campaign recognizes the special circumstances of women with preeclampsia and other hypertensive diseases of pregnancy.

"If the baby is growing very poorly in utero, delivering the baby may be safer. On the maternal side, women may get very sick during pregnancy with preeclampsia or diabetes, making an early delivery necessary," says George A. Macones, MD, chair of The College's Committee on Obstetric Practice.

June 2013

As a new grandfather, the anticipation of awaiting the baby's arrival is still fresh in my mind. Although my stepdaughter was happily awaiting the birth of her first child, she had also grown a bit weary of the discomfort of that final month. Eventually, though, the baby came, the delivery went smoothly, and my stepdaughter and grandson are doing quite well. Although we all were impatient, as a pediatrician I knew that in a healthy pregnancy it¹s best that the baby sets the delivery date, not the grandfather or even the mother (or the obstetrician¹s schedule). Some families, however, request an earlier delivery, or the attending suggests inducing delivery for scheduling purposes.

True, there is sometimes a medical need to schedule delivery early. But for most pregnancies, it¹s best to wait. Babies delivered at 39 weeks have fewer health risks, such as breathing difficulties, cerebral palsy, and learning difficulties, than do those born even a couple of weeks earlier. Forgoing elective delivery may reduce these risks. If you¹re a mother to be, or know someone who is, I recommend you visit our Web page¹s discussion, Information for Moms to Be, of waiting until at least 39 weeks before delivering to find out more about the health benefits of letting the baby set the delivery date. The page was developed by the National Child and Maternal Health Education Program.

Alan E. Guttmacher, M.D.

Director of National Institute of Child Health and Human Development (NICHD)



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