Does Elective Induction of Labor at 39 Weeks Raise Risk for Cesarean Delivery?

Almost one quarter of pregnant women in the U.S. undergo induction of labor. Observational studies have suggested that, compared with expectant management, elective induction (i.e., without medical indications) in nulliparous women with a cervix unfavorable for induction at term is associated with higher rates of cesarean delivery. In this randomized trial, investigators assessed the effects on risk for cesarean delivery of elective induction versus expectant management (awaiting onset of labor or spontaneous rupture of membranes) in 162 nulliparous women with an unfavorable cervix (Bishop cervical examination score ≤5) at 39 weeks' gestation.

Cesarean delivery rates were 31% and 18% in the induction and expectant management groups, respecti…