Dr. Asna Walfisch

In Israel the number of births goes up right before and during Passover. Of course, whenever a child is born it is a joyous event. Recent research has revealed a vital discovery regarding how the timing of a baby’s birth affects the child’s health.

Revolutionary research done by Dr. Asnat Walfisch, Head of the Obstetrics/Gynecology Department of Hadassah Medical Organization in Jerusalem (Mount Scopus), has revealed the relationship between a child’s long term health and early term birth. Dr. Walfisch specializes in high risk pregnancies, and treats women suffering from various placenta related pregnancy complications such as preeclampsia, preterm delivery and fetal growth restriction. “I am specifically passionate about the relationship between gestational age at birth, even within ‘term pregnancy’ which is 37 to 42 weeks, and later child health,” says Dr. Walfisch. “I am always looking for ‘perfect timing’ to deliver, both in the short as well as the long term perspective.”

Dr. Walfisch, 46, was motivated to conduct this research because she sees the impact of delivery timing and how it affects the baby’s health. “As doctors, delivery timing is a common dilemma we face every day when we are scheduling a date for a Cesarean section or labor induction,” she says. “Sometimes women ask for a certain date because of non-medical reasons such as the holidays, convenience, or just because they are tired from the pregnancy.”

Research Findings. Her research focused on how pregnancy complications, mode of delivery, and gestational age at birth each affect long term health of the baby.

The first finding is that “early term” (which is 37 to 39 weeks’ gestation) is not the perfect time to deliver, and delivery should be postponed to full term (39 to 41 weeks), if there is no medical indication to deliver earlier. In both the short term and the long term, children born “early” exhibit health issues that are similar to those typical of premature babies (those born before 37 weeks) but to a lesser extent.

The second finding revealed that children born “early” tend to be hospitalized more often due to respiratory, cardiac, and metabolic issues. Obstructive sleep apnea necessitating surgery (like tonsillectomy) and otitis media (ear infection) are also more common in these children. Other researchers have found higher risk of attention deficit disorders in early term babies.

Another aspect of the research relates to mode of delivery. Apparently, babies born via C-section are more likely associated with later health issues compared to babies born via vaginal delivery. This may be due to the benefits of passing through the birth canal and exposure to the different bacteria there, which helps the immune system to develop.

This research was conducted at the Ben Gurion University of the Negev, and The Soroka University Medical Center, Beersheva. “Our research group consisted of Professor Eyal Sheiner, Dr. Tamar Wainstock, Ruslan Sergienko and myself,” Dr. Walfisch says. “We worked on a unique and huge database of roughly a quarter of a million births occurring between 1991 and 2014 that combines perinatal data and later hospitalizations of the children.”

Dr. Walfisch is confident these research results will help women. “I think that when women are considering when and how to deliver their baby,” she says, “they need to have the full picture of how these decisions will affect the lives of their babies in the long run. If delivery can be postponed to full term and carried out the natural way, within medical safety limits of course, the better.”

This research is just the beginning. Dr. Walfisch explains, “There is so much more we need to study and understand. A combined database of several regions within Israel and maybe the entire country can give us a more comprehensive picture of the health of offspring in the long run and the association with different pregnancy and delivery characteristics.”

Each year the number of babies delivered at Hadassah Medical Organization increases. Nearly 14,000 babies were delivered at Hadassah’s Mount Scopus and Ein Kerem hospitals this year, which is 5 percent more than last year. Dr. Walfisch said she feels blessed to be part of this historic hospital in Jerusalem. “The newly opened delivery rooms (in Mount Scopus) are a combination of great design and cutting edge technology,” she explains, “so that women can feel at home while the team has everything needed to provide a safe and healthy delivery.” Her goals at Mount Scopus? “I want the woman to feel she is getting the delivery experience she dreamt of, ‘custom made’ for her.”

Dr. Walfisch knows a lot about babies, as a doctor and also as a professor. At Ben Gurion University and soon to be teaching at Hebrew University Hadassah Medical School in Jerusalem, her subject is long term health of babies. Her experience is also firsthand, as a mother of three children, ages 18, 15 and 10. Regarding motherhood: “Of course, there are always compromises, when raising kids and working. But I believe it’s not the amount of time you spend with your kids, it’s the inspiration you give them.” As a doctor whose father, husband and brother are doctors, she doesn’t predict that her children will become doctors but she tells them, “Do something that is meaningful for you and for society.”

Passover “Special Delivery” Stories

The Doctor Gets a Surprise

Even professionals can’t always guess when they’re due when it comes to Passover. Dr. Tamar Elram, Director of Hadassah Mount Scopus is herself an obstetrician. Eleven years ago, she invited her entire extended family to her home for Passover. It might have been a bit much, even for the highly capable overachieving Dr. Elram. But it was her fifth child and she thought she had everything under control…until she went into labor and had to leave family and guests to fend for themselves! “I was sorry for missing the fun with the family,” says Dr. Elram. “But I didn’t complain that someone else swept up the matzo crumbs.”

Seder in the Delivery Room

“My grown children went to the other side for Seder, and despite many invitations from family and friends,  I chose to make the Seder at my second home  Hadassah Mount Scopus,” says Dafna Tayer, a midwife at Mount Scopus.

“Although there is a large Seder in the hospital, we make our own in the delivery room, where we need to be on hand. Ours is an unusual group—nurses and doctors, Jews and Arabs, from Israel and abroad, one from Mexico. Each of us brings a first course, main course and dessert—all kosher for Passover. Of course we do all the blessings and ceremonies if we have time. We substitute grape juice for the four cups of wine. We have a wonderful family feeling in Mount Scopus, and the joy of making a Seder in the delivery room stays with us for the whole year. The first time I agreed to be on duty, I knew I had made the right decision to be in the right place at the right time.”

This the first of four exclusive articles about medical breakthroughs from Hadassah Medical Organization, a world-renowned healthcare leader and a global destination for advanced care, continued innovation and cutting-edge research. As part of Hadassah’s “360 Degrees of Healing” initiative, the iconic Round Building at Hadassah’s Ein Kerem campus in Jerusalem is being modernized and expanded to advance its services as the hub of innovative medicine.

This article is presented by Hadassah, the Women’s Zionist Organization of America, Inc. which is a volunteer organization founded in 1912 and and is committed to strengthening a connection to Israel, building a better world through medicine and healthcare, and US advocacy around women’s health.

Original article by April Zion, published in The New York Jewish Week on 10th April 2019 - Click here to read original