New research from the University of Massachusetts Amherst reveals that Black and Latinx birthing people face significantly higher rates of severe maternal morbidity (SMM) following planned repeat cesarean deliveries compared to their white counterparts. These complications—ranging from heart attacks to kidney failure—can have lasting health consequences and are considered “near misses” for maternal mortality.
Lead author Laura Attanasio noted that while SMM rates were similar across racial and ethnic groups for vaginal births after cesarean (VBAC), disparities emerged with planned repeat C-sections. “Among White birthing people, severe maternal morbidity rates were similar for VBAC and for planned repeat cesarean,” she said. “But for Black and Latinx birthing people, planned repeat cesarean had a higher rate of severe maternal morbidity compared to VBAC.”
The study analyzed over 72,000 births in Massachusetts between 2012 and 2021. Even after adjusting for medical risk factors, disparities persisted. Attanasio suggested that “quality of clinical care can be worse for people from marginalized racial and ethnic groups,” whether due to under-resourced settings or structural and interpersonal racism.
Unplanned repeat cesareans—when labor begins with the intent of vaginal birth but ends in surgery—had the highest SMM rates across all groups. However, the racial disparities were most pronounced in the planned repeat cesarean category, underscoring the need for targeted interventions. Researchers call for improved care quality and equity-focused strategies to reduce these risks for marginalized communities.
See: “Planned repeat C-sections: Marginalized groups more often experience serious maternal complications” (June 10, 2025)
