A recent study conducted by the National Bureau of Economic Research has uncovered a significant disparity in the rates of unscheduled cesarean section (C-section) deliveries among Black and white women.
The study reveals that Black women are 25% more likely to undergo the procedure than their white counterparts.
The study, which analyzed data from 2008 to 2017, found that 21% of Black women in New Jersey who had unscheduled deliveries received C-sections, compared to 17% of white women in similar situations.
While researchers acknowledge that medical factors play a role, they suggest that the disparity may be more reflective of provider preferences than the medical needs of the mothers.
The research team, led by Adriana Corredor-Waldron, an assistant professor of economics, examined nearly 1 million births across 68 hospitals in New Jersey.
They found that the racial disparity in unscheduled C-sections nearly disappeared when adjusting for hospital availability, specifically when scheduled C-sections were already happening.
Corredor-Waldron explained, “What we show is that it’s not likely this disparity is coming from something the physician is seeing that we—the researchers—are not seeing in the medical records.”
The study highlights implicit racial bias as a potential factor contributing to this disparity, with some hospitals potentially having a financial incentive to keep operating rooms busy.
Corredor-Waldron pointed out that if Black mothers were truly better candidates for unscheduled C-sections, the gap would persist regardless of hospital capacity.
Mark Simon, M.D., chief medical officer at Ob Hospitalist Group, described the findings as alarming and noted that disparities in maternal health outcomes along racial and socioeconomic lines are not unique to New Jersey.
The U.S. has seen a rise in C-section deliveries in recent years, with both planned and unplanned procedures now accounting for one in three births, far exceeding the World Health Organization’s recommended rate of 10–15%.
The study raises important questions about the underlying causes of this trend, but researchers caution that more data is needed to fully understand the reasons behind these disparities.
Corredor-Waldron noted that while physicians may be driven by concerns over perceived risk, particularly given high infant mortality rates among Black infants, the decision-making process remains complex.
