EBB 339 - Q & A on the ARRIVE Trial with the EBB Research Team

Evidence Based Birth®

Rebecca Dekker

Pregnancy, Health & Fitness, Childbirth, Parenting, Birth, Medicine, Kids & Family, Doula, Obstetrician, Midwife

4.6 • 978 Ratings

🗓️ 11 December 2024

⏱️ 45 minutes

🔗️ Recording | iTunes | RSS

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Summary

Dr. Rebecca Dekker and EBB Research Fellow Morgan Richardson Cayama tackle your questions about the ARRIVE trial and elective inductions at 39 weeks. They explore the evidence behind this controversial study, discuss the implications for Cesarean rates, and unpack the concept of patient autonomy in maternity care. Plus, they share practical tips for managing pressure to induce and delve into how the ARRIVE trial impacts outcomes like breastfeeding, epidurals, and costs. Tune in to hear this Q&A session originally broadcast to listeners worldwide.

Episode 334: The ARRIVE Trial and Elective Induction at 39 Weeks

(03:38) How often are we seeing pressure from obstetricians to induce?

(07:20) How can you manage pressure from an obstetrician to get an induction at 39 weeks?

(12:00) What are the geographic trends in induction rates?

(15:30) What are the statistics on infant death and mortality?

(19:56) What happens if a midwife or obstetrician refuses a 39-week elective induction requested by a birthing person?

(21:50) Why did the ARRIVE trial report such high rates of preeclampsia and hypertension?

(32:16) Is induction considered to be more cost-effective?

(34:54) Are inductions affecting breastfeeding and epidural rates?

(36:54) Is there research around maternal satisfaction and birthing experience?

(40:11) Why are IVF and advanced maternal age clients often pressured or offered induction?

(41:24) What strategies can doulas use to support clients facing discussions about 39-week induction with their provider?

For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.

Transcript

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0:00.0	Hi, everyone. On today's podcast, we're going to answer your questions all about the evidence
0:04.8	on the arrived trial and elective induction at 39 weeks.
0:12.0	Welcome to the evidence-based birth podcast. My name is Rebecca Decker, and I'm a nurse with my
0:17.2	PhD and the founder of evidence-based birth. Join me each week as we work together to get
0:23.0	evidence-based information into the hands of families and professionals around the world. As a
0:28.9	reminder, this information is not medical advice. See eBbirth.com slash disclaimer for more details.
0:37.7	Hi, everyone, and welcome to the evidence-based birth podcast. Before we get started, I want to let
0:42.8	you know that we do have some big plans coming up for 2025. So if you're not already receiving
0:48.5	our free email newsletter, make sure you go to our homepage at evidence-basedbirth.com. So you can get a notification when we announce
0:56.1	our plans for 2025 and how you can benefit. So a few weeks ago in Evidence-Based Birth podcast,
1:02.6	episode 334, we shared the evidence on the arrived trial and elective induction at 39 weeks.
1:08.8	You can find that episode and a full-length signature article
1:12.2	on that subject by simply navigating to eBbirth.com slash arrive. You can also get a free
1:18.8	two-page handout there on the arrive trial. So if you haven't listened to episode 334 yet,
1:24.8	I strongly recommend you do so before listening to today's episode. But as a quick
1:30.2	refresher, the arrived trial was a large randomized control trial published in 2018,
1:36.0	comparing elective induction at 39 weeks of pregnancy with expectant management or waiting
1:41.0	for labor to start on its own or inducing labor later if there was a medical
1:45.2	reason or if the patient elected to induce labor. So they compared health outcomes from those two
1:51.3	options. And they did not find any difference between groups with regard to their primary research
1:57.0	outcome of serious injury or death for babies. However, they did see a slight decrease
2:03.0	in the rate of caesarian with elective induction. As a result, obstetricians in the U.S.,
	...

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