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ARRIVE
About the Trial
The A Randomized Trial of Induction Versus Expectant Management trial randomized 6,106 low risk nulliparous women to labor induction at 39 weeks or expectant management. Induction reduced cesarean delivery from 22 to 19 percent, opposite the common belief that induction raises cesarean risk, and reduced hypertensive disorders and respiratory support need. Perinatal deaths were rare in both arms. ARRIVE changed counseling for low risk first pregnancies: 39 week induction became a commonly offered option with no cesarean penalty observed. The trial illustrates how obstetric dogma, induction causes cesarean, collapsed under randomized scrutiny. Labor and delivery units adapted scheduling accordingly.
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