But new evidence has recently prompted the definition of full term to be tightened to no earlier than 39 weeks.

Medical research shows that a trend towards planned births occurring before that time is associated with an increase in health problems amongst newborns, such as needing specialised care for breathing or feeding. Children born before 39 weeks are at increased risk of long-term developmental problems such as poorer school performance and Attention Deficit Hyperactivity Disorder.

University of Sydney Professor Jonathan Morris says in order to improve neonatal health outcomes and save the health system money, there is need to halt the trend towards earlier births.

“Information from the Australian Commission on Safety and Quality in Health Care shows that 52 per cent of planned caesarean sections in the public sector are occurring before 39 weeks with no strong clinical indication and in the private sector its 60 per cent,” says Professor Morris, who is the Director of Clinical and Population Perinatal Health Research at the Kolling Institute.

“There is  a general lack of awareness amongst clinicians, mothers and their families of the short, medium and long term implications of being born even slightly early.”

In a Sydney Health Partners-supported initiative, Professor Morris and colleagues have developed a multi-lingual education campaign to encourage cultural change amongst obstetricians and midwives - and different choices by expectant mothers. Called Every Week Counts, the campaign provides easily-understood information for both clinicians and mothers as to why even small differences in gestation time can have a big influence on a baby’s development during pregnancy.

“Between 37 and 39 weeks the parts of a baby’s brain responsible for learning, movement and co-ordination continue to develop,” said Professor Morris. “Our education campaign promotes the message that, providing it is medically safe, it’s much better for a child’s development that it remains in the womb until full term.

The education campaign has been enthusiastically received during trials at several hospitals within the Sydney Health Partners region and elsewhere in NSW. Early Birth Education Project Manager, Lyndsey Harvey, says it has been particularly welcomed by midwives.

“We’ve had very positive feedback from midwives, who we found are already very much aligned with the message,” said Ms Harvey. “It confirms what many of them have long believed based on their clinical experience.”

The campaign has also been supported by the Australian Pre-term Birth Prevention Alliance and also warmly received by Women’s Healthcare Australasia who wish to distribute material through their network.   Encouraged by the positive reception, the education campaign was preparing to go national in the second quarter of 2019 via launch of a dedicated website, supported by social media.

Professor Morris says that while reception at all levels have been very encouraging, it will be some time before there is clear evidence that it has made a difference to health outcomes.

“In the areas where the education materials have been distributed we are collecting data on rates of stillbirth, neonatal mortality and morbidity. It is only when we see a decline in these, and a reduction in costs to the health system, that we will be able to ascertain the effectiveness of the approach.”