Interpreting the ARRIVE Study
When the ARRIVE study results were published in 2018, many Women were told that elective induction at 39 weeks is safest. Many people have been misinformed on both the study details as well as the results, and we would like to clarify a bit and point to slightly different interpretations and critiques of the ARRIVE study. One such examination is by Henci Goer, and can be read here.
When asked, Dr. Bootstaylor commented:
“I would essentially echo ACOG’s noting 3 elements of caution: 1) “the values and preferences of the pregnant woman”, 2) facility and staff resources to perform elective inductions, and most importantly 3) inductions should be given 12 – 18 hrs after ROM before considering it a failed induction, WHEREAS in the study an induction of > 12 hrs can be considered “failed”. This last element is to ensure Ob’s (and perhaps Midwives) don’t go backwards in not giving the mother a chance, harking back to the Friedman’s curve (and putting her on a ticking clock).
In their response, which you can find here, The American College of Obstetrics and Gynecology (ACOG) stated:
The safe prevention of the primary cesarean delivery is of utmost concern to ACOG. While the study suggests that induction of labor in the 39th week of pregnancy resulted in fewer cesarean deliveries, ACOG does not currently recommend routine induction of labor for low-risk pregnant women at 39 weeks.
The American College of Nurse-Midwives wrote a response as well, saying “The American College of Nurse-Midwives Affirms Its Support of Normal Physiologic Birth, Shared Decision Making, and Individual Autonomy, ” and that the college “Acknowledges Quality of Study but Raises Concerns about Potential for Misapplying Results”. You can read their full press release here.