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- Divergent Social Paths for C-Sections: A Statistical Analysis of Cesarean Delivery Birth Rates Among Mothers from 2014 to 2017, Accounting for State-Level Medicaid Expansion under the Patient Protection and Affordable Care Act (ACA)
- Wright, II, Dennis
- Data To Policy
- Conference Proceedings ( sobekcm )
- Cesarean section deliveries are correlated with increased risks to health and recovery for mothers and their newborns than vaginal deliveries. In 2014, the Centers for Disease Control and Prevention (CDC) identified a national trend of increasing medically unnecessary (low-risk) cesarean rates(1). In 2015, the World Health Organization (WHO) produced a statement asserting, among other conclusions, a disassociation of maternal and newborn mortality rate reductions for cesarean deliveries at or above 10% at the population level(2). Both the CDC and the WHO highlight limited access to care as a barrier to maternal health and associated with higher rates of cesarean deliveries. Using federally-available trend data, I measured state-level low-risk cesarean rates from 2014 through 2017 and compared the rates of change between 2014 and 2017. Further, I compared these rates of change against states that either opted into or out of Medicaid expansion via the ACA. The results indicate that low-risk cesarean delivery rates remain two to three times higher than the recommended WHO threshold. Further, the results highlight a racial disparity with black mothers in both having the highest percentage of cesarean deliveries and being the lone group who has experienced an average increase in cesarean deliveries. Last, Medicaid expansion is positively associated with both an increase in access to health care and more variability in cesarean delivery rates across the United States. Policy implications include increased research and funding to study these low-risk cesarean rate disparities, investment into early intervention prenatal services and strengthening the protections under the ACA to prevent a relapse to pre-ACA cesarean delivery rates.
- Collected for Auraria Institutional Repository by the Self-Submittal tool. Submitted by Dennis Wright, II.
- Publication Status:
- General Note:
- (1) Centers for Disease Control and Prevention: Trends in Low-risk Cesarean Delivery in the United States. https://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_06.pdf
(2) World Health Organization: WHO Statement on Caesarean Section Rates. April 2015
- Source Institution:
- Auraria Institutional Repository
- Holding Location:
- Auraria Library
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- All applicable rights reserved by the source institution and holding location.
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