Likelihood of Primary Cesarean Section Following Induction of Labor in Singleton Cephalic Pregnancies at Term, Compared With Expectant Management: An Australian Population-Based, Historical Cohort Study

( Acta Obstet Gynecol Scand . 2024;103:946–954. doi:10.1111/aogs.14785) In high-income countries, there has been a clear trend toward earlier deliveries and a rise in the use of labor induction (IOL) and cesarean deliveries (CD) for women with term pregnancies. From 1990 to 2018, the average CD rate in high-income settings increased from 12% to 27% and is expected to reach 37% by 2030. Likewise, the rate of IOL rose from 20% in 1990 to 30% in 2019. Subsequently, the average length of pregnancy at delivery has dropped in the United States and Australia from 40 to 39 weeks. Australia has seen greater IOL and CD rates than other affluent nations. From 2010 to 2020, there was a rise in IOL rates from 25% to 37%, and CD rates increased from 31% to 36% for pregnancies at full term. There is concern that Australia’s CD rate may hit 45% by 2030. Cesarean delivery imparts increased risk for maternal and neonatal morbidity as well as substantial financial challenges for individuals and health care systems. This study investigated the probability of needing a CD after IOL in women with single, head-first pregnancies at 37 to 40 weeks, compared to women with spontaneous labor.