A groundbreaking new study has revealed that healthy Black women with low risk factors are significantly more likely to undergo unnecessary C-sections compared to their white counterparts. The report, which analyzed nearly one million births across 68 hospitals in New Jersey, sheds light on racial bias in maternal care and the financial incentives that may drive these surgical decisions.
Black Women 20% More Likely to Have Unnecessary C-Sections
The study found that Black women were about 20% more likely to have a C-section than white women with similar medical histories, even when treated by the same doctor at the same hospital. These unnecessary procedures put Black women at a higher risk for complications, including wound ruptures and prolonged recovery times.
“Physicians may have certain beliefs about Black women,” said Janet Currie, a health economist at Princeton University and co-author of the study. “They might not be listening to Black women as much, or be more afraid that something will go wrong.”
Financial Incentives and Racial Bias: A Dangerous Combination
One of the study’s most concerning findings is that the disparity in C-sections increased when hospitals had empty operating rooms. In these cases, Black women were far more likely to be given C-sections, suggesting that financial incentives, paired with racial bias, may be influencing medical decisions.
When operating rooms were filled with scheduled C-sections, the likelihood of Black and white women receiving the surgery was the same. However, when the rooms were empty, 8% of healthy Black women ended up delivering by C-section compared to only 4.8% of healthy white women.
“If you have an operating room set up to do a C-section, they like to keep that busy too,” Currie noted.
The Impact of Unnecessary Surgeries
Although C-sections can be lifesaving in certain situations, unnecessary surgeries increase risks for mothers, including longer recovery times, surgical complications, and higher medical costs. In fact, the U.S. C-section rate is nearly double what is considered medically appropriate by the World Health Organization, with 30% of births delivered this way.
The new study highlights how these unnecessary procedures disproportionately affect Black women, particularly when operating rooms are underutilized. While C-sections are sometimes seen as routine, they carry risks, including lower odds of successful breastfeeding and more extended hospital stays.
Doctors May Be Reacting to Racial Disparities in Childbirth Outcomes
The study’s findings also suggest that doctors may rush to perform C-sections on Black women due to their heightened awareness of racial disparities in maternal health outcomes. However, this well-intentioned concern may be contributing to yet another disparity.
“Doctors know the data showing worse birth outcomes for Black women, and that could play into their having lower risk tolerance,” said Dr. Ijeoma Okwandu, an obstetrician and researcher of racial disparities in C-sections. “But at the same time, they’re perpetuating another disparity in C-sections.”
Urgent Need for Reform
The findings from this study underscore the need for reforms in maternal care to ensure that decisions are based on medical necessity rather than financial incentives or unconscious racial biases. The overuse of C-sections, particularly among Black women, poses severe risks to both mothers and babies and highlights the ongoing disparities in healthcare access and treatment.
For Black women, advocating for oneself during childbirth is critical, but the medical system must also address these systemic issues to protect all mothers.