While the overall occurrence of cesarean births has decreased among all women in the United States, the percentage of cesarean births for Black women has increased over the past decade, according to a new study from scholars at the Oregon Health & Science University.
The study authors examined data from over 30 million births between 2012 and 2021, finding that Black women consistently experienced higher rates of cesarean births compared to women from other groups. Furthermore, this disparity increased over the study period. Cesarean birth among Black women was 12 percent higher in 2012 than was the case overall. By 2021, Black women were 17 percent more likely than other women to have a cesarean birth.
This racial disparity was consistent across different birthing scenarios. Among first births, cesarean births for Black women were 20 percent higher in 2012 and 23 percent higher in 2021. Among women who had a prior vaginal delivery and no prior cesarean, Black women were 32 percent more likely to have a cesarean birth in 2012 and 33 percent more likely in 2021.
“There are many reasons why someone might come into a labor and delivery unit and need a cesarean delivery — it’s a critically important, life-saving procedure — but race is not one of them,” said Marie Boller, the study’s lead author. “These findings are cause for concern, because we know these disparities have no biological basis and are rooted in structural racism.”
She continued, “We need to implement quality improvement efforts that reduce unnecessary cesarean births among this population, but also address the structural racism that drives these outcomes. This should include upstream interventions that support healthier pregnancies from the very beginning, even before conception.”
