Racial and Ethnic Differences in the Likelihood of Vaginal Birth After Cesarean Delivery
Background A major contributor to the increase in cesarean deliveries over recent decades is the decline in vaginal births after cesarean (VBAC). Racial and ethnic disparities in other perinatal outcomes are widely recognized, but few studies have been directed toward racial/ethnic differences in VB...
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| Veröffentlicht in: | Birth (Berkeley, Calif.) Calif.), 2015-09, Vol.42 (3), p.249-253 |
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| creator | Cheng, Erika R. Declercq, Eugene R. Belanoff, Candice Iverson, Ronald E. McCloskey, Lois |
| description | Background
A major contributor to the increase in cesarean deliveries over recent decades is the decline in vaginal births after cesarean (VBAC). Racial and ethnic disparities in other perinatal outcomes are widely recognized, but few studies have been directed toward racial/ethnic differences in VBAC rates.
Methods
We used the population‐based Massachusetts Pregnancy to Early Life (PELL) database to investigate racial/ethnic differences in rates of VBAC for Massachusetts residents with one prior cesarean from 1998 to 2008.
Results
The overall VBAC rate was 17.3 percent. After adjusting for demographic, behavioral, and medical risk factors, non‐Hispanic Asian mothers had a greater likelihood of VBAC than non‐Hispanic white mothers (adjusted risk ratio 1.31 [95% CI 1.23–1.39]). No other racial/ethnic group was significantly different from non‐Hispanic whites in adjusted analyses. The likelihood of VBAC also decreased with increasing maternal age.
Discussion
Non‐Hispanic Asian women are significantly more likely to have VBAC than non‐Hispanic white women. Efforts to reduce cesarean delivery rates in the United States should address these disparities. Future research should investigate factors underlying these differences to ensure that all women have access to appropriate maternity care services. |
| doi_str_mv | 10.1111/birt.12174 |
| format | Article |
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A major contributor to the increase in cesarean deliveries over recent decades is the decline in vaginal births after cesarean (VBAC). Racial and ethnic disparities in other perinatal outcomes are widely recognized, but few studies have been directed toward racial/ethnic differences in VBAC rates.
Methods
We used the population‐based Massachusetts Pregnancy to Early Life (PELL) database to investigate racial/ethnic differences in rates of VBAC for Massachusetts residents with one prior cesarean from 1998 to 2008.
Results
The overall VBAC rate was 17.3 percent. After adjusting for demographic, behavioral, and medical risk factors, non‐Hispanic Asian mothers had a greater likelihood of VBAC than non‐Hispanic white mothers (adjusted risk ratio 1.31 [95% CI 1.23–1.39]). No other racial/ethnic group was significantly different from non‐Hispanic whites in adjusted analyses. The likelihood of VBAC also decreased with increasing maternal age.
Discussion
Non‐Hispanic Asian women are significantly more likely to have VBAC than non‐Hispanic white women. Efforts to reduce cesarean delivery rates in the United States should address these disparities. Future research should investigate factors underlying these differences to ensure that all women have access to appropriate maternity care services.</description><identifier>ISSN: 0730-7659</identifier><identifier>EISSN: 1523-536X</identifier><identifier>DOI: 10.1111/birt.12174</identifier><identifier>PMID: 26088760</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adult ; Asian People ; cesarean delivery ; Cesarean section ; Cesarean Section - statistics & numerical data ; Childbirth & labor ; Cultural differences ; Databases, Factual ; delivery method ; Ethnicity ; Female ; Health care access ; Health Status Disparities ; Humans ; Massachusetts - ethnology ; Maternal child nursing ; Multivariate Analysis ; Obstetrics ; Pregnancy ; Racial differences ; racial/ethnic disparities ; Risk Factors ; vaginal birth after cesarean ; Vaginal Birth after Cesarean - statistics & numerical data ; White People ; Young Adult</subject><ispartof>Birth (Berkeley, Calif.), 2015-09, Vol.42 (3), p.249-253</ispartof><rights>2015 Wiley Periodicals, Inc.</rights><rights>Copyright Wiley Subscription Services, Inc. Sep 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5894-50c288aaf1e3a9bd65cc4bf20b56def4eace29cd535e09f67712d73d6a0d56973</citedby><cites>FETCH-LOGICAL-c5894-50c288aaf1e3a9bd65cc4bf20b56def4eace29cd535e09f67712d73d6a0d56973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbirt.12174$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbirt.12174$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,30999,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26088760$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cheng, Erika R.</creatorcontrib><creatorcontrib>Declercq, Eugene R.</creatorcontrib><creatorcontrib>Belanoff, Candice</creatorcontrib><creatorcontrib>Iverson, Ronald E.</creatorcontrib><creatorcontrib>McCloskey, Lois</creatorcontrib><title>Racial and Ethnic Differences in the Likelihood of Vaginal Birth After Cesarean Delivery</title><title>Birth (Berkeley, Calif.)</title><addtitle>Birth</addtitle><description>Background
A major contributor to the increase in cesarean deliveries over recent decades is the decline in vaginal births after cesarean (VBAC). Racial and ethnic disparities in other perinatal outcomes are widely recognized, but few studies have been directed toward racial/ethnic differences in VBAC rates.
Methods
We used the population‐based Massachusetts Pregnancy to Early Life (PELL) database to investigate racial/ethnic differences in rates of VBAC for Massachusetts residents with one prior cesarean from 1998 to 2008.
Results
The overall VBAC rate was 17.3 percent. After adjusting for demographic, behavioral, and medical risk factors, non‐Hispanic Asian mothers had a greater likelihood of VBAC than non‐Hispanic white mothers (adjusted risk ratio 1.31 [95% CI 1.23–1.39]). No other racial/ethnic group was significantly different from non‐Hispanic whites in adjusted analyses. The likelihood of VBAC also decreased with increasing maternal age.
Discussion
Non‐Hispanic Asian women are significantly more likely to have VBAC than non‐Hispanic white women. Efforts to reduce cesarean delivery rates in the United States should address these disparities. Future research should investigate factors underlying these differences to ensure that all women have access to appropriate maternity care services.</description><subject>Adult</subject><subject>Asian People</subject><subject>cesarean delivery</subject><subject>Cesarean section</subject><subject>Cesarean Section - statistics & numerical data</subject><subject>Childbirth & labor</subject><subject>Cultural differences</subject><subject>Databases, Factual</subject><subject>delivery method</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Health care access</subject><subject>Health Status Disparities</subject><subject>Humans</subject><subject>Massachusetts - ethnology</subject><subject>Maternal child nursing</subject><subject>Multivariate Analysis</subject><subject>Obstetrics</subject><subject>Pregnancy</subject><subject>Racial differences</subject><subject>racial/ethnic disparities</subject><subject>Risk Factors</subject><subject>vaginal birth after cesarean</subject><subject>Vaginal Birth after Cesarean - statistics & numerical data</subject><subject>White People</subject><subject>Young Adult</subject><issn>0730-7659</issn><issn>1523-536X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqNkU9vFCEYh4nR2G314gcwJF4ak6kwDDBzMWm3f2x21dhU7Y0wzEuHdpapMNu6316m227Ug5ELB57fD3gfhF5RskfTele7MOzRnMriCZpQnrOMM3HxFE2IZCSTgldbaDvGK0KILArxHG3lgpSlFGSCLs60cbrD2jf4aGi9M_jQWQsBvIGIncdDC3jurqFzbd83uLf4m750PmUO0r0t3rcDBDyFqANojw8TeAth9QI9s7qL8PJh30Ffj4_Opx-y-eeT0-n-PDO8rIqME5OXpdaWAtNV3QhuTFHbnNRcNGAL0AbyyjSccSCVFVLSvJGsEZo0XFSS7aD3696bZb2AxoAfgu7UTXALHVaq1079eeJdqy77W1UIWgoxFuw-FIT-xxLioBYuGug67aFfRkVlThnnpGL_gZJiRAVJ6Ju_0Kt-GdLU7inOkyY-Um_XlAl9jAHs5t2UqNGtGt2qe7cJfv37Tzfoo8wE0DVw5zpY_aNKHZyenT-WZuuMiwP83GR0uFZpNpKr759OFKmOZ2z28YuasV8Wmb3u</recordid><startdate>201509</startdate><enddate>201509</enddate><creator>Cheng, Erika R.</creator><creator>Declercq, Eugene R.</creator><creator>Belanoff, Candice</creator><creator>Iverson, Ronald E.</creator><creator>McCloskey, Lois</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201509</creationdate><title>Racial and Ethnic Differences in the Likelihood of Vaginal Birth After Cesarean Delivery</title><author>Cheng, Erika R. ; Declercq, Eugene R. ; Belanoff, Candice ; Iverson, Ronald E. ; McCloskey, Lois</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5894-50c288aaf1e3a9bd65cc4bf20b56def4eace29cd535e09f67712d73d6a0d56973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Asian People</topic><topic>cesarean delivery</topic><topic>Cesarean section</topic><topic>Cesarean Section - statistics & numerical data</topic><topic>Childbirth & labor</topic><topic>Cultural differences</topic><topic>Databases, Factual</topic><topic>delivery method</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Health care access</topic><topic>Health Status Disparities</topic><topic>Humans</topic><topic>Massachusetts - ethnology</topic><topic>Maternal child nursing</topic><topic>Multivariate Analysis</topic><topic>Obstetrics</topic><topic>Pregnancy</topic><topic>Racial differences</topic><topic>racial/ethnic disparities</topic><topic>Risk Factors</topic><topic>vaginal birth after cesarean</topic><topic>Vaginal Birth after Cesarean - statistics & numerical data</topic><topic>White People</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cheng, Erika R.</creatorcontrib><creatorcontrib>Declercq, Eugene R.</creatorcontrib><creatorcontrib>Belanoff, Candice</creatorcontrib><creatorcontrib>Iverson, Ronald E.</creatorcontrib><creatorcontrib>McCloskey, Lois</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Birth (Berkeley, Calif.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cheng, Erika R.</au><au>Declercq, Eugene R.</au><au>Belanoff, Candice</au><au>Iverson, Ronald E.</au><au>McCloskey, Lois</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Racial and Ethnic Differences in the Likelihood of Vaginal Birth After Cesarean Delivery</atitle><jtitle>Birth (Berkeley, Calif.)</jtitle><addtitle>Birth</addtitle><date>2015-09</date><risdate>2015</risdate><volume>42</volume><issue>3</issue><spage>249</spage><epage>253</epage><pages>249-253</pages><issn>0730-7659</issn><eissn>1523-536X</eissn><abstract>Background
A major contributor to the increase in cesarean deliveries over recent decades is the decline in vaginal births after cesarean (VBAC). Racial and ethnic disparities in other perinatal outcomes are widely recognized, but few studies have been directed toward racial/ethnic differences in VBAC rates.
Methods
We used the population‐based Massachusetts Pregnancy to Early Life (PELL) database to investigate racial/ethnic differences in rates of VBAC for Massachusetts residents with one prior cesarean from 1998 to 2008.
Results
The overall VBAC rate was 17.3 percent. After adjusting for demographic, behavioral, and medical risk factors, non‐Hispanic Asian mothers had a greater likelihood of VBAC than non‐Hispanic white mothers (adjusted risk ratio 1.31 [95% CI 1.23–1.39]). No other racial/ethnic group was significantly different from non‐Hispanic whites in adjusted analyses. The likelihood of VBAC also decreased with increasing maternal age.
Discussion
Non‐Hispanic Asian women are significantly more likely to have VBAC than non‐Hispanic white women. Efforts to reduce cesarean delivery rates in the United States should address these disparities. Future research should investigate factors underlying these differences to ensure that all women have access to appropriate maternity care services.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>26088760</pmid><doi>10.1111/birt.12174</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Birth (Berkeley, Calif.), 2015-09, Vol.42 (3), p.249-253 |
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| source | MEDLINE; Access via Wiley Online Library; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Adult Asian People cesarean delivery Cesarean section Cesarean Section - statistics & numerical data Childbirth & labor Cultural differences Databases, Factual delivery method Ethnicity Female Health care access Health Status Disparities Humans Massachusetts - ethnology Maternal child nursing Multivariate Analysis Obstetrics Pregnancy Racial differences racial/ethnic disparities Risk Factors vaginal birth after cesarean Vaginal Birth after Cesarean - statistics & numerical data White People Young Adult |
| title | Racial and Ethnic Differences in the Likelihood of Vaginal Birth After Cesarean Delivery |
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