A new University of Colorado Boulder study published in the Journal of Health and Social Behavior examines how widespread racism in U.S. maternal care could lead to unnecessary labor induction procedures among Black and Latina women.
The study examined 46 million births across nearly three decades. It found decisions on childbirth for Black and Latina mothers are based largely on maternal health care trends in the white population, even when some childbirth procedures could be more risky for non-white demographics.
"The rising use of a medical procedure does not appear to be matching the needs and preferences among women of color," said Ryan Masters, senior author of the study who studies health and mortality trends at CU Boulder.
The study focuses on induced labor, when care providers use medicine or other methods to start labor based on concerns about health complications to the mother or baby. The rate of labor inductions in the U.S. has tripled since 1990. For white pregnant women, the increase in labor inductions is strongly linked with high risk factors during pregnancy such as low maternal education, gestational tobacco use, maternal diabetes and maternal hypertension.
But in pregnancies among Black and Hispanic women, researchers didn't find the same correlation. Rather, increased inductions were unassociated with these populations' demographic risk factors. For Masters, "That in-of-itself is alarming."
Masters said labor induction should be undertaken in response to a specific patient's needs, but his research suggests it is being used as standard practice for Black and Latina mothers.
Masters said there are two potential explanations. Since U.S. labor and delivery rooms have normalized labor induction as a way to manage risky pregnancies, Masters said hospitals have tended to utilize the procedure more often than may actually be necessary.
Or, Masters suggested, it could be a sign of how racism infiltrates risk perception for pregnant mothers. Black and Latina women may simply be perceived and diagnosed as having riskier and less healthy pregnancies than white women.
