I had my first appt with my doc today after being transferred from my RE. I am (and will be) 40 when I deliver. I had to have a c-section with #1 after a failed induction at 40+6. She told me today that she delivers women over 40 at 39 weeks, because 40 year old placentas don't work as well (I have no problem with this language - I appreciate her candor). I have the option to be induced, but it didn't work last time, so I'm not excited about that again. Has anyone else had this experience? I really like my doc (she offered to re-induce me with LO1 if I wanted to - I went for the section) but was a little surprised.
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I have never heard of this. Do you want to wait? I’m sure if you are concerned your OB might let you wait or offer other advise.
I know this is bad but personally I don’t like being pregnant. I had a transverse breech baby so I was scheduled for a C-section at 39 weeks. I was kind of glad because that would mean less time I would be pregnant for!
edit : Again I know the longer a baby stays in the better for it... but yeah pregnancy was not kind to me.
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I have heard that the placenta deteriorates at a different rates with AMA than those 35 & under. They usually check on the placenta at the end more often (ultrasounds) with AMA as well.
(what I've known from friends/coworkers experience, not my own) -
I wouldn't be opposed. Especially, if you were wanting a repeat c. I understand your doctors point. I think my placenta deteriorated faster with DS2 ( had at 35) compared to DS1 (had right before I turned 34).
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I'd call BS on that one. A friend of mine delivered a perfectly healthy baby at age 40 and about 41w gestation. They can monitor the placenta and deliver early if it shows any signs of trouble.
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I'm not the U.S. but this certainly isn't in common practice in New Zealand and personally I would decline an induction solely based on my age.
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It's all about your comfort level but as far as I know this is not evidence based medicine or good practice to generalize a procedure to a group of women based on age. I would personally be asking that they monitor the placenta at the end and that we decide at the time what is best for me and baby based on how my body and baby are doing.
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Are you hoping to VBAC or have another c-section. If you're wanting another c-section, I would ask to wait until closer to 40 week, but sure, I don't think it's a difference.
If it's a VBAC you're shooting for, I also call BS. In a healthy, normal pregnancy, there is no reason to routinely deliver at 39 weeks because of AMA. Obviously, if there's a reason to suspect your placenta isn't healthy at the end, that is different. She might prefer this, but there are actual laws, and this is not one of them.
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*sometimes* placentas of AMA women age faster, but not everyone should be painted with the same brush. I would do NSTs and/or BPPs to check on baby and the health of the placenta and only induce if there was a problem. Nothing is mandatory - you have a choice. Your body, your birth, your baby! Good luck
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Thanks, everyone. I think I'm going to talk to her about monitoring and then doing the section if needed. My body obviously is not a fan of being induced, so I think it's either VBAC w/o induction or c-section for me. I'd like to have a VBAC, but I don't have my heart set on it. I'm hoping the second one comes more quickly and I won't have to worry about it anyway.
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What's your goal? I was 40 when LO2 was born. I also had a failed induction and C-section with LO1. I was fully onboard and requesting a repeat C-section for LO2. My OB wanted to do my RCS at 38 weeks. I obliged.
I also had gestational diabetes in both pregnancies, so was monitored for growth and placenta issues through U/S.
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A 39 week delivery is standard (AMA or not) for a routine scheduled RCS at my dr's practice. I had one for LO 2...I had no interest in a VBAC.
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I've definitely heard that inducing at 39 weeks for women 40 and over could prevent late stillbirth. Just from a quick Google, there's this BBC article talking about a British study: http://www.bbc.com/news/health-21277369
I'd talk to her about it some more, look at the evidence and give it some thought!
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