Charanya Rengarajan
Pronouns: She/Her/Hers
UROP Fellowship: Women and Gender Summer Fellowship Program
Research Mentor(s): Joanne Motino Bailey, CNM, PhD
Women and Gender Studies/Nurse-Midwifery Michigan Medicine
Presentation Date: Monday, July 27, 2020 | Session 1 | Presenter: 4
Authors: Charanya Rengarajan, Joanne Motino Bailey
Abstract
INTRODUCTION: Elective labor induction has been a controversial topic among professionals in the field of women’s health for many years. In particular, the ARRIVE Trial (A Randomized Trial of Induction Versus Expectant Management) published in 2019 has led to a paradigm shift in the way midwives and physicians view elective labor induction and counsel their patients regarding potential options for giving birth. The ARRIVE Trial concluded that inducing nulliparous, low-risk women into labor at 39 weeks gestation reduced their risk of having a cesarean birth.
AIM: The purpose of this project is to analyze differences in practice of one group of Certified Nurse-Midwives (CNM) in response to the ARRIVE results.
METHOD: An existing database of patients who gave birth with the CNM Service from 2016-2019 was reviewed to identify elective inductions. For patients with an elective induction, counseling notes were reviewed for content related to ARRIVE.
RESULTS: From 2016 to 2019, the number of elective inductions yearly increased from 2 to 26. The majority of elective inductions were done during the 39th week of pregnancy. The majority of mothers who were electively induced during this time period were multiparous. After ARRIVE study was published, there were 3 times as many elective inductions. Three of the qualitative notes analyzed also explicitly mentioned a discussion of the ARRIVE results with patients in regards to their request of having an elective induction.
CONCLUSION: The overall number of elective inductions in the CNM Service has substantially increased after the ARRIVE study was published. These changes appear to be based on patient requests. The subjective notes documented by CNM also served as an indicator of how care may have been modified over time to reflect midwives’ perspectives and attitudes towards encouraging patients and counseling them regarding elective labor inductions.
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Research Disciplines
Biomedical Sciences, Interdisciplinary
