A: While obstetricians are not in uniform agreement about the best time to initiate a post-date induction, most agree that inducing labor at or beyond 41 weeks may be beneficial.

As pregnancy progresses beyond your 41 weeks, your placenta continues to age and may be less effective at nourishing your growing baby. Post-dates babies have an increased chance of fetal asphyxia (inadequate oxygen), a decrease in the amount of amniotic fluid cushioning the umbilical cord and an increased chance of passing meconium (the baby’s first bowel movement) into the amniotic cavity. Some babies inhale meconium during labor, which can cause serious respiratory problems.

Induction after 41 weeks reduces the risk of perinatal death and meconium-stained fluid. Additionally, studies suggest that women who are induced after 41 weeks have a lower risk of Caesarean section compared to women who wait for spontaneous labor.

If this is your first baby or if your cervix is firm, closed and long, your doctor may suggest preparing your cervix for labor using a medication placed in or around your cervix. This softens the cervix and facilitates dilation, and has the added bonus of starting contractions in some cases.

If your cervix has already begun to dilate (open), other techniques may be used. “Sweeping” or “stripping the membranes” takes place when a provider uses a finger to separate the amniotic membrane from the lower uterus. This increases your chance of beginning labor and can be done during an office visit. “Artificial rupture of membranes” or “AROM” takes place when your provider breaks the bag of water using a small plastic hook to initiate or augment labor. This happens when you are already admitted to the hospital. AROM stimulates the production of helpful prostaglandins, and can intensify labor. However, breaking the bag of water can increase the risk of infection.

All of these techniques can be used in conjunction with Pitocin®, the most common medication used to stimulate uterine contractions. Pitocin is given through an intravenous line. The dose is adjusted to regulate the strength and frequency of your contractions. Your baby’s heart rate will be continuously monitored while this medication is used.

Although medications can assist with the onset and progression of labor, there is no shortcut. You will still need to endure hours of strong regular contractions before you meet your new baby. It’s important to be sure of your due date if you and your doctor are contemplating an induction. If your health is fine and your baby is thought to be doing well, there’s not usually a reason to induce labor before 41 weeks.