C-Sections Are Most Common — and Most Dangerous — for Black Parents

But who exactly gets a C-section isn’t always equal. From 2018 to 2020, 35.8 percent of Black infants in the U.S. were born by cesarean, compared to 30.9 percent of white infants, according to the March of Dimes, a nonprofit organization focused on maternal and infant health.

While C-sections can be lifesaving procedures, they also pose a significant risk for both birthing parents and babies. Women who had cesareans experienced ruptured uteruses, unplanned hysterectomies and ICU admissions more frequently than women who had vaginal births, according to a May 2015 report from the Centers for Disease Control and Prevention (CDC).

This trend is troubling to many health experts, considering the pregnancy-related mortality rate is already three times higher for Black women than white women, according to a September 2019 CDC report.

People have taken to Twitter to speak about personal losses of Black mothers in their lives due to cesarean section complications, expressing how different things would be if their friends were listened to in delivery rooms.

In April 2020, a woman named Amber tweeted: “Can’t wait to write a tell-all about my experience during my last two trimesters dealing with incompetent doctors…” Five days later, one of her followers shared that Amber died during her C-section.

Amber’s story is not the first of its kind, and numerous stories like hers can be found on Twitter under the search “C-section Black women.”

The big question on everyone’s minds is “‌Why‌?”

The concept of medical racism was first identified in the 1990s, ob-gyn Charis Chambers, MD, a pediatric and adolescent gynecologist, tells LIVESTRONG.com. Dr Chambers’s resident research project focused on the disparities in cesarean sections among Black women.

Once researchers identified higher mortality rates among Black birthing parents, they started to dig deeper for an explanation. Various studies compared the birthing experiences of women of color with those of white women who had the same access, insurance coverage, yearly income and educational levels and even gave birth in the same hospitals, according to Dr. Chambers.

Even after in-depth analyses — including a May 1999 study in the ‌Journal of the National Medical Association‌ and a March 2004 report in ‌Birth‌ — researchers couldn’t determine what accounts for higher rates of C-sections or delivery-related deaths among people of different races.

“You should pick your doctor like your life depends on it, and unfortunately, in some cases, it does.”

“There was no benefit to being college-educated or having more money and resources, which are all of the reasons that people point to,” Dr. Chambers says. “It’s none of those things. It really points to the things we can’t measure, like racism and bias.”

The researchers stressed the need for more attention to be paid to patient-level factors that have not been measured, including provider-physician interactions and patient preferences.

Decades of medical racism serve as a reminder that there is a need for larger, systemic, societal changes across the health care industry, which takes time. In the meantime, there are some ways you can protect yourself if you’re giving birth, even though the responsibility shouldn’t solely fall on you.

To arm you with the information you need to become an empowered patient, several Black ob-gyns shared tips here about how you can advocate for the best care while pregnant and during delivery.

Start by thinking through your own priorities and/or sitting down with your partner to discuss what’s most important, including your ideal birthing process and prenatal care, prior to meeting with doctors, says Diana Wilson, MD, an ob-gyn at Morehouse School of Medicine.

Deciding the type of birth you want can be difficult, and you should remember even the best birth plans don’t always go the way you want them to. But knowing what you truly want may help you find the perfect doctor for you.

That might look like a less traditional birthing experience, such as:

• Visiting a midwifery center: These facilities aren’t part of a hospital or doctor’s office, but midwives and/or ob-gyns assist during the birthing process.
• Having a home birth: Delivering at home is typically monitored by a midwife.
• Working with a doula: Doulas are trained supporters rather than health care professionals who aid parents through the birthing process and other related experiences.

If you choose a midwifery center, Dr. Wilson recommends interviewing different midwives and asking how they work with physicians. If you end up needing to go to a hospital, for example, “does the midwife have privileges there?” she suggests asking. “If the doctor does have to do a C-section, does the midwife assist the physician?”

You’ll also want to talk to potential midwives and ob-gyns about the safest option for you. Midwifery centers and home births are not without their own risks, even if they sound more appealing to you. For example, an August 2020 study in the ‌American Journal of Obstetrics and Gynecology‌ found 13 out of every 10,000 midwife-attended home births resulted in infant death, compared to 6 per every 10,000 hospital births.

Cont ….