06/20/2026
🚨 An Important BIRTH STUDY which wasn't widely circulated in the media highlights the impact of the ARRIVE study as well as real world c-section rates with inductions.
"Although the ARRIVE trial demonstrated a lower c-section rates in very low-risk nulliparous women with induction at 39 weeks in academic medical centers, we hypothesized that, because of the wide variability in hospital practices regarding c-section delivery and induction of labor, the findings of reduced c-section delivery with induction would not hold in community, non-academic conditions in hospital settings with already low c-section rates.
"This study examined rates of labor induction and c-section delivery in very low-risk NTSV patients in the years before and after ARRIVE trial in 3 Sacramento Valley Sutter Health hospitals.
"We also examined whether induction of labor in this very low-risk group was associated with risk of cesarean delivery and other adverse maternal and neonatal outcomes.
"We found that for low-risk NTSV mothers in a community, non-academic, hospital setting with a relatively low rate of cesarean delivery, labor induction was associated with increased odds for c-section delivery after adjusting for covariates.
"The rate of labor induction in this population increased by more than 50%, from 14.9% in 2016 to 23.1% in 2022. The adjusted odds for cesarean delivery increased with labor induction from the earlier to the later period."
What does this mean? The controlled ARRIVE study in high resource academic settings does not necessarily translate to similar results in community settings with varied resources.
So, with all the studies, does induction increase c-sections or not? Ultimately, it depends on the source you read, the location of birth, the provider attending (OB vs midwife), and reason for induction.
For those considering an elective induction, it's important to weight the benefits vs risk of potential cascade of intervention. For those facing a medically necessary induction, you don't need to necessarily assume a high increased risk of c-section, and you can assess provider choice and birth location. But in both cases, it is helpful to be aware of the increased risk of c-section seen in some studies.
👇🏽 What have you seen post ARRIVE study?
