Between 2018 and 2020, cesarean delivery rates were the highest for black infants, at 35.9 percent, with Hispanic infants reaching 31.5 percent.
New research surfaced, offering more insights into the potentially dangerous racial disparities in c-section deliveries. Consider this, in 1st time live births, healthy Hispanic and African American women were 26 and 21 percent higher to deliver by c-section than white women. That is despite the women being low-risk. Unfortunately, the increased number of c-sections seemed to heighten the risk of morbidity.
The 20 percent increase in the odds of cesarean deliveries among healthy, nulliparous, and low-risk women at term (with limited obstetric or medical explanation) is an increasing concern. Especially considering that c-sections are one of the most common surgical procedures in the United States.
A study published in the January 2020s issue of Obstetrics & Gynecology provides an understanding of the racial gap in c-sections, which are often riskier than vaginal births. Various studies show that black and brown women have cesarean deliveries more often than non-Hispanic white women. A number of studies show that Latina/Hispanic women also experience c-sections more than white women. While there is no hard data explaining why more black and Hispanic women have c-sections, there are theories.
One theory is that Hispanic and black women have more comorbidities (a simultaneous presence of 2 or more diseases or medical conditions), which leads to higher chances of c-sections. This theory was tested in a randomized trial studying the induction of labor.
The study focused on more than 5,000 women; 46.6 percent were white women, 24.3 percent were black women, and 30 percent were Hispanic women. Significant differences in the groups included:
- Maternal Age: 21 - Black 22 - Hispanic 26 - White
- Private Insurance: 75% White - 17% Black and Hispanic
- Employment: 71% White - 37% Black - 31% Hispanic
1,158 of the women underwent c-section deliveries. The numbers verify that Black and Hispanic women have higher chances of delivering their babies by c-section.
The University of California Press posted a detailed piece on behalf of the Society for the Study of Social Problems. The report discussed the truths behind unequal motherhood and the socioeconomic and racial-ethnic disparities or differences in c-sections in the U.S.
Public health research shows that low-income and racial-ethnic women are more likely to deal with pregnancy-related risks that lead to medically required c-section delivery. It is known that low-income and racial-ethnic minorities have the least access to healthcare and, more often than not, get inadequate care. There is a clear association between lower socioeconomic status (SES), poor health, and higher mortality rates.
Income is a strong predictor of whether someone has access to health care. Of course, people of every race and ethnicity can have low incomes. The SES makes up most of the monitored racial disparities in health; racial and ethnic minorities are not proportionately represented among the poor. This presents a significant disadvantage in comparison to non-Hispanic white people.
Existing research shows the profound effect of race-ethnicity on health. People’s race is a marker of exposure to racism. Science Direct shared AJOG global reports with similar results and findings as many others.
The report revealed that all ethnic or racial minority groups had higher rates of c-sections than non-Hispanic white women. Similar ethnic or racial differences in c-section rates were discovered among ALL education levels. However, higher levels of education were generally associated with lower chances of having a c-section delivery, especially in women with advanced degrees, compared to those that didn’t graduate from high school.
While maternal education is associated with protective effects in non-Hispanic Asian and non-Hispanic white women, respectively, for women with an advanced degree. A smaller protective effect was recognized in non-Hispanic Black women, with Hispanic women getting no protective effect whatsoever.
Various studies and reports make it clear that there’s a significant ethnic/racial disparity in the generality of low-risk nulliparous, singleton, term, and vertex c-section deliveries in the US. While the researcher’s findings suggest that a higher maternal education level can be associated with lower chances of c-section births, the protective effect varies among ethnic and racial groups. More research is required to find the underlying causes for the disparity, but it seems reasonably clear.