Black mothers are having more C-sections than white mothers. Here's why
OAKLAND, Calif. - A study of over one million births found that Black women are more likely to receive Cesarean sections than their non-Hispanic white counterparts, and researchers found it may not always be medically necessary.
Though becoming a parent can be a joyful time, for some parents, welcoming a new bundle of joy could come with added risk. A new study released by the National Bureau of Economic Research examined births across a set of New Jersey hospitals. The study revealed that healthy Black mothers with unscheduled deliveries are 25% more likely to deliver by C-section than their non-Hispanic white counterparts.
The study examined more than one million births across 68 New Jersey hospitals. Economists found one possible cause for that disparity between births of Black and white children: money.
The study found that Black mothers with low-risk factors are sent into C-sections more often than their white counterparts. So even if a Black mother were delivering at the same hospital with the same doctor as a white mother, the Black mother is 20% more likely to have a C-section.
This often happens when operating rooms are empty, leading researchers to believe it could be a way to keep those operating rooms full, thus generating more funds for hospitals and insurance companies.
For many patients, particularly Black patients, being heard by their doctor can be a challenge:
"Time and time again you just often hear that mothers just say they are not being listened to, their concerns are not being taken seriously," Dr. Irogue Igbinosa, maternal-fetal medicine physician at Stanford University told KTVU. C-sections, though sometimes necessary, come with risk when compared to vaginal births.
"The reason why we really push for vaginal birth, especially during that first birth. You didn’t have a surgery, you have less blood risk, less hemorrhage or blood transfusions, less complications if you’re able to deliver vaginally. C-section is a surgical procedure, it is entry into the abdomen and there can be additional risk associated with that," Dr. Igbinosa told KTVU.
Dr. Igbinosa says advocacy groups and studies birthed out of these concerns help bolster patient outcomes and experiences.
"This all helps promote change. All of these things are needed to truly change a system that is providing equitable care," Dr. Igbinosa said.
A few California hospitals are already tackling the problem of racial disparity in birth outcomes. Alta Bates Hospital, a Sutter Health facility in Berkeley, has been a leader in decreasing unnecessary C-sections. The hospital was recognized in "California’s 2022 Maternity Care Honor Roll" for its efforts.
"I really think having a patient-centered approach where you have really respectful care is the key. Patients generally know what’s going on with their bodies, and a lot of times when you have these poor outcomes the patient would say 'I knew something was wrong, but I wasn’t connecting with my healthcare team,’ so we create an environment on our campus and all Sutter facilities where the patient is first," said Dr. Angelyn Thomas with Sutter Health told KTVU.
"The result of us looking at data serves us all. We're proud that we're brave. This is a wakeup call, this is a call to action and as my mom always said, ‘When you know better, you do better,’ and that's what we're doing," Dr. Carla Wicks, Kaiser Permanente's Regional Medical Director Culturally Responsive Care & Inclusion told KTVU.
We asked three doctors how to safely advocate for you or your loved one during delivery, and each of them suggested the option of a doula and a birth plan.
"Doulas are labor support individuals, so when you’re going in and already have a plan for your delivery, just having someone there to advocate for you is really important. We already have really good evidence that doulas help decrease Cesarean births," Dr. Igbinosa said.
Dr. Igbinosa also suggests empowering a family member as an advocate during delivery, in case a doula is not an option.