Healthcare Professionals

Every week counts.
Why is this important?

Over the past two decades clinicians considered 37 to 41 weeks of gestation to be a term pregnancy, and there was an assumption that birth outcomes at 37 weeks were similar to those at 38, 39 or 40 weeks. There is a growing body of evidence and literature that shows there is very important development, particularly brain development, that happens in the last few weeks of pregnancy.

This website provides an overview of the benefits for babies who are born closer to their due date at 40 weeks – as long as the pregnancy is healthy and progressing without any issues.

When discussing the timing of birth with expectant mothers, clinicians face decisions about whether to schedule birth or wait for labour to begin naturally, and this discussion is even more pertinent when there are health complications. Determining the optimal timing of birth involves balancing the short and long-term health benefits to the mother and her baby, with any risks specific to her pregnancy.

Why does every week count?

Birth before 40 weeks may be necessary. However, for each additional week of gestation achieved there are significant reductions in risk – delaying the birth by even a few days may be beneficial, providing it is safe to do so.

Short term benefits:

  • • With every week that babies are delivered before 39 to 40 weeks, there is an increased risk of neonatal morbidity and mortality. Even infants born at 37 to 38 weeks of gestation are at higher risk than infants born at 39 weeks – the risk decreases week by week up to 39 weeks.
  • • Birth prior to 39 weeks increases the likelihood of readmission to hospital in the first year of the baby’s life.
  • • The risk of a baby requiring admission to a NICU/SCN becomes less the closer the birth is to 39 to 40 weeks – thus also reducing the risk of separation of the baby from its mother at this crucial time for bonding and establishing feeding.

Delaying the birth by even a few days may be beneficial, providing it is safe to do so.


Longer term implications of early birth:

  • • Early (at less than 39 weeks) planned birth is associated with an elevated risk of poor child development at school age – as concluded in a large New South Wales population-based study investigating the association of gestational age with early child development.
  • • Moderate and late preterm (MLPT) birth is associated with smaller brain size, less developed myelination of the posterior limb of the internal capsule, and more immature gyral folding than those associated with full-term birth. These brain changes may form the basis of some of the long-term neurodevelopmental deficits observed in MLPT children.


Awareness of the association between early planned birth and child development at school age, together with the fact that the timing of planned birth is modifiable, has led us to support strategies, such as this website, to provide information that may assist in ensuring optimal child health and development.


The weekly stillbirth rate remains less than 1 per 1000 ongoing pregnancies up to 40 weeks, rising to more than 1 per 1000 ongoing pregnancies at 41 weeks and beyond. The rate of stillbirth has been calculated using the fetus-at-risk approach. This approach takes into account all fetuses in utero (yet to be born) at a given gestational age, in addition to those born in that week. For example, fetuses at risk of stillbirth at 35 weeks include babies born at 35 weeks as well as those yet to be born in subsequent weeks. As the pool of women remaining pregnant becomes smaller each week, the weekly rate of stillbirth increases, (as this is the number of stillbirths divided by a decreasing number of fetuses yet to be born and therefore at risk).

The National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Stillbirth (Stillbirth CRE) has led the development of the eLearning modules which provide evidence-based and collaboratively designed learning resources for healthcare professionals working with pregnant women.

The following modules are available:

  • • The Safer Baby Bundle: This module provides evidence-based information for maternity health care providers on the 5 elements of the bundle: Smoking Cessation, Fetal Growth Restriction (FGR), Decreased Fetal Movements (DFM), Side Sleeping and Timing of Birth.
  • • IMPROVE: This is a training package consisting of six courses and is designed to support healthcare professionals in responding to women who have experienced stillbirth.

Click to register for free access to the Safer Baby Bundle and IMPROVE eLearning modules.

NSW Perinatal data collection, 2006-2015

Joseph KS et al. Acta Obstet Gynecol Scand 2018; 97:454–465.

To view all mentioned research studies, please click here