Risk: Born After Hours

by Dr. Michele Brown OB/GYN

Paparazzi Baby

baby dressed as the New YearThe countdown to midnight is here, but instead of being in Times Square with millions of others watching the crystal ball drop, imagine being a woman in the final pushes of labor in a delivery room. She is yelling at the top of her lungs, but oddly enough, it's not over the intensity of her labor pains. She is actually yelling at the clock on the far wall which still reads ten minutes to midnight. It seems to her as if the minute hand is stuck in place as she prays that her baby can wait just another few minutes to be the first one born in the New Year!

As if having a baby is not exciting enough, what a fantastic start it would be to have the media snapping photos and praising your baby for arriving first on New Year's Day. New Year's (12:01 a.m.) babies are so exciting, but delivery outside prime time hospital hours has its risks.

But as an OB/GYN, please take it from me that this is not the kind of thing you should be thinking about just when your baby is in the most vulnerable position of life, upside down and trying to be born. Why?

Research

Because research shows that there is an added risk when delivering a newborn in the middle of the night, off hours, or on holiday weekends.

Pasupathy in the British Medical Journal: One such recent study concludes that delivering an infant outside the normal working week hours of Monday through Friday and from 9 to 5 was associated with increased risk. The differences had nothing to do with maternal, infant, or obstetrical characteristics, which hospital you delivered in, or mode of delivery.

Gould in Obstetrics and Gynecology: Another study showed an increased risk for infants born during the late night.

Accounting for These Risks

There may be many reasons for these added risks. Among them are differences in numbers of staff members and decreased availability of senior, experienced staff members at odd hours. Other causes may be due to decreased availability for obstetrical operating rooms, fatigue among staff members working on night shifts and fewer paraprofessionals, such as blood bank staff members, on duty.

Higher Danger for Low Risk Births

Is this finding associated equally with both low risk births and high risk births? No. Interestingly, increased risks were found to be more common in the lower risk births. Why? Because as the research suggests, the higher risk situations have anticipated problems and have the ability to identify and mobilize the needed resources very quickly, while the unanticipated problems that suddenly arise in lower risk pregnancies, may cause delays in getting the appropriate personnel and material to the given situation in a timely fashion. Very low birth weight infants seem to have sufficient and adequately trained staff members at all times.

Your Medical Team's Response

New rules and regulation have been implemented to reduce this risk: