Premature deliveries are best avoided

Dear doctor,
I am now 36 weeks pregnant and too exhausted with my pregnancy. I want to be delivered early but my doctor has refused. What should I do?

There is no doubt that pregnancy can be stressful in many ways. There is initial excitement when a desired pregnancy becomes a reality. But as pregnancy advances, many changes occur in your body. Some changes are undesirable; like poor sleeping patterns, easy exhaustion, and pelvic discomfort among others. Most of such symptoms are luckily of an innocent nature. But it can all get too much, hence the wish to get it all over and done with when you get too overwhelmed.

But nature is clever, and will allow your pregnancy to progress till about 40 weeks before spontaneous labor ensues. This ensures delivery of an optimally mature baby, who is ready to live outside the uterus. Thus in pregnancies without any complications, decisions to deliver the baby prematurely are best avoided. Complicated pregnancies are a different matter altogether. In such cases, there may be compelling reasons to terminate the pregnancy earlier, either in the mother’s or the unborn baby’s interests.

If your desire to be delivered early is based on mundane but annoying symptoms, you may wish to reconsider your wishes. Babies born before 37 completed weeks are considered premature. They are prone to a multitude of problems of immaturity, and in extreme cases may require prolonged care in newborn units. It can be very distressing to care for a premature baby, both emotionally and financially.

The best way out for you is to review your ongoing symptoms with your doctor. There are many remedies to help cope with most innocent symptoms in pregnancy. It may be worthwhile to check that your exhaustion is nothing to do with low levels of iron, which commonly occurs in the second half of pregnancy. A simple test can confirm whether all you need is some supplements. There are other micro-nutrients that may need to be supplemented, and your doctor should be able to advice.

On a personal level, you need to review your daily activities. If your day is full of physically demanding commitments, this may be contributing to your exhaustion. Take it easier, even if it means taking some days off work to get some rest. Or reducing your working hours to manageable limits. Get your partner to be involved as much as possible with your pregnancy, this helps with your coping mechanisms.

In exceptional cases, labor can be induced early even in uncomplicated pregnancies. Such a decision must be carefully made, balancing all the potential poor outcomes with any perceived benefits of an earlier delivery. Special precautions would normally be put in place, but the potential drawbacks cannot be completely eliminated.