A groundbreaking study shows that induction at 39 weeks is better for mom and baby—but the debate is far from settled.
Amanda Selk went into labour for all three of her children at 39 weeks. They were easy deliveries—uncomplicated and under eight hours. The only major difference was that for the last two, she chose to be induced. “I was. I’m five foot two and teeny-tiny, and I didn’t want my babies to get bigger,” she says. “I know the literature and I felt it was reasonable.”
Numerous studies have shown that at 39 weeks babies transition better to the world. “They feed well, they have fewer breathing issues from water to air. It’s just a good week,” says Selk, who is also an OB/GYN at Women’s College Hospital in Toronto. Beyond 40 weeks, there are increased risks, including low amniotic fluid and having larger-than-average babies, which can increase the risk of a Caesarean section. So should all women be induced at 39 weeks? Well, it’s complicated and not everyone agrees.Historically, it was feared that induction increased the risk of C-section.
“I refer to this study a lot in my clinic [when discussing elective induction],” says Lindsay Shirreff, an OB/GYN and assistant professor at the University of Toronto. “It was a randomized controlled trial, which is the best type of evidence we have in medicine.”Upon seeing the results, the American College of Obstetricians and Gynecologists not only included the choice to be induced at 39 weeks in their guidelines, but also dropped the term “elective” when referring to induction at this time.
Still, inductions elicit mixed feelings from both parents and care providers. After the ARRIVE trial came out, the Association of Ontario Midwives published a response to help clients interpret the findings. They pointed to higher C-section rates in the province compared with the US hospitals studied, the young age of study participants , and the fact that 73 percent of eligible birthing parents declined to participate in the study—all factors that may have influenced positive outcomes.
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