To fill operating rooms and financial incentives, obstetricians are often performing unneeded cesarean sections on Black women, according to researchers who analyzed about 1 million births across 68 New Jersey hospitals.
The researchers, who are health economic experts, found that a Black mother with an unscheduled delivery is 25% more likely to deliver by C-section than a non-Hispanic white mother — even when both mothers have similar medical histories and are seen by the same hospital physician.
The study authors examined data from more than 1,700 unique providers who delivered babies between 2008 and 2017.
The 25% gap "disappears when the costs of ordering an unscheduled C-section are higher" than a scheduled C-section occurring at the same time. The researchers said the racial disparity could be because of risk factors related to race or "it could be that providers are exercising their discretion and are more likely to conduct unnecessary C-sections on Black mothers."
The study suggests more evidence for the latter hypothesis.
In 2016 and 2017, the average cost of a vaginal birth was $12,235, according to research published in The American Journal of Managed Care. For C-sections, the average cost was $17,004.
Ijeoma Okwandu, MD, an obstetrician with Kaiser Permanente in Atlanta, told The New York Times in a Sept. 10 report that the research stands out because it "followed the money."
"That really is the driver of so much that happens in medicine," Dr. Okwandu said.