Are there differences in when care providers recommend induction of labor?

Care providers may disagree about whether to induce labor in certain situations. These include:

• Prelabor rupture of membranes (PROM). If your water breaks and your pregnancy has reached full term (at least 37 weeks), this is a usually a sign that your labor is about to begin. For some women, labor contractions kick in within the first few hours, but for other women the process takes longer. If your water is broken for many hours, the risk of infection increases. Your care provider may suggest inducing labor to lower this risk, but providers may differ in how long they want to wait before inducing labor. Some may suggest inducing right away while others will wait 12 hours, 24 hours or longer. Your provider's recommendation may be based on his or her routine practice or your specific circumstances. If you choose to wait for labor to begin on its own, prevent infection by avoiding vaginal exams, sexual intercourse or placing anything in your vagina. Read what the research says about PROM and induction here.
• Pregnancy lasting beyond the estimated due date. Many women remain pregnant past their "estimated due date" at the 40-week mark. If a woman remains pregnant until 42 weeks or longer, the risk of stillbirth or newborn death increases significantly, so most care providers will recommend induction before 42 weeks. Some will recommend induction on the woman's due date or even earlier, while others wait until the woman is more than 41 weeks pregnant. Read what the research says about due dates and induction here.
• Your provider thinks you will have a large baby. A large baby may be more difficult to deliver, leading to a C-section or injury to the baby during vaginal birth (an uncommon outcome). However, studies have shown that inducing labor does not reduce the chance of newborn injury and, in fact, seems to increase the likelihood of a C-section. In addition, both ultrasound and hands-to-belly estimates of fetal weight are unreliable and often overestimate the baby's size. The baby’s actual weight can only be known after birth. Many babies delivered early because of suspicion that they are large are found to be in the normal range when born. Also, few women actually experience extra difficulty giving birth to larger babies. Waiting for labor is likely to be the safest approach.