Racial and Ethnic Differences in the Likelihood of Vaginal Birth After Cesarean Delivery. Issue 3 (19th June 2015)

• Record Type: Journal Article
• Authors: Cheng, Erika R.; Declercq, Eugene R.; Belanoff, Candice; Iverson, Ronald E.; McCloskey, Lois
• Is Part Of: Birth. Volume 42:Issue 3(2015:Sep.)
• Page Start: 249
• Page End: 253
• Publication Date: 2015-06-19
• Subjects: Childbirth -- Periodicals; Obstetrics -- Periodicals; Newborn infants -- Care -- Periodicals; Natural childbirth -- Periodicals; 618.1
• DOI: 10.1111/birt.12174
• Languages: English
• ISSNs: 0730-7659

Abstract

<abstract abstract-type="main" id="birt12174-abs-0001"> <title>Abstract</title> <sec id="birt12174-sec-0001" sec-type="section"> <title>Background</title> <p>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.</p> </sec> <sec id="birt12174-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="birt12174-sec-0003" sec-type="section"> <title>Results</title> <p>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.</p> </sec> <sec id="birt12174-sec-0004" sec-type="section"> <title>Discussion</title> <p>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.</p> </sec> </abstract>