How to pick a hospital with a lower C-section rate
A new report highlights racial bias in 1 in 5 U.S. hospitals
I am writing this on April fools’ day when I wish most of what I’ve written here…or what I’ve seen lately on the news…was a joke. But sadly, it’s not. The good news? We don’t have to be helpless. We can inform ourselves and take back some control in the process. So read on for just how to do that this week, and if you’re up for it, share this post with a friend. -Dr. Jen
In the news: In 20% of U.S. hospitals, being Black increases your C-section chances
A March 2025 report was just released by The Leapfrog Group highlighting an urgent issue in maternity care: disparities in the NTSV (Nulliparous, Term, Singleton, Vertex) C-section rates based on race and ethnicity.
According to their latest data, non-Hispanic Black patients have higher C-section rates compared to non-Hispanic white patients in one out of every five hospitals surveyed. More than 1,700 hospitals participated in this report, making it the only national-level resource of its kind.
Research shows that these disparities aren't explained by medical necessity alone.
Instead, they reflect deeper issues in how maternity care is delivered, including bias, systemic inequities, and differences in access to supportive care like midwives and doulas.
Why does this matter? While C-sections can be lifesaving in certain situations, they aren’t risk free and should be done only when truly needed. Having a C-section means higher chances of infection, complications in future pregnancies, and longer recovery times. And the obvious: IT’S MAJOR ABDOMINAL SURGERY!
This data is critical in addressing the larger crisis in U.S. maternal health care. The CDC reports that 80% of pregnancy-related deaths in the U.S. are preventable, yet we continue to see disparities in outcomes by race and ethnicity because of racism and bias. Improving quality of care, expanding access to supportive services, and holding hospitals accountable for their maternity outcomes are necessary steps toward change.
But what can I *do* about this?
If you're pregnant or planning a pregnancy, one thing you can do is ask your hospital about their C-section rates—especially for first-time, low-risk births, and especially if you are a Black birthing person. Scroll down to my resource of the week to see exactly where to get this info.
The more we push for transparency and equity in maternity care, the better outcomes we can create for all parents and babies.
Q&A: How do I know when to go to the hospital?
A: First, let’s get one thing out of the way—you’re never wrong for coming in to get checked. If you think you might be in labor but get sent home, that doesn’t mean you made a mistake. Labor isn’t always predictable!
That said, here are the clear reasons to head to Labor & Delivery:
Your water breaks.
Your contractions are regular, painful, and you can’t talk through them.
Your baby’s movements have changed—you’re feeling less movement or none at all.
You’re bleeding heavily or enough to make you concerned.
Now, there are also some “maybe” reasons where it’s best to call your provider first:
Contractions that aren’t quite regular or strong yet. Painful but still far apart? Every 5 minutes but mild? Let’s talk.
Spotting. This can be normal after sex or a membrane sweep, but it’s worth checking in.
Increased mucus discharge. A sign labor could be coming soon…but not a reason to rush in by itself.
A small leak of fluid after a sneeze. Probably urine, but if you’re unsure, we can check.
One last thing—if you’re less than 37 weeks or have a high-risk pregnancy, always reach out to your provider. And if something just feels off, trust yourself. You always have the right to come in and be evaluated.
Want to get your question answered in the BBC newsletter? Shoot me a message and I’ll incorporate them into future newsletters!
*no personalized medical advice
Resource of the week
This is one of my favorite resources because it pulls back the curtain and empowers you in making your choice about where to have your baby. Because if you can choose between a hospital that has a 30% episiotomy rate or one with a 3% rate…I think I know which one I’d trust with my vagina!
The Leapfrog Group has lots of reports on hospital safety, but it’s their maternity care section that I want to share with you. You can put in your zip code and get information on the following topics and statistics:
I want to call out that this isn’t perfect or the end-all-be-all. In fact, asking your own doctor or midwife about their own rates of interventions like episiotomies or C-sections is may be even more important. But this is one way to feel a bit more informed, and therefore, empowered.
Until next time,
Dr. Jen