ArticleAmerican journal of public health1995
Racial/ethnic differences in the likelihood of cesarean delivery, California.
Article in American journal of public health, 1995. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
50 citing papers in PubMed, 5 syntheses or guidelines pooled it, 157 citations in OpenAlex.
- Caesarean sections in teaching hospitals: systematic review and meta-analysis of hospitals in 22 countries.BMJ open · 2021Pooled it
- Caesarean section in uninsured women in the USA: systematic review and meta-analysis.BMJ open · 2019Pooled it
- Pooled it
- Caesarean sections and for-profit status of hospitals: systematic review and meta-analysis.BMJ open · 2017Pooled it
- International migration and caesarean birth: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2013Pooled it
- Racial/Ethnic Differences in Labor Outcomes with Prostaglandin Vaginal Inserts.Journal of racial and ethnic health disparities · 2015Trial
- The Association Between Experiencing Racial Discrimination and Delivery Method Among Women in the United States, PRAMS 2016-2021.Journal of racial and ethnic health disparities · 2026Article
- Racial and Ethnic Disparities in Low-Risk Unplanned Cesarean Birth: Disaggregating Asian Data.Journal of racial and ethnic health disparities · 2026Article
- Disparities in indication for primary cesarean delivery before and after implementation of quality initiatives.Pregnancy (Hoboken, N.J.) · 2026Article
- Racial inequities in cesarean use among high- and low-risk deliveries: An analysis of childbirth hospitalizations in New Jersey from 2000 to 2015.Health services research · 2025Article
- Socioeconomic disadvantage and racial/ethnic disparities in low-risk cesarean birth in California.American journal of epidemiology · 2025Article
- Historical Primer on Obstetrics and Gynecology Health Inequities in America: A Narrative Review of Four Events.Obstetrics and gynecology · 2023Review
- Pain Severity and Pain Interference in Late Pregnancy: An Analysis of Biopsychosocial Factors Among Women Scheduled for Cesarean Delivery.Pain medicine (Malden, Mass.) · 2023Observational
- Racial-ethnic disparities in potentially preventable complications after cesarean delivery in Maryland: an observational cohort study.BMC pregnancy and childbirth · 2022Observational
- Variations in Low-Risk Cesarean Delivery Rates in the United States Using the Society for Maternal-Fetal Medicine Definition.Obstetrics and gynecology · 2022Article
- Racial variations of adverse perinatal outcomes: A population-based retrospective cohort study in Ontario, Canada.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
- Multi-level Drivers of Disparities in Hispanic Cesarean Delivery Rates in US-Mexico Border States.Journal of racial and ethnic health disparities · 2020Article
- Socioeconomic and migration status as predictors of emergency caesarean section: a birth cohort study.BMC pregnancy and childbirth · 2020Article
- Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe purpose of this study was to determine whether women's sociodemographic characteristics are independently associated with cesarean delivery.
methodsA retrospective review was conducted of hospital discharge data for singleton first births in California in 1991.
resultsAfter insurance and personal, community, medical, and hospital characteristics had been controlled, Blacks were 24% more likely to undergo cesarean delivery than Whites; only among low-birthweight and county hospital births were Blacks not at a significantly elevated risk. Among women who resided in substantially non-English-speaking communities, who delivered high-birthweight babies, or who gave birth at for-profit hospitals, cesarean delivery appeared to be more likely among non-Whites and was over 40% more likely among Blacks than among Whites.
conclusionsThe findings cannot establish causation, but the significant racial/ethnic disparities in delivery mode, despite adjustment for social, economic, medical, and hospital factors, suggest inappropriate influences on clinical decision making that would not be addressed by changes in reimbursement. If practice variations among providers are involved, de facto racial differences in access to optimal care may be indicated. The role of provider and patient attitudes and expectations in the observed racial/ethnic differentials should also be explored.
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Registered trials
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