Labor Management

WSHA Safe Deliveries Roadmap’s Response to ARRIVE Trial.

In 2019, the ARRIVE trial — a multi-center randomized controlled trial comparing induction of labor at 39 weeks gestation with expectant management of labor in first-time mothers.

While the findings presented indicate that cesarean birth rates were lower in the induction group (18.6%) than the expectant management group (22.2%) without causing a statistically significant increase in adverse perinatal outcomes, WSHA’s Safe Deliveries Roadmap encourages all our member hospitals to continue to promote the current labor management guidelines (ACOG, SMFM, BREE collaborative & Safe Deliveries Roadmap: Labor Bundle).

We encourage continuing to follow these recommendations until the ARRIVE trial has been formally published and reviewed for its strengths, limitations and clinical implications.

National position statements on labor management:

• American College of Obstetricians and Gynecologists (ACOG)
  •  Clinical Guidance for Integration of the Findings of The ARRIVE Trial: Labor Induction Versus Expectant Management in Low-Risk Nulliparous Women
• American College of Nurse Midwives
• Society for Maternal-Fetal Medicine (SMFM) 
• California Maternal Quality Care Collaborative (CMQCC)

Labor Management Care Bundle

Implementation Packet

• • Under construction