Implementation of new consensus recommendations for the safe prevention of the primary cesarean delivery (CD) was associated with a reduction of the rate of primary CD performed for arrest of first-stage labor (AoL) with no apparent increase in immediate adverse neonatal outcomes in nulliparous women at term with singleton pregnancies in vertex presentation and with epidural anesthesia. This according to a retrospective cohort study at a university referral hospital that examined the impact of recommended changes in labor management for prevention of the primary CD from the 2014 ACOG/SMF Obstetric Care Consensus statement. Among the findings:

• The study included 3,283 and 3,068 women in the before and after periods, respectively.
• The global CD rate decreased significantly from 9.4% in the preguideline to 6.9% in the postguideline period.
• The CD rate for first-stage AoL dropped in half, but was significant only among nulliparous women.
• The CD rate for second-stage AoL decreased but not significantly between periods and the CD rate for failure of induction remined similar.