I have really wrestled with what to write about from the Controversies in Childbirth Conference. We've been so busy around here lately, it's given me time to mull things over.
I will reference a talk given by Lucky Jain, MD, MBA from the Conference. I feel that the information he gave was so astounding, all should be made aware. Briefly, a short biography of Dr. Jain: He is currently the Richard W. Blumberg Professor and Executive Vice Chairman for the Department of Pediatrics at Emory University School of Medicine. He also serves as the Medical Director of the Emory Children's Center. In addition, he is an investigator at the Center for Cell and Molecular Signaling and holds a joint appointment in the Department of Physiology.
Obviously, a smart and well-educated fellow.
The information he gave was so well researched, clear, and concise, they let him go over on his time. He is the only individual that was allowed this privilege. I believe that if pregnant women had this information, they would make wiser decisions during pregnancy.
The topic Dr. Jain was speaking on was "Are C-sections Causing Premature Births and Adding to NICU Costs? I think we all know the answer to that question.
Babies are presumed to be "mature" at 34 weeks. He posed the question, is it safe to deliver a baby after this time? The answer is yes and no. 50% of babies born at 34 weeks will be in NICU. While we have decreased the rate of stillbirths in this country, prematurity has dramatically risen.
What are the long term effects of prematurity? Dr. Jain had a very distinct picture of a baby's brain at 35 weeks versus the brain at 40 weeks. There was a HUGE difference. The 40 week brain was significantly more developed.
Studies have found that 74% of handicapped adults were born between 33 and 37 weeks gestation. In addition, babies born before 37 weeks are five times more likely to be in special education by the time they are in kindergarten through fifth grade.
While the baby's body looks fairly well developed in the last trimester, this is the time when the brain is developing. Cholesterol, yes, you heard me right, and good foods, including proteins, are essential in the baby's brain growing and developing. Each week, day, even hour, that a baby stays in the womb is invaluable.
Another interesting item Dr. Jain addressed was Fetal Lung Fluid. I must admit, this was the first time I've heard of this. I took comfort in seeing that most of the other people in attendance didn't seem to know much about it either! According to Dr. Jain, fetal lung fluid is produced to inflate the lungs and pours out into the amniotic fluid. This is how the lungs are checked for maturity during pregnancy by checking the amniotic fluid. When labor is allowed to start on its own (no induction!), the valve that releases this fluid is shut off. The fetal lung fluid levels gradually decrease over the course of days leading up to labor. It really is true that the baby triggers labor. If a C-section is done without the onset of labor, the baby does not receive this message. This is a contributing factor to C-section babies having a more difficult time breathing. According to Dr. Jain, a C-section should NEVER be scheduled to take place before 39 weeks and it is crucial that the dates are correct. He felt strongly that it should be later than that, if done at all. The average in the US is 38.2 weeks, however. Remember, the average means that there are many babies being born on the lower end of that number. According to United Healthcare, if a baby is born before 38 weeks, he is twice as likely to be admitted in the NICU.
I hope you will ponder this information and share it with your friends and family who might be pregnant. The womb really is the best place to grow a baby -- not an incubator in the NICU.
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