Choosing Wisely:

Avoid elective, non–medically-indicated inductions of labor between 39 weeks 0 days and 41 weeks 0 days unless the cervix is deemed favorable.

Rationale and Comments: Ideally, labor should start on its own initiative whenever possible. Higher cesarean delivery rates result from inductions of labor when the cervix is unfavorable. Health care clinicians should discuss the risks and benefits with their patients before considering inductions of labor without medical indications.
Sponsoring Organizations:
  • American College of Obstetricians and Gynecologists
  • American Academy of Family Physicians
  • Sources:
  • AAP/ACOG guidelines
  • Cochrane Database of Systematic Reviews
  • Disciplines:
  • Obstetrical
  • References: • American Academy of Pediatrics, American College of Obstetricians and Gynecologists. Guidelines for Perinatal Care. 6th ed. Elk Grove Village, Ill.: AAP; Washington, DC: ACOG; 2007.
    • American College of Obstetricians and Gynecologists. Induction of labor. Practice bulletin no. 107. Obstet Gynecol. 2009;114:386-97.
    • Gulmezoglu AM, et al. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database Syst Rev. 2012;(6):CD004945.

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