Decision Aid to Assist Low-Risk Nulliparous Women Considering Induction of Labor At 39 Weeks

Exclusion Criteria

• •1\. First sonographic examination after 20 weeks 2. Women with any of the following comorbidities (at the time of randomization):
• •1. Autoimmune disorders (antiphospholipid antibody, lupus, rheumatoid arthritis, scleroderma)
• •2. Cerclage in the index pregnancy
• •3. Diabetes mellitus-gestational or pre-gestational
• •4. Hematologic disorders (coagulation defects, sickle cell disease, thrombocytopenia, thrombophilia)
• •5. Hypertension (chronic or pregnancy induced) before enrollment
• •6. HIV (human immunodeficiency virus)
• •7. Institutionalized individuals (prisoners)
• •8. Prior obstetric history of: 1) intrauterine growth restriction, 2) preterm birth before 34 weeks, 3) severe preeclampsia, eclampsia, HELLP syndrome, and 4) stillbirth after 24 weeks or neonatal death
• •9. Preterm labor or ruptured membranes before enrollment
• •10. Psychiatric disorder (bipolar, depression) on medication
• •11. Placenta previa / 3rd trimester bleeding
• •12. Renal insufficiency (serum creatinine \> 1.5 mg/dL)
• •13. Restrictive lung disease
• •14. Fetal red blood cell isoimmunization
• •15. Seizure disorder on medication
• •16. Thyroid disease on medication
• •17. Body Mass Index (BMI) above 40 kg/m 3. Major fetal Anomaly including: anencephaly, spina bifida, bilateral renal agenesis, cystic hygroma with hydrops, diaphragmatic hernia, or congenital heart defects 4. Unable to understand consent in English or Spanish