The Article in Brief

A Preventive Approach to Obstetric Care in a Rural Hospital: Association Between Higher Rates of Preventive Labor Induction and Lower Rates of Cesarean Delivery

James M. Nicholson, MD, MSCE, and colleagues

Background Cesarean deliveries, which tend to have more medical complications than vaginal births, are increasing in North America. Clinicians have developed a method for inducing labor in women who are near the upper limit of the safest and most advantageous time period for their delivery. This study compares cesarean section rates between practitioners who often use this process (called the Active Management of Risk in Pregnancy at Term, or AMOR-IPAT) and those who do not.

What This Study Found In this 4-year study at a rural hospital, patients of clinicians who practiced AMOR-IPAT had a significantly lower cesarean delivery rate than patients of other clinicians. Women who received AMOR-IPAT did not have higher rates of other birth complications.

Implications

• As rates of cesarean deliveries rise, the authors encourage clinicians to consider the potential benefits of AMOR-IPAT as an alternative method of maternity care.
• The authors call for more study of this possible approach to preventing cesarean deliveries.