In pregnancy, when should labor ideally be induced, if both the mother and child are healthy?

Question

If there is no sign of fetal distress, no measurable or detectable health problems, and no otherwise discernible complication - at what point should labor be induced?
I have heard alot of mixed information: some seem to be for inducing at 40 weeks, some at 41, some at 42, and even a few who are against induction at any of these points. All cite a number of reasons for their opinions.

My wife is, if she calculated her period correctly, at 41 weeks - or if the ultrasound is more accurate, at 40 weeks. Tomorrow, her doctor is going to try and talk us into induction - nay, he seems to be rather set on it. She is having no problems or complications, our baby has shown no signs of distress or complications, and many of the precursors of labor (braxton-hicks contractions, loss of mucous plug) have been occurring in the past two days - they seem to be progressing rather rapidly. But actual labor may still be a few days away if induction does not take place.
Our doctor took our last visit to tell us that "nothing good happens after the due date" and run down a short list of increased risks of post-term pregnancy.
We, however, have mixed feelings about induction. I have no doubt it is certainly necessary in some cases, but I also have no doubt that it carries increased risks, especially drug induced induction. So both post-term pregnancies and inductions seem to carry risk - but which is worse? The more we read about cytotec, the more we dislike it - and pitocin (or at least the way it's administered) isn't far behind. But at the same time, we don't want to put our baby at risk of complications from post-term pregnancy either.
So what should we do? Everyone is healthy, and I very much think my wife will go into labor naturally within the next few days, if given the chance. For the past several days we have been seeing new signs of it every day. But which way is less risky to mother and child? Can the risk of post-term complications be managed and monitored well enough to catch them before they become a serious problem, or is induction just a better idea all around? Or are the risks either induction or post-term pregnancy overstated?
I have done some research on this, but again, I have gotten mixed information. Our doctor is great and competent in many ways, but he is very set in his ways and thinking outside the box or discussing something outside of his point-of-view seems to be beyond him. But, of course, my wife has the right to refuse any treatment.
Any info on this subject would be very helpful. Links and references are welcome. Thanks for any answers in advance, and God bless!

? · Accepted Answer

your doctor needs to be told due dates are estimations NOT eviciton notices. He's trying to cover his own butt so you can't sue him for malpractice. 

Risks of induction:
Increased risk of abnormal fetal heart rate, shoulder dystocia and other problems with the baby in labor. 
Labor induction is done by intervening in the body's natural process, typically with powerful drugs to bring on contractions or devices that are used to break the water before labor starts. Both of these types of induction can cause the baby to react in a manner that is called fetal distress as seen by fetal monitoring.
Increased risk of your baby being admitted to the neonatal intensive care unit (NICU). 
Babies who are born via induction have not yet sent signals to the mother to start labor. This means that they simply aren't yet ready to be born. This risk is worth it if the baby or mother's lives are in danger, but simply to take this risk for elective reasons may not be well advised.
Increased risk of forceps or vacuum extraction used for birth. 
When labor is induced babies tend to stay in unfavorable positions, the use of epidural anesthesia is increased and therefore the need to assist the baby's birth via the use of forceps and vacuum extraction is also increased.
Increased risk of cesarean section. 
Sometimes labor inductions don't take, but it's too late to send you home, the baby must be born. The most common cause of this is that the bags of waters has been broken, either naturally or via an amniotomy. Since the risk of infection is greater, your baby will need to be born via c-section.

Risks of going over 42 weeks:
For several reasons, an overdue pregnancy can be risky both for the mother and the baby. In addition to higher odds of numerous complications, there's said to be an increased risk of stillbirth in pregnancies that have progressed beyond 42 weeks. But exactly how much increased risk is there? Here is what UpToDate, an online health resource for doctors and patients, has to say about stillbirth risk in an overdue pregnancy:

Here is a link to a paper on risks of going past 40 weeks. There was too much to quote it here in the answer. And it is a medical paper so it's a bit hard to read. But I'd take to your doctor. http://www.glorialemay.com/blog/?p=116

Anonymous · Answer

Once you hit 42 weeks you need to keep a close eye on things but CAN continue a pregnancy safely to 44 or even 45 weeks.
Doctors like to induce (which has a huge list of risks for mom and baby and starts the cascade of interventions) for THEIR convenience.  They only take X number of patients during a specific time period. If you go over due you go into their next patient load and they don't like that.,

Whatever you do, do NOT let them even come close to your wife with cytotec. It says RIGHT on the bottle "Not for use when pregnant".

You are correct that your wife can refuse ANY treatments. If he talks you into an induction and you guys get home and decide it's not what you want then don't show up for it, call him and say "oops. I slept in." or some crap excuse. He'll schedule you another appointment with him to check the baby and so continues.

Good luck! You guys sound like you've done some good research.

Iggy rocks · Answer

she can refuse if she wants, but if she is 41 weeks then she may need a little push...induction is nothing to be worried about  its very common..if she doesnt want it then chat with teh doctor

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In pregnancy, when should labor ideally be induced, if both the mother and child are healthy?

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