Hands Of A Couple Embracing The Baby Inside Her Growing Belly

A new study by the Leverhulme Centre for Demographic Science’s Senior Postdoctoral Researcher Dr Andrea Tilstra and colleagues at the University of Colorado Boulder finds that ‘obstetric racism’ is ubiquitous in U.S. labour and delivery rooms, and contributing to a sharp rise in medically questionable inductions that could be harming Black and Latina mothers and babies.

The findings come amid rising concerns about high maternal mortality rates among Black mothers, who are nearly three times more likely to die of pregnancy-related causes than white mothers, and their infants, who are twice as likely to die in their first year.

The study of 46 million births across nearly three decades is among the first to provide population-level statistical evidence of “obstetric racism,” a term coined recently to describe a concerning pattern of maltreatment of non-white pregnant women, including a disregard for their birthing wishes.

To explore whether obstetric racism is happening at the population level, the researchers used state-level data from the National Vital Statistics Systems to analyse single-child first-births among 26.4 million white women, 6.2 million Black women and 8.4 million Latina women, looking at whether induction occurred and at the health of the mother.

Read the full Press Release here.

The study was published yesterday in the Journal of Health and Social Behavior, and shows that medical induction of labour nearly tripled between 1990 and 2017 in the U.S., growing from 12.5% of births in 1990 to 34.4% in 2017.

This trend is concerning as previous research from the authors show that early induction can lead to low birthweight babies and a host of associated problems later in life.

While the increase in inductions among white women can largely be explained by an increase in higher-risk pregnancies among the white childbearing population, the same cannot be said for Black and Latina women, the study found. Instead, decisions about their care are being based on trends in the white population.

Dr Andrea Tilstra who has a PhD in Sociology from the University of Colorado Boulder said, “The U.S. medical system has a long history of centering care on the needs of dominant or majority populations, i.e. white patients, rather than considering the specific needs of marginalized populations. Our results show systemic racism is also shaping U.S. obstetric care.”

The authors hope that their work will encourage policymakers and clinicians to address biases and realise that even brief micro-interactions in the labour and delivery room can add up, leading to differences in care between different racial and ethnic populations.

Dr Andrea Tilstra adds, “Pregnancy and childbirth are an incredibly vulnerable and difficult time in one's life. Everyone deserves to have equal access to good care.”

This is a summary of the University of Colorado Boulder’s press release that can be found here.