Despite a nationwide decline in cesarean births over the past decade, Black women have seen their risk of receiving C-sections grow compared to other groups, according to a new study analyzing 30 million births from 2012 to 2021.
Non-Hispanic Black women now face the highest cesarean delivery rate at 30.9 percent, surpassing Asian or Pacific Islanders at 28 percent, Hispanic women at 27.6 percent, and non-Hispanic whites at 26.5 percent. The disparity actually widened during the study period, with Black women’s relative risk increasing from 2012 to 2021.
“What this tells me is we need to center the work that’s addressing these disparities in all of our quality improvement work in obstetrics,” said Dr. Marie J. Boller of Oregon Health and Science University, who led the research.
While cesarean deliveries can be lifesaving, they also contribute to excess illness and death. National efforts beginning in 2014 successfully reduced overall cesarean rates, yet these improvements failed to reach Black mothers equally. The persistent gap existed even among first-time mothers and those without previous C-sections.
Boller expressed disappointment that recent attention to racism in healthcare hasn’t translated into measurable progress for Black women. She emphasized the need to “continue to address these disparities by getting uncomfortable and dismantling racism wherever it’s evident.”
The findings call for targeted policy changes and quality improvement programs specifically designed to help Black women and other underserved groups who haven’t benefited from broader trends.
See: “Racial Disparities in C-Sections Persist Despite Overall Decrease” (November 18, 2025)Â
