Planned C Section at 33 weeks, being told I can have Steroids but that the risks may outway the benefits

[M_fox]

Hi hoping someone has had a similar experience. I had my 33 week scan and baby all good. Doctor mentioned that as they want me to have a c section at 37 weeks (due to my age, ivf baby, donor egg and other risk factors) I have an option to take corticoid steriods prior to the delivery but they aren’t giving us a recommendation as there are risks involved on both sides. The leaflet they gave us is clear that in trials the benefits weren’t seen fully.. so if baby is born with lung issues the steroids don’t necessarily improve this percentage but it does say longer term the trials have shown an impact to baby’s mental ability and has in the past, increased the chances of behavioural issues.

It seems all this is is due to the timing of the c section . If it was scheduled before 37 weeks then the benefits are significant as baby would be preterm.. but there is a gray area from 37 to 38.6 weeks where they offer the steriods but aren’t providing a recommendation due to the results of the trials.

Anyways hoping there are experiences out there that are similar and can offer advice.

Thanks xx

[JenRoy]

What country is this? Is it UK? I’m surprised they’re saying 37 weeks. I doubt there’s a huge difference in risks for you in having a C section between 37 vs 38 weeks?! But I know the risks for a baby are higher before 38 weeks. But I’m sure they have their reasons.

I’m 43, IVF baby, donor egg and I’ve been told they won’t let me go past 39 weeks but that’s it. But I’ve no other risk factors.

Steriods beneficial prior to 37 weeks but by 37 weeks lungs are mature. I personally wouldn’t take. If it looks like you’re in premature Labour then they can give steriods then.

37 weeks is considered term.

C sections themselves increase risk of short term issues with the breathing of newborns but it happens at any gestation (called Transient Tachypnoea of Newborn) and can happen after natural Labour too.

Are you at particular risk of preterm delivery?

I’ve worked in neonates and steriods usually given pre 37 weeks.

IVF Mummy but hospital doctor too x

[M_fox in reply to JenRoy]

Hi Jen thanks for replying, I’m in Scotland. Yes wondering myself now why they’re scheduling me for 37 weeks when maybe I could be left until 39 weeks.. I’m 47 so maybe that’s why they are concerned if they leave me longer (15 years of trying for a baby so I understand my age isn’t ideal)

Thanks for your input it makes me feel better, that I’ve understood the risks and am making the best decision not to take them if I stay at 37 or more xxx

[Cinderella5]

I had a section at 37 weeks and had steriods. I actually wasn't given a choice but was told why I needed them. I was having twins so wasn't allowed over 37wks but if you're worried could they not leave you an extra week?xx

[M_fox in reply to Cinderella5]

Thanks Cinderella for replying, I did read that with twins it would be a definite benefit so it makes sense that you got them ahead of delivery. This is the first time I’ve been in a position that doctors aren’t giving they’re recommendations I have one more scan before my date and I’ll ask again and see if delaying my date is an option xx

[RecipIVF]

My baby was diagnosed with static growth and measuring in the 10th percentile (after previously being at the 95th percentile) and my section date was brought forward to 38+2weeks. The doctor said they wouldn’t give steroids as technically baby was full term. Baby was born slightly bigger than the scan measurements at 5lb 13oz and no issues with his lungs. Should also say this is an ivf baby and my wife’s egg. Lots of luck with whatever you decide xx

[M_fox in reply to RecipIVF]

That’s a good sign, thanks for sharing xx

[Fluffy21]

Hi Iv not had a c section but went in to be induced at 36+3 after waters broke and was told I didn’t need steroids as the hospital considered babies lungs to be mature from 36 weeks. Goodluck whatever you decide x

[sun-and-rain in reply to Fluffy21]

I do agree, no need for extra steroids at least after w36. At my ward the limit was w34 fir long. Maybe they've extended it a little now, but no way they'd give steroids at w37!

[M_fox in reply to Fluffy21]

Thanks that’s amazing baby was healthy, it’s my main worry xx

[JuicyLu]

Hello - we’re having pretty much the same conversation right now. We’re having a c section at 38+1 and have to decide re steroids. It was meant to be 39 weeks but I’m now considered very high risk due to reduced movement so it’s been brought forward to this week, hence the steroid conundrum.

The consultant said there is no right answer, and doctors don’t know themselves. I think this is all quite new and there is no proper guidance yet.

Basically there is an increased risk without steroids that the baby might have to go to special care for help with breathing, which can be distressing. But this might happen even with steroids and is something they can treat and baby will be monitored. At the moment we aren’t planning to have them as we are worried about the developmental risks but it’s basically a punt. He said ‘whatever you decide will be right’. 🤷🏼‍♀️

So hard assessing risks when you’ve already been through so much to get to this point x

[M_fox in reply to JuicyLu]

Thanks Lu, at least the information we are both getting is consistent, such a worry as doctors normally have a best guess.

We’re now thinking as you are that we leave the steriods and hopefully whatever baby needs once here they can support. xx wishing you all the luck with your little one when they arrive xx

[JuicyLu]

I should add - I think the c section makes a difference. Having a baby before 39 weeks vaginally is lower ‘risk’ than having a c section in relation to breathing.So I’m trying to look for c section specific guidance. But it’s hard to find! That’s the only thing that’s making me waver - if I wasn’t having a c section and having the baby at 38+1 I’m pretty sure I wouldn’t be considering steroids. It’s only because of the c section I’m considering it. But still haven’t decided!

[Maui2020]

Hi there! Holding my newborn delivered at 37+1 weeks, elective C section following breast cancer diagnosis. Although I am 42 with an ivf pregnancy so felt ok about having an earlier delivery. We originally were going to deliver at 34 weeks and weren’t given a choice on avoiding steroids. At 37 weeks we weren’t even given a choice to have them!

I was under a maternal medicine professor as well as an obstetrician and it was her call that the risks could outweigh benefits. At 37 weeks baby is considered at term and hopefully no intervention needed.

Very thankfully that was also my experience. Good luck xx

[sun-and-rain in reply to Maui2020]

At 34 weeks it's strongly recommended to have them, but so much is changed by 37 weeks from then! I follow the advices/guidelines you've been asigned to 100%!!!

[Maui2020 in reply to sun-and-rain]

I was so lucky my obstetrician handed over to more experienced maternal consultants from a UCLH as she wanted to be extra cautious. I respect her for admitting she didn’t have the answers and didn’t leave any medical decisions in my hands. Through some unfortunate experiences I have learnt Drs don’t have the expertise to know everything as there are so many sub-specialities to everything!

[M_fox in reply to Maui2020]

Maui that’s amazing! Thank you are sharing you give me hope xxx

[DianeArnold Partner]

Hi. M/ Usually given to mature baby's lungs a little more.Trust eith your specialist and go with what he/she advises. Good luck! Diane