A recent study of births in New Jersey reveals that Black pregnant patients are significantly more likely to undergo unscheduled cesarean sections than white patients—even when their medical histories are identical. Researchers found that Black patients were about 25% more likely to receive an emergency C-section, a disparity that persisted even after adjusting for health status, hospital quality, and socioeconomic factors.
Adriana Corredor-Waldron, an economist at NC State University and co-author of the study, explained that the remaining gap appears to be driven by provider discretion. “Even if they see the same physician,” she said, “the Black patient is more likely to be given a C-section.”
C-sections can be life-saving in high-risk cases, but for low-risk patients, they carry increased risks and often lead to repeat surgeries in future pregnancies. The study used machine learning to analyze over 900,000 births, ruling out medical necessity as the primary driver of the disparity.
Interestingly, the racial gap in unscheduled C-sections disappeared when operating rooms were occupied with scheduled procedures, suggesting that availability and provider decision-making play a role. Corredor-Waldron noted that factors like perceived risk, cultural misunderstandings, or lack of patience may influence these decisions.
To address the issue, she recommends increasing diversity among physicians, expanding access to birth doulas, and shifting to value-based payment models that prioritize patient outcomes over procedure volume.
See: “What Is Causing Disparities in C-Section Rates between Black and White Pregnant People?” (November 20, 2024)
