Advancing Birth Equity
Addressing disparities in cesarean birth outcomes and promoting patient-centered care.
The Problem
The U.S. cesarean rate of 32% exceeds healthy levels. In California, C-sections are a contributing factor in 37% of severe maternal health issues, disproportionately affecting Black women.
Why VBAC Matters
Most people who have a first C-section will later give birth via Elective Repeat Cesarean Delivery (ERCD), which can increase certain health risks. The NIH has identified increasing the Vaginal Birth After Cesarean (VBAC) rate as a public health priority. Safely increasing the VBAC rate in a patient centered way could help reduce avoidable morbidity and mortality in childbirth. The VBAC rate in California persistently falls below the national average.
Challenges in Equitable Access
Black and Latinx patients report more interest in VBAC than White patients, but they also face more barriers to accessing VBAC services. Tools like the VBAC calculator have historically discouraged Black and Latinx patients from attempting VBAC, reinforcing disparities in care.
Our Approach
We are committed to investigating how multi-level racism impacts care after a first C-section. Our work involves gathering data, engaging diverse stakeholders, and developing community-driven solutions to improve maternal health equity.
Building a Better Future
By addressing disparities in post-cesarean care, we aim to improve birth experiences, reduce negative postpartum outcomes, and ensure that all birthing people have access to safe, patient-centered options.
The Challenge of Unplanned Cesarean Births
The World Health Organization calls for every birthing person to have a positive perinatal experience. But for many, especially those undergoing unplanned cesareans, that goal remains out of reach. Research shows that these births are associated with higher rates of mistreatment, trauma, and reduced quality of life — with lasting emotional, physical, and social impacts.
Systemic Disparities in Birth Outcomes
The U.S. cesarean rate of 32% exceeds healthy levels. In California, C-sections are a contributing factor in 37% of severe maternal health issues, disproportionately affecting Black women. In the United States, Black and Latinx birthing people face higher rates of unplanned first-time cesareans and systemic barriers to accessing vaginal birth after cesarean (VBAC) services. Experiences of racism, disrespect, and lack of informed consent during cesarean birth are common — and harmful. These inequities affect physical health, mental health, breastfeeding success, and maternal-infant bonding.
Why VBAC Access Matters: Equity in Future Births
A negative cesarean experience shouldn’t have to be repeated. But many hospitals in California do not offer VBAC, forcing people into repeat cesareans. Black and Latinx patients interested in VBAC can face barriers to accurate information about their birth options, encounter biased VBAC decision support tools, and restricted access to VBAC services.
Our Study: Community-Engaged Research in California
We partnered with Black and Latinx birthing people in California to explore their experiences with cesarean birth, focusing on two key questions:
- How do patients experience informed decision-making during and after a cesarean birth?
- What are the roles of mistreatment, racism, and respectful care during and after a cesarean birth?
Our findings will directly inform the design of a culturally responsive, equity-centered intervention to improve cesarean care experiences and outcomes.
Join Us in Reimagining Cesarean Care
Whether you’re a patient, researcher, advocate, or clinician — your voice matters. Together, we can create safer, more respectful, and more equitable birth experiences.