Inductions are a hot topic in the labor and delivery world! There is a lot of information floating around, both positive and negative, and it seems like every person has their own, differing opinion.
I would venture to say that a lot of people get a sour taste in their mouth when they hear the word induction. They totally get a bad rap, but I am here to tell you that it’s possible to have a positive and uncomplicated birth experience with an induction. Trust me mama, I see it happen all the time!
In this article, I will spend some time exploring the ARRIVE Trial with you and will also cover the pros and cons of induction vs. spontaneous labor. Without wasting another minute, let’s get down to whether or not you should be induced at 39 weeks!
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Long story short, the ARRIVE Trial was a study that compared elective induction at 39 weeks gestation with expectant management of low-risk, first-time moms. Expectant management is more of a “watch and wait for spontaneous labor” approach as opposed to inducing labor.
The point of the study was to determine whether or not electively inducing women at 39 weeks, without a medical indication, would result in a lower rate of complications. Some examples of these potential complications could include: fetal macrosomia (large baby), shoulder dystocia, need for an episiotomy, or a vacuum or forcep-assisted birth. In addition, it looked at the impact a 39 week elective induction has on the incidence of C-sections.
According to the NIH, the ARRIVE Trial found, “a significantly lower risk of Cesarean birth and no significant difference in composite neonatal complications after elective induction, compared to expectant management.”
To break it down for you, the ARRIVE Trial determined that inducing low-risk, first-time mamas at 39 weeks helped to slightly decrease the C-section rate in those women.
And while it did help to slightly decrease the incidence of C-sections, it did not have any impact on labor and birth complications for mama or baby.
In other words, the chance of needing a C-section was a little bit lower with those mamas induced at 39 weeks but there was not a difference in the two groups when it came to potential complications (large baby, shoulder dystocia, episiotomy, vacuum or forceps, unplanned C-section.)
The American College of Obstetricians and Gynecologists (ACOG) is the governing body that oversees and helps obstetricians and gynecologists make decisions that guide their practice.
There are a handful of reasons why a medical induction might be recommended, including:
Where it becomes a bit more gray is when you get to elective inductions. Different providers have different opinions about elective induction. A lot of these opinions are guided by ACOG. So, what is ACOG’s stance on 39 week inductions after all?
According to ACOG, “In addition to some conditions for which labor induction is recommended, new research suggests that induction for healthy women at 39 weeks in their first full-term pregnancy may reduce the risk of Cesarean birth.”
ACOG basically states that while an induction prior to 39 weeks, without medical indication, should not be performed, an induction at 39 weeks plus might be an option for some women.
Leaving it ultimately up to the provider and patient, ACOG says that a 39 week elective induction might be up for discussion if:
Even though a baby is considered early term at 37 weeks, a baby born at 39 weeks vs. 37 or 38 weeks has a better chance at healthy outcomes.
Therefore, a healthy mama carrying a healthy baby should not be induced prior to 39 weeks without a medical indication. (source)
I think the answer to this truly depends on your provider and your place of delivery. As I previously mentioned, different providers have different opinions and views on 39 week inductions.
To make a general statement saying 39 week inductions are common practice at all facilities would simply not be fair or true. If you look hard enough, and honestly you might not even have to look that hard, you will absolutely find a provider that is supportive of inducing a first-time, healthy mama at 39 weeks.
With that being said, I personally know of several providers that feel strongly about waiting until 40 or 41 weeks to induce healthy first-time mamas. And before you think to yourself, “that’s just cruel and ridiculous”, I encourage you to research the benefits of spontaneous labor!
But you are in luck! I have several resources that discuss the benefits of spontaneous labor and why it’s important to prep your body for labor – you can check them out below!
Related Reading: Natural Ways to Induce Labor: Everything You Need to Know!
Related Listen: EP77: Why It’s Important to Prep Your Body for Labor
Before I tell you to advocate for (or against) an induction at 39 weeks, let me encourage you to continue doing some research. You are certainly on the right track if you have made it this far along in the article, but I hope you will dive even deeper.
To determine whether a 39 week elective induction is right for you, I want you to first think about your birth wishes and desires. Do you want to birth without an epidural or with one? Are you okay with continuous monitoring or would you prefer intermittent? These decisions should ultimately be what guides whether you ask for a 39 week induction or not. And just hang tight – I’ll get into more of the pros and cons below!
I am not here to say that you can’t have an epidural-free birth if you get induced. I witness it quite frequently actually. All I’m getting at is that you typically will have a greater chance of success minimizing interventions throughout labor and birth if you go into labor spontaneously.
And at the end of the day, no matter what you do to try and send your body into labor, sometimes it’s just not quite ready and needs a little help.
I know inductions can sometimes come with negative feelings, but I see women have beautiful and uncomplicated births following an induction all the time.
So don’t stress if you choose the induction route. Your birth will still be just as amazing as you are, mama!
If you have taken (or plan on taking) my Birth It Up Online Birthing Courses, you will see that I have an entire bonus section dedicated to induction of labor. In this lesson of the course, I cover all kinds of specifics regarding inductions, including what it is, risk and benefits, elective inductions, and induction methods.
In this article, I want to briefly touch on some of the pros and cons of planned inductions, but just know that my birth classes are here for you if you want to learn even more!
Pros of a planned induction
Potential cons of a planned induction
Just like with an induction, there are also pros and cons to spontaneous labor as well.
Pros of spontaneous labor
Cons of spontaneous labor
The bottom line with the ARRIVE Trial is that it might slightly decrease your chances of needing a C-section. Aside from that, there is actually little to no evidence that an elective induction of a healthy, first-time mama at 39 weeks has any impact on complications for mom or baby.
By sifting through the pros and cons of elective induction vs. spontaneous labor and discussing it with your OB provider, I hope you will have all the information you need to determine whether or not one might be a good option for you.
And if you want some additional learning about inductions, labor, and birth, look no further than here: