Big news for women who are 38 weeks pregnant: you are no longer considered “full term.” The American College of Obstetricians and Gynecologists announced today that they would introduce a new classification system for the end of pregnancy. Previously women who were 37 to 41 weeks pregnant were all considered “full term” and women 42 weeks pregnant or over “postterm.” The new classification system calls for four groups: early term (37 to 38 weeks); full term (39 to 40 weeks); late term (41 weeks) and postterm (42 weeks and more).
I know, that’s a lot of terms. But the big change here is to separate out the 37- to 38-week period and acknowledge that, for most babies, this isn’t the ideal time to be born. Evidence has been piling up that babies born in this period do worse than babies born at 39 or 40 weeks. One very recent paper shows babies at 37 to 38 weeks are more likely than those born later to need time in the NICU, mechanical ventilation and IV fluids. But as induction and scheduled C-sections have become more common, the share of babies born at 37 or 38 weeks has risen from 17% in 1983 to 27% in 2009. Many of these deliveries are elective and driven, at least in part, by the perception by women (or their doctors) that things are ready to go at 37 weeks. The push to reduce these early-term deliveries has been going on for years.
This change in wording could make a big difference in practice. Early-term births are expensive because of their added complications, and by explicitly distinguishing them it makes it easier for insurers to refuse to cover elective births in this period. The problem, however, with having a strict guideline like this is that sometimes people start to treat it the cutoff itself as meaningful.
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