The American College of Obstetrics and Gynecology recommends that
elective c/s be done at 39 weeks gestation or later (assuming that
one's dates are reliable) or may be performed earlier with
documentation of fetal lung maturity.  Over the past 25 years, a
number of studies have documented the dangers (neonatal morbidity and
mortality) of 'elective' c/s prior to 39 weeks without documented
fetal lung maturity.  Unfortunately, I have found that many OB's are
either ignorant of the data and the ACOG recommendations or choose to
ignore them.  (For instance, "I am going on vacation, so I might
as well do the c/s before I go away.")  Most of the time, the baby is
fine.  I have personally taken care of a number of babies in the NICU
who have suffered significant respiratory problems after being
delivered via elective c/s prior to 39 weeks gestation and no
documentation of fetal lung maturity.  Their respiratory problems had
nothing to do with infection.

By the way, how does this relate to breastfeeding?

Danny Hirsch, MD, FAAP, CLC
Neonatologist
Director, Lactation Institute of Westchester
Assistant Professor of Pediatrics
New York Medical College
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