Factors associated with increased cesarean risk among African American women: Evidence from California, 2010

M. Huesch and Jason Doctor

American Journal of Public Health, 2015, vol. 105, issue 5, 956-962

Abstract: Objectives: We studied if both observed and unobserved maternal health in African American women in hospitals or communities were associated with cesarean delivery of infants. Methods: We examined the relationship between African American race and cesarean delivery among 493 433 women discharged from 255 Californian hospitals in 2010 using administrative data; we adjusted for patient comorbidities and maternal, fetal, and placental risk factors, as well as clustering of patients within hospitals. Results: Cesarean rates were significantly higher overall for African American women than other women (unadjusted rate 36.8% vs 32.7%), as were both elective and emergency primary cesarean rates. Elevated risks persisted after risk adjustment (odds ratio generally >1.27), but the prevalence of particular risk factors varied. Although African American women were clustered in some hospitals, the proportion of African Americans among all women delivering in a hospital was not related to its overall cesarean rate. Conclusions: To address the higher likelihood of elective cesarean delivery, attention needs to be given to currently unmeasured patient-level health factors, to the quality of provider-physician interactions, as well as to patient preferences.

Keywords: African American; cesarean section; female; human; insurance; Obstetric Labor Complications; pregnancy; risk factor; statistics and numerical data; United States, African Americans; California; Cesarean Section; Female; Humans; Insurance Coverage; Obstetric Labor Complications; Pregnancy; Risk Factors (search for similar items in EconPapers)
Date: 2015
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2014.302381_1

DOI: 10.2105/AJPH.2014.302381

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