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Updated: Jun 30, 2025

Using the Race Model Inequality to Quantify Behavioral Multisensory Integration Effects
Published on: May 10, 2019
The association between decision and incision time by race and ethnicity
Rodney Bruno1, Gianna Wilkie2, Julianne Lauring3
1Department of Obstetrics and Gynecology, Boston University Medical Center, Boston, MA, USA.
Background:
Identifying and reducing inequities in the delivery of care is crucial to improving health disparities in obstetric outcomes. This study sought to evaluate the effect of race and ethnicity on time from decision for cesarean delivery to incision following implementation of a case classification system.
Methods:
A retrospective cohort study was performed to identify women who had cesarean deliveries from October 1, 2020, to March 31, 2021, at a single, tertiary care institution. Medical records were reviewed for demographics and cesarean delivery case classification. Case classification was divided into STAT cesarean delivery (within 10 minutes), level A (within 30 minutes), level B (within 60 minutes), or scheduled/unscheduled other. The "decision to incision time" was determined from the time the case surgical order was placed to the case start time.
Results:
There were 565 eligible individuals who had a cesarean delivery during the study period, with 13.6% identifying as Black/African American, 29.0% as Hispanic/Latina, and 57.3% as White. Hispanic women were more likely to need interpreter services than other race/ethnicity groups. There was no statistically significant difference in "decision to incision time" by race/ethnicity. Within the total cohort, 51.8% of cesarean delivery cases went within the goal time according to case classification, which also did not differ by race/ethnicity.
Conclusions:
Race and ethnicity do not impact cesarean delivery "decision to incision time" or case classification. Only half of cesarean deliveries went within the goal time, so further evaluation to improve workflow and improve this metric for all patients is needed.
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