Recommendations from others
A 1999 American College of Obstetricians and Gynecologists (ACOG) practice bulletin states that labor may be induced for logistic reasons such as psychosocial factors and distance from hospital, as long as 1 of these 4 criteria is met: (1) fetal heart tones have been documented for 20 weeks by nonelectronic fetoscope or for 30 weeks by Doppler; (2) it has been 36 weeks since a positive serum or urine human chorionic gonadotropin pregnancy test was performed; (3) ultrasound measurement of crown-rump length, obtained at 6 to 12 weeks, supports a gestational age of at least 39 weeks; (4) ultrasound obtained at 13 to 20 weeks confirms the gestational age of at least 39 weeks determined by clinical history and physical examination. The ACOG recommendation (which dates back to 1989) is for induction of low-risk pregnancy at the 43rd week of gestation.7
The Royal College of Obstetricians and Gynaecologists recommends that women with uncomplicated pregnancies be offered induction of labor beyond 41 weeks.8 The Department of Obstetrics and Gynecology and Reproductive Biology at Harvard Medical School recommends routine induction of labor be recommended at 41 weeks’ gestation.9