A new multi-state study reveals that Black and Hispanic women are significantly more likely to undergo cesarean sections during low-risk deliveries, raising concerns about racial and socioeconomic disparities in maternal care. Researchers analyzed over 245,000 hospital births in Maryland, Florida, and Wisconsin between 2017 and 2020, focusing on deliveries without medical complications that would typically require surgical intervention.
The findings show that Black women had 16% higher odds and Hispanic women 23% higher odds of receiving cesarean sections compared to white women. Women with private insurance and those delivering in for-profit hospitals also faced increased odds. In contrast, patients from higher-income ZIP codes had lower rates of cesarean use.
“Cesarean delivery among low-risk patients is associated with increased maternal risks,” the authors noted, including infection, hemorrhage, and longer recovery. These risks are compounded for women of color and those from low-income communities, who are more likely to experience complications and less likely to receive equitable care.
The study also found wide variation in cesarean rates across hospitals, suggesting that institutional practices and provider discretion may be driving overuse. In Florida, for example, some hospitals had rates exceeding 12% among low-risk deliveries, compared to just 5.3% in Wisconsin.
Researchers call for renewed policy efforts to reduce unnecessary cesarean sections and address the systemic factors contributing to disparities. “Women of color and women residing in low-income communities are more vulnerable,” the authors concluded.
See: “Evaluating rates and factors associated with cesarean section and inpatient cost among low-risk deliveries in selected U.S. states” (October 7, 2025)
