Skip to content
How It Works
Explore
Resources Ask a Question
Who It's For
Patients Caregivers Providers
Log In Ask a Question
PubMed This is a summary of 18 peer-reviewed journal articles Updated
Maternal-Fetal Medicine

Pregnancy and Delivery Planning with Gastroschisis

At a Glance

For a gastroschisis pregnancy, vaginal delivery is typically recommended around 37 to 38 weeks. It is crucial to deliver at a hospital with a Level III or IV NICU and 24/7 pediatric surgical care so your baby can receive immediate treatment after birth.

Planning for the arrival of a baby with gastroschisis involves a shift in focus toward the end of your pregnancy. While the diagnosis adds extra steps to your care, many of the standard “rules” of birth still apply. Your team’s goal is to keep the baby in the womb as long as it is safe, allowing their lungs and digestive system to mature [1][2].

The Mode of Delivery: Vaginal vs. C-Section

There is a common misconception that babies with gastroschisis must be born via C-section to protect the exposed intestines. However, current medical evidence shows no clear neonatal benefit to a routine C-section for gastroschisis [3].

  • Vaginal Delivery: This is the preferred and standard recommendation unless there is a separate medical or obstetric reason for a C-section [2][1].
  • C-Section: This is typically reserved for standard reasons, such as the baby being in a breech position or signs of fetal distress [3]. Your doctor will discuss the safest path based on your specific health and the baby’s position.

Timing the Arrival

In the past, some doctors induced labor early (around 34–36 weeks) to limit the bowel’s exposure to amniotic fluid. However, modern research and obstetrical guidelines suggest that delivering around 37 to 38 weeks is optimal for the baby [4][5].

Babies born prematurely (before 37 weeks) are at a higher risk for [1][6]:

  • Longer stays in the Neonatal Intensive Care Unit (NICU).
  • Increased risk of infections (sepsis).
  • Delays in starting and reaching full “enteral” feeds (feeding by mouth or tube).

Your care team will carefully balance the risk of the bowel becoming irritated in the amniotic fluid against the risks of continuing the pregnancy too long (such as unexplained fetal complications) or delivering too early [7].

Third-Trimester Monitoring

Starting around week 32, your Maternal-Fetal Medicine (MFM) specialist will likely increase the frequency of your appointments [8]. These “check-ins” usually include:

  • Bowel Measurements: Doctors measure the diameter of the bowel loops, both inside the baby’s belly (intra-abdominal) and outside (extra-abdominal) [9][10].
  • Amniotic Fluid Levels: They monitor for polyhydramnios (too much fluid), which can sometimes be a sign of a blockage in the baby’s digestive tract [11][10].
  • Fetal Growth and Well-being: Regular “biophysical profiles” or non-stress tests ensure the baby is thriving and the placenta is working well [12][7].

Choosing Your Delivery Hospital

Because your baby will need immediate specialized care, it is critical to deliver at a hospital equipped for the task. You should look for a facility that offers:

  1. Level III or IV NICU: These units have the highest level of technology and specialized staff to care for complex medical needs [13][14].
  2. 24/7 Pediatric Surgery: A pediatric surgeon should be available to evaluate the baby and begin the repair process immediately after birth [15][16].
  3. Multidisciplinary Team: Your care should involve MFM specialists, neonatologists, and pediatric surgeons working together on a coordinated plan [17][18].

Common questions in this guide

Do babies with gastroschisis need to be born by C-section?
No, babies with gastroschisis do not automatically require a C-section. Vaginal delivery is the preferred and standard recommendation unless there is a separate medical reason, such as the baby being breech or showing signs of distress.
When is the best time to deliver a baby with gastroschisis?
Modern medical guidelines suggest that delivering around 37 to 38 weeks of pregnancy is optimal. Delivering earlier increases risks associated with prematurity, such as longer NICU stays, infections, and delays in starting oral feeds.
What kind of hospital is needed for a gastroschisis delivery?
It is critical to deliver at a hospital equipped with a Level III or Level IV Neonatal Intensive Care Unit (NICU). The hospital must also have a pediatric surgery team available 24/7 to begin the repair process immediately after birth.
What will my doctor monitor during the third trimester?
Your maternal-fetal medicine specialist will closely monitor the baby's growth and perform regular ultrasounds. They will measure the baby's bowel loops, check amniotic fluid levels for signs of blockage, and ensure the placenta is working well.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Does this hospital have a Level III or Level IV NICU with a pediatric surgeon available 24/7?
  2. 2.What is the standard protocol here for delivery timing—are we aiming for 37 weeks, 38 weeks, or letting the baby decide?
  3. 3.Based on the baby's bowel measurements, do you see any reasons to recommend a C-section over a vaginal delivery?
  4. 4.What specific ultrasound markers will we be watching for in the third trimester that might change our delivery plan?
  5. 5.Will the pediatric surgical team be available to meet the baby immediately at the bedside in the delivery room?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (18)
  1. 1

    Gestational Age at Delivery and Neonatal Outcomes among Infants with Gastroschisis in the Children's Hospitals Neonatal Consortium (CHNC).

    Riddle S, Acharya K, Agarwal N, et al.

    American journal of perinatology 2024; (41(6)):756-763 doi:10.1055/s-0042-1744510.

    PMID: 35553040
  2. 2

    Gastroschisis: A State-of-the-Art Review.

    Bhat V, Moront M, Bhandari V

    Children (Basel, Switzerland) 2020; (7(12)) doi:10.3390/children7120302.

    PMID: 33348575
  3. 3

    Mode of delivery and mortality among neonates with gastroschisis: A population-based cohort in Texas.

    Lopez A, Benjamin RH, Raut JR, et al.

    Paediatric and perinatal epidemiology 2019; (33(3)):204-212 doi:10.1111/ppe.12554.

    PMID: 31087678
  4. 4

    European reference network for rare inherited congenital anomalies (ERNICA) evidence based guideline on the management of gastroschisis.

    Burgos CM, Irvine W, Vivanti A, et al.

    Orphanet journal of rare diseases 2024; (19(1)):60 doi:10.1186/s13023-024-03062-8.

    PMID: 38347519
  5. 5

    Trends in Attempted Vaginal Delivery among Pregnancies Complicated by Gastroschisis, 2014 to 2020.

    Schmidt CN, Wen T, Friedman AM, et al.

    American journal of perinatology 2024; (41(5)):543-547 doi:10.1055/a-1990-8668.

    PMID: 36452974
  6. 6

    High risk of spontaneous preterm birth among infants with gastroschisis.

    Baer RJ, Chambers CD, Ryckman KK, et al.

    American journal of medical genetics. Part A 2019; (179(1)):37-42 doi:10.1002/ajmg.a.60675.

    PMID: 30549407
  7. 7

    Development of a prenatal clinical care pathway for uncomplicated gastroschisis and literature review.

    Chabra S, Peterson SE, Cheng EY

    Journal of neonatal-perinatal medicine 2021; (14(1)):75-83 doi:10.3233/NPM-190277.

    PMID: 32145003
  8. 8

    National Practice Patterns for Prenatal Monitoring in Gastroschisis: Gastroschisis Outcomes of Delivery (GOOD) Provider Survey.

    Amin R, Domack A, Bartoletti J, et al.

    Fetal diagnosis and therapy 2019; (45(2)):125-130 doi:10.1159/000487541.

    PMID: 29791899
  9. 9

    Prenatal Prediction of Outcome by Fetal Gastroschisis in a Tertiary Referral Center.

    Nitzsche K, Fitze G, Rüdiger M, Birdir C

    Diagnostics (Basel, Switzerland) 2020; (10(8)) doi:10.3390/diagnostics10080540.

    PMID: 32751744
  10. 10

    Ultrasound Markers for Complex Gastroschisis: A Systematic Review and Meta-Analysis.

    Ferreira RG, Mendonça CR, de Moraes CL, et al.

    Journal of clinical medicine 2021; (10(22)) doi:10.3390/jcm10225215.

    PMID: 34830497
  11. 11

    It Is Complex: Predicting Gastroschisis Outcomes Using Prenatal Imaging.

    Fisher SG, Anderson CM, Steinhardt NP, et al.

    The Journal of surgical research 2021; (258()):381-388 doi:10.1016/j.jss.2020.08.067.

    PMID: 33051061
  12. 12

    Outcome of fetuses with gastroschisis after modification of prenatal management strategies : Prenatal management and outcome of gastroschisis.

    Bauseler A, Funke K, Möllers M, et al.

    Archives of gynecology and obstetrics 2016; (294(2)):239-43 doi:10.1007/s00404-015-3961-1.

    PMID: 26573013
  13. 13

    Inter-center variations in inpatient outcomes for infants with gastroschisis from the Children's Hospitals Neonatal Consortium.

    Ling CY, Zaniletti I, Riddle S, et al.

    Journal of perinatology : official journal of the California Perinatal Association 2025; (45(8)):1105-1113 doi:10.1038/s41372-024-02160-6.

    PMID: 39663394
  14. 14

    The Effect of Level of Care on Gastroschisis Outcomes.

    Apfeld JC, Kastenberg ZJ, Sylvester KG, Lee HC

    The Journal of pediatrics 2017; (190()):79-84.e1 doi:10.1016/j.jpeds.2017.07.008.

    PMID: 29144275
  15. 15

    Sutureless closure for the management of gastroschisis.

    Diyaolu M, Wood LS, Bruzoni M

    Translational gastroenterology and hepatology 2021; (6()):31 doi:10.21037/tgh-20-185.

    PMID: 34423152
  16. 16

    Vanishing Gastroschisis: The Importance of Prenatal Diagnosis in a Seemingly Normal Abdomen.

    Massaguer C, De Haro Jorge I, Saura García L, et al.

    European journal of pediatric surgery reports 2025; (13(1)):e151-e154 doi:10.1055/a-2692-6661.

    PMID: 40951522
  17. 17

    Abdominal Wall Defects: A Review of Current Practice Guidelines.

    Mowrer AR, DeUgarte DA, Wagner AJ

    Clinics in perinatology 2022; (49(4)):943-953 doi:10.1016/j.clp.2022.07.004.

    PMID: 36328609
  18. 18

    Gastroschisis: embriology, pathogenesis, risk factors, prognosis, and ultrasonographic markers for adverse neonatal outcomes.

    Muniz TD, Rolo LC, Araujo Júnior E

    Journal of ultrasound 2024; (27(2)):241-250 doi:10.1007/s40477-024-00887-8.

    PMID: 38553588

This page provides educational information on preparing for childbirth with a fetal gastroschisis diagnosis. Always consult your maternal-fetal medicine specialist and pediatric surgeon for your specific delivery plan.

Get notified when new evidence is published on Gastroschisis.

We monitor PubMed for new peer-reviewed studies on this topic and email a short summary when something meaningful changes.