A Quantitative Analysis of the Race-Correction Factor and Vaginal Birth After Cesarean Eligibility

Abstract

In 2007, the Maternal Fetal Medicine Units Network created a calculator that provided an early estimate of the success a woman would have if she chose to attempt a vaginal birth after cesarean delivery (VBAC). Race was one of six demographic variables used in the algorithm. Women who identified as either Hispanic or African American received a score seven points lower than Caucasian women, thereby making minority women on average less likely to be recommended for a VBAC. The use of a race-correction factor is a problematic practice that has received pushback from physicians across the country due to the concern that it may propagate race-based medicine and exacerbate health disparities. The aim of this thesis was to assess how many women at a federally qualified health center were negatively affected by the race factor during a one-year period. From April 2020 to April 2021, the participating hospital had a VBAC rate of 1.90%. The authors found that without the use of race adjustment, this number could have been as high as 3.03%. To continue paving the way for an equitable healthcare system, the tools and algorithms used to treat patients must be critically analyzed and assessed.