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Racial and Ethnic Disparities in Low-Risk Unplanned Cesarean Birth: Disaggregating Asian Data.

Sydney M Spencer1,2, Amy A Laurent3, Vivienne L Souter4

  • 1Microsoft Corporation, Redmond, WA, USA. sspenc4@uw.edu.

Journal of Racial and Ethnic Health Disparities
|March 27, 2025
PubMed
Summary

South Asians experienced higher rates of unplanned cesarean births compared to other groups, even with fewer risk factors. This highlights the need for better data collection to address health inequities in childbirth.

Keywords:
AsianCesareanDisaggregationEthnicityHealth disparitiesNTSV

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Area of Science:

  • Obstetrics and Gynecology
  • Health Services Research
  • Health Equity

Background:

  • Cesarean birth outcomes are understudied across diverse Asian ethnicities.
  • This study addresses a gap by examining variations in unplanned cesarean births among low-risk, first-time mothers of different Asian backgrounds.
  • Utilizing a clinical birth dataset from Northwestern U.S. hospitals provides a localized perspective on these disparities.

Purpose of the Study:

  • To evaluate disparities in unplanned cesarean births among disaggregated Asian ethnicities.
  • To compare the rates of cesarean birth across various Asian ethnic groups and White individuals.
  • To identify potential inequities in obstetric care for low-risk, first-time mothers.

Main Methods:

  • A cross-sectional study analyzed birth data from 2017-2021.
  • Inclusion criteria focused on nulliparous, term, singleton, vertex presentation, spontaneous labor, and excluded scheduled cesareans, intrapartum transfers, and community births.
  • Multi-level logistic regression models were used to compare unplanned cesarean birth rates, adjusting for relevant risk factors.

Main Results:

  • The study included 40,160 births, with 21.3% identified as Asian.
  • Overall laboring cesarean rate was 23.1%, with significant variation among Asian subgroups (South Asians 33.9%, East Asians 17.0%).
  • South Asians (aOR 2.18) and other specified Asian groups showed significantly higher odds of cesarean birth compared to Whites, while East Asians had lower odds.

Conclusions:

  • South Asians face disproportionately higher odds of unplanned cesarean birth, even when controlling for known risk factors.
  • The findings underscore the critical need for disaggregated race and ethnicity data in medical systems.
  • Collecting detailed data can provide crucial insights for pregnancy management and reducing inequities in cesarean birth rates.