Choosing Wisely®

In March 2016, the American College of Obstetricians and Gynecologists released its list of "Five More Things Physicians and Patients Should Question" in obstetrics-gynecology as part of the Choosing Wisely® campaign, led by the American Board of Internal Medicine (ABIM) Foundation. This list builds on the original "Five Things Physicians and Patients Should Question" released in February 2013.

The combined list includes ten evidence-based recommendations that can support ob-gyns and their patients in making wise choices about their care. The list of ten tests or procedures to avoid as part of the Choosing Wisely® initiative is comprised of the following:

  1. Don’t schedule elective, non-medically indicated inductions of labor or cesarean deliveries before 39 weeks 0 days gestational age.
  2. Don’t schedule elective, non-medically indicated inductions of labor between 39 weeks 0 days and 41 weeks 0 days unless the cervix is deemed favorable.
  3. Don’t perform routine annual cervical cytology (Pap tests) in women 30 to 65 years of age.
  4. Don’t treat patients who have mild dysplasia of less than two years in duration.
  5. Don’t screen for ovarian cancer in asymptomatic women at average risk.
  6. Avoid using robotic assisted laparoscopic surgery for benign gynecologic disease when it is feasible to use a conventional laparoscopic or vaginal approach.
  7. Don’t perform prenatal ultrasounds for non-medical purposes, for example, solely to create keepsake videos or photographs.
  8. Don’t routinely transfuse stable, asymptomatic hospitalized patients with a hemoglobin level greater than 7-8 grams.
  9. Don’t perform pelvic ultrasound in average risk women to screen for ovarian cancer.
  10. Don’t routinely recommend activity restriction or bed resting during pregnancy for any indication.

Additional details about these items, including the evidence to support them, can be found here (PDF).


Pamela Scarrow
Director, Patient Safety and Quality Improvement    
Choosing Wisely

Lauren Lemieux
Senior Program and Research Associate, Strategic Health Care Initiatives  
Alliance for Innovation on Maternal Health (AIM), Council on Patient Safety, Did You Know? Videos, How I Practice Videos, ReVITALize, Women’s Health Registry Alliance

Lisa Ruffin Schauf
Administrative Manager  
All other inquiries


American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998