As racism in the healthcare system continues, a big new study shows shocking differences in the number of unplanned C-sections that Black women have.
A study by the National Bureau of Economic Research (NBER) that looked at almost 1 million births at 68 hospitals in New Jersey found that black women are 25% more likely than white women to have needless C-sections.
More study needs to be done to find out if these differences happen in other states, but the results suggest that hospital delivery rooms could have implicit racial bias at the provider’s choice.
“The results of the new study are shocking. It’s scary that these differences exist and are so big,” said Mark Simon, MD, chief medical officer at Ob Hospitalist Group (OBHG).
“The CDC has released data that clearly shows how the rates of C-sections vary across the country, with New Jersey having one of the highest rates.” But this problem isn’t just in New Jersey; differences in maternal mortality, especially between race and social groups, are well known in other places as well, Simon told Healthline. Simon had nothing to do with the study.
Why do more C-sections happen to black women?
In the United States, the number of cesarean sections (C-sections) has been going up over the past few years.
A lot of C-sections are planned ahead of time, which makes doctors wonder if they are really physically necessary.
About one in three births in the U.S. are planned or unexpected C-sections. This is a lot higher than the 10–15% goal rate set by the World Health Organization (WHO).
Based on the new study, these numbers include an unfairly large number of Black women. It’s not as clear what caused this difference, though.
Researchers from the NBER think that doctors “exercising their discretion and are more likely to conduct unnecessary C-sections on Black mothers” may be the reason why more unplanned C-sections are happening to Black women.
In their report, they talk about past studies that showed Black women are more likely to feel “pressured by a clinician to take medication to start or speed up labor and to have a C-section.”
He said, “I do think this points to implicit bias.” “Implementing implicit bias training is very important for healthcare workers to help them see and fix differences in patient care.” We also know that Black patients have better results when the people who work in hospitals are different. “Everyone benefits when health systems put fair outcomes for pregnant patients first,” Simon said.
What are the risks of having a C-section?
There are risks for both the person giving birth and their baby during a cesarean delivery, whether it was planned or not. On the other hand, C-sections can save lives in an emergency.
Simon said that having a C-section can make you more likely to bleed, get a blood clot, get an infection, or hurt other systems. “On top of that, they increase the risk of future pregnancies, which could include problems like an abnormal placentation,” he said.
Researchers at the NBER say that in general, black women’s health is worse than white women’s. However, experts say there are deeper issues to think about that might affect how healthy Black women are after C-sections.
Simon said, “If more Black women have cesarean deliveries, they are more likely to be at risk.” “These risks are made worse by the fact that Black women already have a higher rate of pregnancy complications and are more likely to have long-term health problems.”
Kecia Gaither, MD, MPH, an OB-GYN who is double board qualified in obstetrics and maternal fetal medicine and the head of Perinatal Services/Maternal Fetal Medicine at NYC Health + Hospitals/Lincoln in the Bronx, agreed that comorbidities often affect how well a C-section goes. Gaither had nothing to do with the new story.
“Is there a lot of overweight people, high blood pressure, diabetes, drug abuse, or HIV?” Gaither asked a question. “That’s a tough question to answer.”
Many things, like racism, bias, not paying enough attention to the medical condition of Black women after surgery, or the quality of the hospital, could affect a woman’s health after having a C-section, Gaither said.
