A new study by researchers at the University of Colorado Boulder found that Black and Latina mothers in the US may have been induced into labor based on the needs of White pregnant women and not their own.
The study, published Wednesday in the American Sociological Association’s Journal of Health and Social Behavior, suggests systemic racism may be shaping obstetric care in the United States.
An analysis of more than 40 million birth records from the National Vital Statistics Systems showed that births in the US in which labor was induced nearly tripled between 1990 and 2017, the study says.
When comparing the experiences of Black, Latina and White women in labor, researchers found all the three groups had similar increased rates of induced labor but said the decisions about the women’s care were likely only driven by how White pregnant women were treated.
“There are norms, assessments, behaviors and institutional practices that might be taking their cues from the White population and then being sort of indiscriminately applied to the Black and Latina childbearing population,” Ryan Masters, one of the study’s authors and an associate professor of sociology at the University of Colorado Boulder, said in a statement.
“That’s incredibly worrisome because it’s effectively institutional level racism manifesting down in these obstetric clinical practices,” he added.
The study was based on a sample of 41.1 million single, first births across the country, including 26.4 million of White women, 6.2 million of Black women and 8.4 million Latinas. Data from births among White women was from all 50 states but data from Black and Latina women only included 43 and 47 states, respectively. All groups were represented in Washington, DC, the study says.
Gestational tobacco use, maternal diabetes, maternal hypertension, and high gestational weight gain were considered as factors for high-risk pregnancies. Researchers said more White women were induced into labor when there was evidence of risk factors in that population.
But there was not a strong link between an increased number of Black and Latina women being induced into labor and the presence of risk factors within their race or ethnic group, the study says.
“The results suggest systemic racism may be shaping U.S. obstetric care whereby care is not ‘centered at the margins’ but is instead responsive to characteristics in states’ White populations,” the study says.
The study’s authors said their findings may be limited but are consistent with “an extensive literature documenting health care inequity” in the US. The study provides strong evidence that obstetric care “has not been centered on the needs of Black and Latina childbearing populations.”
“I hope it is convincing evidence for clinical practitioners and others to heed the calls of others to be sensitive to the ways that whether they are malicious or not. The ways that our institutional practices can perpetuate unequal treatment,” Masters said.