Why induce at 39 weeks

NICHD funded the current study to determine the potential risks and benefits of elective induction at 39 weeks, compared to expectant management, or waiting for labor to begin naturally, with health care practitioners intervening if problems occur.

Roughly half of the women were assigned at random to have their labor induced in the 39 th week of pregnancy; the remaining women received expectant management. The primary outcome occurred in 4. However, the proportion of cesarean delivery was significantly lower for the induced group Similarly, the rate of blood pressure disorders of pregnancy was significantly lower in women who were induced 9.

The researchers estimate that one cesarean delivery could be avoided for every 28 low-risk, first-time mothers undergoing elective induction at 39 weeks. Department of Health and Human Services. Read copyright and permissions information. This information is designed as an educational aid for the public. It offers current information and opinions related to women's health.

It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Labor induction is the use of medications or other methods to start induce labor. Cesarean delivery is surgery and comes with certain risks, including: Bleeding, infection, and injury to the bowel or bladder Longer recovery time than vaginal delivery Cesarean delivery also increases risks for future pregnancies, including placenta problems, rupture of the uterus, and hysterectomy.

You and your obstetrician—gynecologist ob-gyn or other health care professional may talk about induction at 39 weeks if: This is your first full-term pregnancy You are carrying only one fetus You and your fetus are healthy.

The ways to start labor may include the following: Ripening the cervix Stripping the membranes Oxytocin Rupturing the amniotic sac.

Ripening of the cervix may be done in the following ways: Using medications that contain prostaglandins. Amniotomy : Artificial rupture bursting of the amniotic sac. Cervix : The lower, narrow end of the uterus at the top of the vagina. Hysterectomy : Surgery to remove the uterus. Article continues below Advertisement. If you have further questions, contact your ob-gyn. Don't have an ob-gyn? Search for doctors near you. Your health care provider might recommend inducing labor for various reasons, primarily when there's concern for a mother's health or a baby's health.

For example:. Nature typically prepares the cervix for delivery in the most efficient, comfortable way. However, if your health care provider is concerned about your health or your baby's health or your pregnancy continues two weeks past your due date, inducing labor might be the best option. Why the concern after two weeks? When a pregnancy lasts longer than 42 weeks, amniotic fluid might begin to decrease and there's an increased risk of having a baby significantly larger than average fetal macrosomia.

There's also an increased risk of C-section, fetal inhalation of fecal waste meconium aspiration and stillbirth. Elective labor induction is the initiation of labor for convenience in a person with a term pregnancy who doesn't medically need the intervention. For example, if you live far from the hospital or birthing center or you have a history of rapid deliveries, a scheduled induction might help you avoid an unattended delivery.

In such cases, your health care provider will confirm that your baby's gestational age is at least 39 weeks or older before induction to reduce the risk of health problems for your baby.

Techniques such as exercising or having sex to induce labor aren't backed by scientific evidence. Also, avoid herbal supplements, which could harm your baby. Labor induction isn't for everyone. For example, it might not be an option if you have had a prior C-section with a classical incision or major uterine surgery, your placenta is blocking your cervix placenta previa , or your baby is lying buttocks first breech or sideways transverse lie in your uterus.

Inducing labor is a serious decision. Work with your health care provider to make the best choice for you and your baby. There is a problem with information submitted for this request. Sign up for free, and stay up-to-date on research advancements, health tips and current health topics, like COVID, plus expert advice on managing your health.

American College of Obstetricians and Gynecologists , Reaffirmed Committee Opinion No. Methods for Estimating the Due Date. A comparison of foetal and infant mortality in the United States and Canada. Int J Epidemiol 38 2 : Attanasio, L. J Midwifery Womens Health.

Baskett, T. BJOG 11 : Bohren, M. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews, Issue 7.

Boulvain, M. Prospective risk of stillbirth. Randomised trials of earlier induction of labour are needed. BMJ : Buckley, S. Washington, D. Carmichael, S. J Midwifery Womens Health, 64 5 Caughey A. Rockville, MD. March Caughey, A. Measuring perinatal complications: methodologic issues related to gestational age.

BMC Pregnancy Childbirth 7 : Complications of term pregnancies beyond 37 weeks of gestation. Obstet Gynecol 1 : What is the best measure of maternal complications of term pregnancy: ongoing pregnancies or pregnancies delivered? Am J Obstet Gynecol 4 : Cheyney, M. Cotzias, C. Prospective risk of unexplained stillbirth in singleton pregnancies at term: population based analysis.

Darney, B. Elective induction of labor at term compared with expectant management: maternal and neonatal outcomes. Obstet Gynecol, 4 , Declercq, E. New York: Childbirth Connection. Divon, M. Male gender predisposes to prolongation of pregnancy. A functional definition of prolonged pregnancy based on daily fetal and neonatal mortality rates. Ultrasound Obstet Gynecol 23 5 : Fagerlin, A. Helping patients decide: Ten steps to better risk communication.

J Natl Cancer Inst 19 : Feldman, G. Obstet Gynecol 79 4 : Flenady, V. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet : Giscombe, C. Explaining disproportionately high rates of adverse birth outcomes among African Americans: the impact of stress, racism, and related factors in pregnancy.

Psychol Bull 5 : Grobman, W. Labor induction versus expectant management in low-risk nulliparous women. N Engl J Med; Halloran, D. Effect of maternal weight on postterm delivery. J Perinatol 32 2 : Click here. Hannah, M. Induction of labor as compared with serial antenatal monitoring in post-term pregnancy.

A randomized controlled trial. N Engl J Med 24 : Postterm pregnancy: putting the merits of a policy of induction of labor into perspective. Birth 23 1 : Hilder, L. Prolonged pregnancy: evaluating gestation-specific risks of fetal and infant mortality. Br J Obstet Gynaecol 2 : BMJ : ; author reply Huang, D. Determinants of unexplained antepartum fetal deaths. Obstet Gynecol 95 2 : Johnsen, S. Fetal size in the second trimester is associated with the duration of pregnancy, small fetuses having longer pregnancies.

BMC Pregnancy Childbirth 8 : Jukic, A. Length of human pregnancy and contributors to its natural variation. Hum Reprod 28 10 : Keulen, J. Induction of labour at 41 weeks versus expectant management until 42 weeks INDEX : multicentre, randomised non-inferiority trial.

BMJ, , l Khambalia, A. Predicting date of birth and examining the best time to date a pregnancy. Int J Gynaecol Obstet 2 : Kramer, M. Analysis of perinatal mortality and its components: time for a change? Am J Epidemiol 6 : Little, S. Elective Induction of Labor: What is the Impact? Obstet Gynecol Clin N Am 44; — MacDorman, M. Kirmeyer Fetal and perinatal mortality, United States, Natl Vital Stat Rep 57 8 : Main, E. Maiti, K. Evidence that fetal death is associated with placental aging.

Am J Obstet Gynecol, , Margerison-Zilko, C. Post-term birth as a response to environmental stress : The case of September 11, Evol Med Public Health 1 : Martin, J.

Births: Final Data for National Vital Statistics Reports. Menticoglou, S. Routine induction of labour at 41 weeks gestation: nonsensus consensus. Br J Obstet Gynaecol : — Middleton, P. Induction of labour for improving birth outcomes for women at or beyond term.

Cochrane Database of Systematic Reviews, Issue 5. Obstet and Gynec. Mishanina, E. Use of labour induction and risk of cesarean delivery: a systematic review and meta-analysis. CMAJ 9 : Mogren, I. Recurrence of prolonged pregnancy.