While the idea of going into labor on a weekend might seem super convenient for everyone involved, new research has revealed that expectant moms might be better off delivering during the regular work week. Giving birth on a weekend might be more dangerous for both mom and baby, but researchers aren't exactly sure why.
For the most part, hospitals aren't really your typical 9-to-5 operation. Medical staff, especially doctors, can work pretty long shifts and many of them end up being on call for nights and weekends at least a few times a month. Your OB-GYN is probably very familiar with the concept of being "on call" because, unless you've scheduled a planned Cesarean section or induction, you won't know exactly when you're baby will arrive. Babies are kind of notorious for not showing up on their due dates. That being said, if you're delivering at a hospital, the doctor you've been seeing throughout your pregnancy will likely try to be there. But if they can't, another doctor who is on call will step in.
Researchers were looking at maternal and newborn outcomes in more than 45 million pregnancies in the U.S. from 2004 to 2014. They found that women who delivered in a hospital over the weekend had more adverse outcomes (like the need for a blood transfusion, perineal tears, and admissions to neonatal ICU) than women who delivered during the week. They also found that the risk of maternal death was a little higher for women who delivered over the weekend: 21 deaths per 100,000 births. That's not much higher than the average overall, which is 15 deaths per 100,000 births. But researchers still took notice and wanted to understand the reason why the risk was increased.
Researchers in the United Kingdom have looked at this phenomenon, too, and their findings were similar — so it's not just a problem in U.S. hospitals. Both studies wondered if one reason why weekend births seemed to encounter more problems was due to the quality of care being different than it would be during the week. They hypothesized that some staff working weekends may be less experienced. Doctors who are higher up in the hierarchy may be able to get out of working weekends by giving that responsibility to younger doctors.
This is similar to another phenomenon seen in healthcare called The July Effect. Each year in July, new doctors who have just finished medical school enter hospitals to begin treating patients. The influx of many new, and relatively inexperienced, doctors leads to more mishaps and mistakes. Some research has claimed that this period of turnover has statistically resulted in a higher number of complications, and even death, for patients treated during that month of the year. But hospitals, especially teaching hospitals, claim that they ramp up their safety measures to overcompensate for the new doctors.
When it comes to weekends, the study published in the British Journal of Medicine asked a lot of good questions about how staff might make decisions on a weekend as opposed to during the week: they wondered if nursing staff were reluctant to call doctors on a Saturday or Sunday unless an emergency was imminent. They also pointed out that many jobs in healthcare, like in admitting, or other clerical staff, may only be part-time on the weekend, which could contribute to miscommunications.
Researchers also wondered if doctors working weekends might be more distracted (by wanting to be elsewhere, perhaps) or just plain overtired. It's also likely that many hospitals just have fewer staff on the weekends, with multiple departments either having reduced hours or fewer employees.
The researchers in both studies haven't been able to make any definitive determination about cause, and they don't want new parents to totally freak out if they end up in the hospital over the weekend. For one thing, if you go into labor on Friday night or Saturday morning, there's not much you can do to try to avoid a weekend delivery.
As would be the case no matter what day of the week you delivered, there are a few things you can do — first and foremost, don't be afraid to ask questions (or have your support person do the talking). You can also ask your support person to take notes about what's happening around you so that you can stay on top of things. Also make sure that your regular doctor is called when you arrive. If the staff seem hesitant to make the call, go ahead and do it yourself so they know you've been admitted — and don't feel at all bad about interrupting their weekend Netflix binge.