Expectant Management for Optimal Pregnancy Outcomes – James A Nicholson, MD, MSCE

March 4, 2018
Stillbirth Matters Podcast
Expectant Management for Optimal Pregnancy Outcomes - James A Nicholson, MD, MSCE
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In this episode of the Stillbirth Matters podcast, Chris Duffy interviews Dr. James Nicholson regarding his work to identify pregnancies that would benefit from induction prior to 40 weeks.   This work has led to his concern about the “39 week rule” and the unintended consequences that seem to be occurring as a result.

Dr. James A. Nicholson obtained his undergraduate degree from Earlham College in 1977, his medical degree from the University of Pennsylvania in 1981, and completed his internship and residency with the Duke-Watts Family Medicine Residency Program in Durham, North Carolina in 1984.

Following his residency, Dr. Nicholson joined a private practice in North Grosvenordale, Connecticut. In 1997, Dr. Nicholson returned to the University of Pennsylvania to join the Department of Family Practice and Community Medicine. While pursuing a Master’s Degree in Clinical Epidemiology, he published the AMOR-IPAT system of identifying pregnant women who would benefit from induction before 40 weeks of gestation. The publication was an editor’s choice paper in the American Journal of Obstetrics and Gynecology. The AMOR-IPAT concept was further developed and followed-up with a prospective, randomized clinical trial (RCT) of AMOR-IPAT (the HUP-POP Trial). In 2012, Dr. Nicholson moved to the Hershey Medical Center of Penn State University in the Department of Family Medicine and Community Medicine, the Department of Obstetrics and Gynecology and the Department of Pediatrics.

In the last few years Dr. Nicholson has become increasingly concerned about the rising numbers of stillbirths in the US and has studied the correlation between the ’39 week rule’ implementation and the rate of stillbirth. He is speaking to multiple organizations and institutions regarding his concerns about the 39-week rule implementation. His data was presented at the Annual Meeting of the Society for Maternal Fetal Medicine in Feb 2016.  In addition, Dr. Nicholson has been a featured speaker at the Stillbirth Summits in 2014 and 2017.


I completely agree with him. My doctor would not induce me until 41 weeks! He never even mentioned the word “stillbirth” to me. OBs will always convince you that it’s too harmful to induce. Well, I trusted my doctor and my son passed away at 40 weeks + 1 day.

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