Rates of Induction of Labor in the United States over the Last Decade, 2013 to 2022

Perinatal nurses in the United States who care for patients during labor, birth, and postpartum have witnessed the increase in rates of induction of labor (Figure) over the last decade (Centers for Disease Control and Prevention & National Center for Health Statistics, 2024; Hamilton et al., 2015; Martin et al., 2015; Martin et al., 2017), in part due to publication of the ARRIVE trial (Grobman et al., 2018; Wood et al., 2023). Compared to expectant management for low-risk nulliparous women, induction of labor at 39 weeks when conducted under the conditions described in the trial was found to be safe and offered a lower risk of cesarean birth and development of hypertensive disorders of pregnancy, although there was no significant difference in the primary outcome of a composite of perinatal death or severe neonatal complications (Grobman et al., 2018). These benefits have not been found in all studies (Grobman, 2024). Cost of overall care may be lower due to fewer prenatal visits, fewer obstetric triage visits, and lower rates of cesarean and hypertensive disorders of pregnancy; however, the costs of a longer labor and staffing requirements for 1 nurse to 1 patient receiving oxytocin are shifted to inpatient maternity units (Grobman, 2024). Women having induction of labor need adequate information about the process including pros and cons so they can be full partners in their care and decision-making (Runyon, 2023). Safe care during labor induction requires nurse staffing as per the nurse staffing standards from the Association of Women's Health, Obstetric and Neonatal Nurses (2022).Figure:: Induction of Labor in the United States 2013 to 2022