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ACNM Recommends No Change in Practice in Response to Study on Induction of Labor
The American College of Nurse-Midwives
Affirms Its Support of Normal Physiologic Birth.
RELEASE: February 1, 2018
CONTACT: MAURA CHRISTOPHER, 240-485-1822
Spring, MD -- The American College of Nurse-Midwives (ACNM)
affirms its support for normal physiologic birth in light of findings presented
at the Society for Maternal Fetal Medicine Annual Meeting today. The preliminary results of "A Randomized Trial of Induction
Versus Expectant Management (ARRIVE)" suggest that elective induction
of labor in women with low risk pregnancies at 39 weeks may reduce the need for
a cesarean delivery versus waiting for spontaneous labor to occur on its own. The
difference in the reduction of cesarean birth was 19% in the induced group versus 22% in
the spontaneous labor group.
ACNM President Lisa Kane Low, PhD, CNM, FACNM, FAAN
cautioned against any rush to change practice and noted that all of us involved
in maternity care should be seeking improvements to reduce the incidence of unnecessary
cesarean births. However, we should not lose sight of the fact that there are a
number of evidence-based ways to accomplish this goal. ACNM has resources
available for health care providers and consumers at www.BirthTOOLS.org that support changing
the culture of maternity care and optimizing health outcomes for families. "ACNM has consistently noted there
are a number of potentially negative implications when we disrupt the normal
physiological processes of labor and birth," Kane Low said. Research related to the longer-term effects of induction
of labor is emerging, but is still insufficient to determine its full impact.
Additionally, spontaneous labor offers substantial benefits to the mother and her
infant, as ACNM has affirmed in its Consensus Statement on Physiological Birth.
ACNM continues to stand by its current
recommendations and encourages its members and other providers to refer to its
formal position statements for guidance, including its statements on Induction of Labor and Appropriate
Use of Technology In Childbirth. The Society for Maternal-Fetal
Medicine has also stated it will not be updating its guidelines until further
evaluation has been conducted. Kane Low
added, "We acknowledge the importance of the aggregate outcome of the study, but
we also honor birth as an individual and personal experience that requires a
process of shared
decision-making to meet the needs of
those we serve."
"We look forward to the peer-reviewed publication after which we will be better able to review the full study and consider the implications," Kane Low continued. "Until that time, we urge health care providers to be responsible, accurate, and cautious in their messaging to childbearing families before embarking on the use of induction of labor as an intervention to reduce the risk of cesarean delivery."
With nearly 7800 members, ACNM is the professional association that
represents certified nurse-midwives (CNMs) and certified midwives (CMs) in the
United States. ACNM promotes excellence in midwifery education, clinical
practice, and research. With roots dating to 1929, our members are primary care
providers for women throughout the lifespan, with a special emphasis on
pregnancy, childbirth, and gynecologic and reproductive health. ACNM provides
research, administers and promotes continuing education programs, establishes
clinical practice standards, and creates liaisons with state and federal
agencies and members of Congress to increase the visibility and recognition of