OB Guideline 14: Scheduled and Elective Delivery

Elective Delivery refers to delivery of a normal pregnancy without a recognized birthing person or fetal indication.¹

Scheduled Delivery refers to a purposely timed delivery for either induction of labor or for cesarean birth.

Delivery occurring more than seven days prior to the estimated date of delivery (EDD) is associated with an increased risk of adverse neonatal outcomes and may be associated with an increased risk of cesarean delivery in nulliparous patients. Therefore:

Elective delivery of singleton gestations should not be planned to occur before seven days prior to the EDD, i.e., prior to 39 weeks gestation.

When scheduled for birthing person or fetal indications, referred to as a "scheduled indicated delivery," the timing of delivery is determined by the medical situation.

Confirmation of term gestation is dependent on satisfying at least one of the following gestational age criteria:²

• Known date of assisted reproductive technologic intervention
• An ultrasound measurement of the fetus obtained at <20 weeks gestation supports gestational age of 39 weeks or greater
• Fetal heart tones have been documented as present for 30 weeks by Doppler
• It has been 36 weeks since a serum or urine human chorionic gonadotropin pregnancy test has been positive

A test indicating fetal lung maturity does not itself meet the criteria for elective delivery.

1. ACOG Committee Opinion No. 765: Avoidance of nonmedically indicated early-term deliveries and associated neonatal morbidities. Obstet Gynecol. 2019;133(2):e156-e163. doi:10.1097/AOG.0000000000003076
2. Cervical Ripening in Pregnancy: ACOG Clinical Practice Guideline No. 9. Obstet Gynecol. 2025;146(1):148-160. doi:10.1097/AOG.0000000000005951