A friend of a friend recently had an induction at 37 weeks because the doctors feared her baby would be too large to deliver vaginally if she carried to 40 weeks or beyond. When the baby was weighed, she was just a little over 7 lbs. While this is a bit above average for a baby born at 37 weeks gestation, most babies only gain about 1 pound between 37 and 40 weeks gestation. So, at 40 weeks, the baby would have likely been just over 8 lbs. Too big to deliver vaginally? Probably not.

In fact, the average fetal growth from 37-43 weeks gestation is under 2 lbs. So, is there really an indication to induce before the due date for fear of delivering a large baby? I personally don’t believe so.

Suspecting a large or very large baby is not a medical reason for induction. In a November 2002 press release, ACOG reported that induction of labor for macrosomia (large baby) almost doubled the cesarean rate without improving perinatal outcomes (the health of the baby).2 This statement was based on a study published in Obstetrics & Gynecology.3 Several earlier studies also showed that induction for macrosomia increases, rather than decreases, cesarean section rates without improving the health of the baby.4,5,6 In the professional publication Evaluation of Cesarean Delivery, published by the American College of Obstetricians and Gynecologists, the authors recommend against induction for large babies in healthy women, concluding that “Induction of labor for suspected macrosomia [large baby] does not improve outcome, expends considerable resources and may increase the cesarean delivery rate.”

And, just to be clear, I’m not addressing whether I think a woman should be able to make the choice to induce or wait for spontaneous labor, regardless of the circumstances. I’m just presenting this to the moms who may have felt pressured by their OB to induce for fear of a large baby. Don’t let someone tell you that you can’t deliver a big baby, and don’t let them tell you that inducing your labor will prevent a cesarean.