ArticleWomen's health issues : official publication of the Jacobs Institute of Women's Health
Early Elective Delivery Disparities between Non-Hispanic Black and White Women after Statewide Policy Implementation.
Article in Women's health issues : official publication of the Jacobs Institute of Women's Health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Inequities in quality perinatal care in the United States during pregnancy and birth after cesarean.PloS one · 2022Article
- Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes.Frontiers in reproductive health · 2021Review
- Cesarean birth and maternal morbidity among Black women and White women after implementation of a blended payment policy.Health services research · 2020Article
- Strong Start in birth centers: Socio-demographic characteristics, care processes, and outcomes for mothers and newborns.Birth (Berkeley, Calif.) · 2019Article
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5 authors.
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Abstract
backgroundIn 2011, Oregon implemented a policy that reduced the state's rate of early (before 39 weeks' gestation) elective (without medical need) births.
objectiveThis analysis measured differential policy effects by race, examining whether Oregon's policy was associated with changes in non-Hispanic Black-White disparities in early elective cesarean and labor induction.
methodsWe used Oregon birth certificate data, defining prepolicy (2008-2010) and postpolicy (2012-2014) periods, including non-Hispanic Black and White women who gave birth during these periods (n = 121,272). We used longitudinal spline models to assess policy impacts by race and probability models to measure policy-associated changes in Black-White disparities.
resultsWe found that the prepolicy Black-White differences in early elective cesarean (6.1% vs. 4.3%) were eliminated after policy implementation (2.8% vs. 2.5%); adjusted models show decreases in the odds of elective early cesarean among Black women after the policy change (adjusted odds ratio, 0.47; 95% confidence interval, 0.22-1.00; p = .050) and among White women (adjusted odds ratio, 0.79; 95% confidence interval, 0.67-0.93; p = .006). Adjusted probability models indicated that policy implementation resulted in a 1.75-percentage point narrowing (p = .011) in the Black-White disparity in early elective cesarean. Early elective induction also decreased, from 4.9% and 4.7% for non-Hispanic Black and non-Hispanic White women to 3.8% and 2.5%, respectively; the policy was not associated with a statistically significant change in disparities.
conclusionsA statewide policy reduced racial disparities in early elective cesarean, but not early elective induction. Attention to differential policy effects by race may reveal changes in disparities, even when that is not the intended focus of the policy.
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