Although cesarean births can save lives, the U.S cesarean rate of 32% is unhealthy and puts mothers and babies at risk. Cesarean births also exhibit stark racial disparities, with Black women, and in some areas Latinas as well, experiencing higher rates of unnecessary cesareans. In California, cesarean births contribute to poor maternal outcomes with Black women disproportionately affected. Most women with a first cesarean will have a repeat cesarean, and each subsequent cesarean birth raises certain risks for the birthing person and their newborn. Thus, increasing the rate of Vaginal Birth After Cesarean (VBAC) has become a public health goal. The NIH recommends a patient-centered approach to deciding between a VBAC and a repeat cesarean. 

However, multi-level racism may undermine Black and Latinx patients’ ability to make choices about their preferred mode of birth and to experience optimal outcomes after a prior cesarean.  For instance, some hospitals used a tool called a VBAC calculator to discourage Black and Latinx patients from attempting VBAC. Cesareans, compared to vaginal births, are linked to more negative feelings related to the birth, mental health issues, breastfeeding challenges, post-surgical complications, and limited access to VBAC-supportive services.