A new report found more Black mothers are getting unneeded c-sections when compared to white mothers, and it suggests it could be to fill operating rooms in some cases.
“What we see is that it's only when it's cost-effective when the operating room is empty, that we see that there is this racial disparity,” Adriana Corredor-Waldron, health economist and paper co-author, and assistant professor of Economics at North Carolina State University said.
Even with the same medical histories, a Black mother and a white mother at the same hospital, with the same provider — the Black mother is about 20% more likely to give birth via c-section.
Economic researchers examined hospital records from 68 hospitals in New Jersey and about a million births from 2008-2017. Overall, Black mothers were 25 percent more likely than white mothers to have a c-section.
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Black mothers who came in early, healthy, and with the lowest risk were about 149 percent more likely than white mothers to have a c-section, the data found.
"C-sections are major abdominal surgeries. They are far more complicated than having a vaginal birth. There is an increased risk of hemorrhage, an increased risk of infection, an increased risk of damage to nearby organs and increased risk of potentially catastrophic blood clots in your lungs or in your legs,” said Dr. Amanda Williams, chief medical officer for March of Dimes.
She notes that the racial gaps in c-sections have been well documented.
“What this study really points to is provider discretion,” she said. “We've got to dig into the nuances of that decision making and do more study to understand how the providers are making that final decision about whether or not to proceed with C-section.”
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She says more work to counter the power dynamics between doctor and patient could help.
"Known interventions, such as integrating dual care in having low-risk births cared for by midwives, such as flipping the payment incentives to support value-based care ... that's not about individual patient decisions — but, these sorts of things can help make a difference for those difficult conversations and those moments of provider discretion,” she said.
It's important to remember that c-sections can be life-saving for many patients, the authors of the new research emphasize. Experts suggest that patients consider birthing doulas and family advocates and educate themselves as much as possible about the birthing process.
