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C-Section Risks After 40 Weeks

Pregnant women can usually expect to have their baby about 40 weeks after the date of their last menstrual period, but normal births can occur at any time between 37 weeks and 42 weeks of pregnancy. The March of Dimes website reports that one in three babies are delivered by C-section. Risks associated with C-sections are greatest before 39 weeks of pregnancy, but some risks are greater after 40 weeks.

  1. Breathing and Feeding

    • A study, "Timing of Elective Repeat Cesarean Delivery at Term and Neonatal Outcomes," found an increased risk of babies having breathing problems after C-section births before 39 weeks and again after 40 weeks. The same study also found increased risks of infant feeding problems after 40 weeks. Babies are not considered fully developed before 39 weeks and risk problems including low blood sugar and blood infections if birth is before 39 weeks. After 40 weeks, the quality of the placenta begins to decline. The study was funded by the Maternal-Fetal Medicine Network of the National Institutes of Health and Child Development and was conducted at 19 university medical centers across the United States.

    Rupture

    • When women have had previous Cesareans, most doctors will recommend C-sections in subsequent pregnancies as well. Women with a history of previous C-sections are at risk of their previous incision rupturing after 40 weeks of pregnancy. The risk of rupture is why doctors rarely allow women to pursue a vaginal birth after cesarean (VBAC). Ruptures can occur in any stage of pregnancy, including in subsequent C-sections, although the risk is very rare.

    Diabetes

    • When mothers have gestational diabetes, the exposure to high insulin levels throughout pregnancy means that babies are at greater risk when pregnancies go beyond 40 weeks. Babies will often grow larger than normal and for this reason, doctors will usually recommend C-sections for mothers with gestational diabetes. The diabetes itself presents complications during C-sections, including a more difficult healing period for the mother.

    Fetal Distress

    • According to a review of academic literature conducted by the Department of Obstetrics and Gynecology at Sunnybrook, in conjunction with the University of Toronto, pregnancies that go past 40 weeks are associated with higher rates of fetal distress during labor, such as heart rates dropping during contractions. Babies delivered after 40 weeks are also at risk of meconium staining of the amniotic fluid. Meconium is the baby's first bowel movement and its release prior to birth is a sign of extreme physical stress.

    Stillbirth

    • One of the greatest risks of pregnancies going beyond 40 weeks is stillbirth. Babies have a higher perinatal mortality rate as pregnancies go past the due date. C-sections after 40 weeks are associated with a greater risk of stillbirth, so doctors recommend inducing labor by 40 weeks instead of performing a routine C-section after this date.

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