ThinkIR: The University of Louisville\u27s Institutional Repository
Abstract
The cesarean delivery rate has increased and accounts for a third of pregnancies in the U.S., especially among marginalized women. This study applied a newly developed conceptual model to identify potential areas of influence that could reduce rates of cesarean deliveries. The Giving Voice to Mothers - United States data was used for analyses to predict covariates associated with having a cesarean delivery vs. spontaneous vaginal delivery (n=1,876). Significant covariates were determined and included the following: having a prior cesarean delivery (OR: 14.11, 95% CI: 7.99 - 24.90); more than one child (OR: 0.21, 95% CI: 0.13 - 0.35); elevated pregnancy risk (OR: 2.22 - 4.90, 95% CI: 2.22 - 4.90); doctor as perinatal care provider (OR: 2.25, 95% CI: 1.40 - 3.61); and receiving disrespectful perinatal care (OR: 2.16, 95% CI: 1.13 - 4.12). Significant covariates associated with race/ethnicity with white women as the reference group included the following: Asian women had higher odds of having a prior cesarean delivery (OR: 2.59, 95% CI: 1.31 - 5.12) and doctor as their perinatal care provider (OR: 2.31, 95% CI: 1.22 - 4.35); Black women had higher odds of having one or more child (OR: 2.15, 95% CI: 1.11 - 4.14); and Hispanic (OR: 1.89, 95% CI: 1.04 - 3.45) and Indigenous (OR: 3.17, 95% CI: 1.34 - 7.48) women had higher odds of receiving disrespectful perinatal care. Cesarean delivery rates could reduce by intervening at individual and interpersonal levels of influence that incorporate fewer medical interventions and improved patient-provider interactions
