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Disparities in Labor Management Strategies for CD

Obstet Gynecol; ePub 2017 Nov 3; Yee, et al

Differential use of labor management strategies intended to reduce cesarean delivery (CD) rates do not appear to be associated with racial and ethnic disparities, a recent study found. The secondary analysis included women at term with singleton, nonanomalous, vertex, liveborn neonates who were included in 2 cohorts: 1) nulliparous women and 2) multiparous women with prior vaginal deliveries only. Women were grouped as non-Hispanic black, non-Hispanic white, Hispanic, and Asian. Study details included:

  • 75,400 women were eligible for inclusion (47% in the nulliparous cohort and 53% in the multiparous cohort).
  • For nulliparous women, unadjusted CD frequencies were 25.0%, 28.3%, 28.7%, and 24.0% for non-Hispanic white, non-Hispanic black, Asian, and Hispanic women, respectively.
  • Among nulliparous women, the adjusted odds of CD were higher in all racial and ethnic groups compared with non-Hispanic white women.
  • Nonapplication of labor management strategies regarding failed induction, arrest of dilation, arrest of descent, or cervical ripening did not contribute to increased odds of CD for non-Hispanic black and Hispanic women.
  • Similar trends were seen among multiparous women with prior vaginal deliveries.


Yee LM, Constantine MM, Rice MM, et al. Racial and ethnic differences in utilization of labor management strategies intended to reduce cesarean delivery rates. [Published online ahead of print November 3, 2017]. Obstet Gynecol. doi:10.1097/AOG.0000000000002343.