Induction or Spontaneous Labor?

Note: I decided to write a blog post about this because it seems that after the ARRIVE study was introduced, at least one or two class members in each session were offered the option of induction by their doctor.

Induction. It’s not exactly the word you want to hear from your doctor. Imagining how your labor will begin is natural, especially for first-time moms. Most moms daydream about those exciting moments when labor starts on its own—the gentle build-up of surges, your body guiding you through this incredible journey into motherhood. It’s a beautiful vision, and it’s entirely possible for you, regardless of what the latest study or your doctor might suggest about induction. Doctors burst more and more moms’ bubbles early in their prenatal visits. Suggesting Induction at those early visits is a more frequent topic than, say, 20 years ago.

Doctors often bring up The ARRIVE study when discussing elective induction at 39 weeks. They quote it as if it is the study that should dictate how babies enter this world. But what is the ARRIVE study? It’s a large-scale study that looked at whether inducing labor at 39 weeks could lower C-section rates and improve outcomes for moms and babies. While the study did find that early induction could slightly reduce the risk of C-section, it’s important to remember that this finding doesn’t mean every mother should be induced at 39 weeks. Your body knows how to birth; if your vision is to let labor unfold naturally, that is a valid, beautiful choice.

Let’s explore the study and its meaning for you, especially if you want to experience a spontaneous labor onset.

What the ARRIVE Study Says About Induction

The ARRIVE study looked at over 6,000 women with low-risk, first-time pregnancies, dividing them into two groups: one group was induced at 39 weeks, while the other waited for labor to start naturally. The goal was to see if inducing labor at 39 weeks would reduce complications for babies and lower C-section rates. The results showed that induction at 39 weeks led to a slightly lower chance of needing a C-section, but it didn’t significantly improve outcomes for babies.

What This Means for You

If you’re hoping for a natural, spontaneous labor, your doctor quoting this study shouldn’t make you feel pressured to change your birth plan. The reduction in C-section rates was small. For many moms, the idea of induction—particularly when it involves medical interventions like synthetic oxytocin or cervical ripening agents—doesn’t align with their vision of how birth should unfold.

Physicians often recommend induction based on the ARRIVE study. But that doesn’t mean you have to say yes. If you are low-risk and your dream is a spontaneous labor, go for it – unless there are last-minute special circumstances (unlikely, but we have to say there might be).  Your birth plan is yours, and it’s okay to stick to your vision of spontaneous labor. In your HypnoBirthing class, we will review the options you have for your birth plan. You do have options, no matter how insistent your doctor may be, unless you choose not to exercise them.

The Importance of Informed Decision-Making Around Induction

Just because your doctor suggests induction at 39 weeks doesn’t mean you’re obligated to follow that path. Every pregnancy is unique, and the decision to induce or wait for labor to start naturally should be made based on your health, your baby’s health, and your personal preferences—not pressure from anyone else.  AND

It’s crucial to remember that induction is a medical intervention, and like any intervention, it comes with its own set of risks and benefits. In the ARRIVE study, hospitals were the primary settings for the births, where medical interventions are more common and sometimes considered routine. However, in settings like birth centers or home births, where midwives are more likely to guide the process, spontaneous labor is often supported with fewer interventions. C-section rates tend to be much lower in these settings. This highlights that induction at 39 weeks is just one option—there are many other ways to support a healthy, low-intervention birth.

Other Ways to Support Your Birth Experience

If you’re hoping to avoid a C-section or reduce interventions, there are plenty of options to consider beyond early induction. One powerful tool is continuous labor support. Having a doula or a birth companion to offer emotional and physical support during labor has been shown to significantly lower C-section rates—up to 25%! That’s a much bigger reduction than the slight difference seen with induction at 39 weeks in the ARRIVE study.  The reduction in the c-section rate when women feel supported is one reason why our curriculum spends time training dads on the exact things to do in the role of providing emotional and physical support during birth.

Working with a midwife instead of an OBGYN is another way to reduce intervention. Note that there is a definite difference between an independent midwife and one hired by the hospital to work under the hospital’s direction. However, they often emphasize a natural, physiological approach to birth, stepping in with interventions only when necessary. This kind of care can be incredibly empowering, especially if your goal is to let labor begin and progress on its own.

Trust Yourself and Your Body

Your body is designed to give birth. If you prefer to wait for labor to start spontaneously, that is an entirely valid choice. Birth is deeply personal, and no one-size-fits-all solution works for everyone. You have the right to make the best decisions for you and your baby.

If your doctor suggests induction, take the time to have an open, thoughtful conversation. Ask questions like:

• Why are you recommending induction?
• What are the risks and benefits of waiting for labor to start on its own?
• Are there any concerns about my health or the baby’s health that make induction necessary?
• What alternatives are there to early induction?

These conversations are essential for making informed choices that align with your values and your vision for birth.

You Have Options

At the end of the day, it’s your birth experience. Whether you choose to be induced or wait for spontaneous labor, the most important thing is that you feel supported, empowered, and confident in your choices. Remember, just because your doctor offers induction doesn’t mean it’s the best or only option for you. Trust your instincts, ask questions, and surround yourself with care providers who respect your wishes.

Birth is a transformative, beautiful experience, and it’s yours to shape. Hold onto your vision and know that, barring special circumstances, you can birth the way you desire. The ARRIVE study offers insights, but your voice, your choices, and your preferences matter most.

In the end, what truly counts is how you feel about your birth—empowered, supported, and informed. And that, dear mama, is the key to a successful birth story. You’ve got this!

Register for classes now. Learn how to have self-advocacy discussions with your doctor.