A: Dear Stephanie,

Obstetricians sometimes recommend inducing labor in a pregnancy before 37 weeks if there are complications. Without knowing the specifics about your pregnancy, it’s hard to make a recommendation. But it is great that you have already reached 34 weeks!

When a pregnancy is complicated, it may be because of problems the mother has during the pregnancy (e.g., diabetes, high blood pressure), fetal problems (such as inadequate growth) or conditions such as premature labor or premature rupture of the amniotic membranes.

Even though your nurse practitioner told you it is safe to give birth after 35 weeks, ideally a baby should develop a little longer inside its mother. Premature babies are small (less than 6 pounds), and may have trouble with feeding, breathing on their own, maintaining their temperature, and jaundice. On the other hand, most babies born after 35 weeks will ultimately do well if they receive good medical care in a neonatal intensive care nursery.

Sometimes we must balance the risks of premature deliveryof the baby with the potential benefits to the mother of having an early delivery. For example, a mother who has elevated blood pressure in pregnancy and develops severe pre-eclampsia will likely improve after she delivers her baby. An early induction in this case would allow the mother’s condition (which can be life-threatening) to improve as soon as the baby delivers. Similarly, a fetus with “intrauterine growth retardation” (which means the fetus is not growing well) may have an easier time growing once it is born. An induction for this problem is done to help the baby to grow outside of the uterus and to reduce the chances of fetal demise. And, if the bag of water ruptures prematurely, the risk of infection to the baby increases over time; an early delivery can prevent a neonatal infection.

If your doctor is recommending an induction, it is important that you understand the risks and the benefits of this intervention. Ask questions which will allow you to learn about risks to the baby from being delivered early versus the risks of staying inside your body. Find out whether your own condition is likely to worsen during the pregnancy or whether it is stable. Ask whether any tests will give more information. For example, an amniocentesis (removal of some of the amniotic fluid from around the baby) done in the third trimester can suggest whether your baby is likely to breathe on its own after birth. Fetal heart rate monitoring can show whether the baby seems to be in distress. An ultrasound can show if adequate fluid is around the baby. Together with your doctor, you can decide whether it is safest to continue the pregnancy or choose to induce labor prematurely.