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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 1

Category: Health Equity/Community Health

Poster Session 1

(122) Trends in non-medically indicated induction of labor at 39 weeks by insurance type

Wednesday, February 11, 2026
10:30 AM - 12:00 PM  
Objective:
The ARRIVE trial was published in 2018 and quickly led to an increase in utilization of non-medically indicated induction of labor (IOL) at 39 weeks. Given possible disparities in uptake, we sought to assess whether there was a difference in the rate of IOL compared with expectant management (EM) by insurance type.

Study Design:

This was a retrospective cohort study of singleton, non-anomalous births in California between 2017-2020. We only included gestational ages 39-41 weeks and stratified by IOL versus EM. Medical indications for IOL and planned cesarean deliveries were excluded. We examined the utilization of IOL by year and stratified by insurance type to examine the trend in each group.

Results:
There were 345,597 births included in this analysis, of which 178,054 had private insurance and 167,543 had public insurance. The proportion of births managed with IOL increased over time for both groups but was higher for those with private insurance each year compared to public insurance (Figure). Furthermore, the rate at which IOL increased over time was significantly higher for those with private insurance than public insurance.

Conclusion:
The utilization over time of non-medically indicated IOL was significantly higher for those with private insurance than public insurance and increased at a faster rate. Future studies should assess the factors driving these differences and resultant patient outcomes.