When a pregnant passenger goes into labor on a flight, the priority is to get her to definitive obstetric care as quickly as possible while keeping her safe and comfortable. If possible, determine the gestational age to help guide triage and what kind of facility may be needed once she lands. Coordinating rapid transport to a medical facility ensures she can be managed by trained obstetric professionals with the necessary equipment, which isn’t available on board. Staying with her and keeping her comfortable reduces stress and helps with any adjustments during transfer. Terminating labor or inducing labor on the aircraft isn’t appropriate given the lack of sterile conditions and supervision, and waiting until landing would delay critical care and could increase risk. So, the best course is to determine gestational age and arrange rapid transport, while keeping the patient safe and comfortable.