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Experiences of Discrimination Are Associated With Risk for Cesarean Delivery [A157]

INTRODUCTION: Discrimination is a chronic stressor associated with poor health outcomes and may contribute to persistent disparities in health and pregnancy outcomes. The purpose of this study is to examine the association between discrimination reported in pregnancy and nulliparous, term, singleton, vertex (NTSV) cesarean birth rates. METHODS: Participants between the ages of 18 and 39 with singleton pregnancies at 18–27 weeks recruited from obstetrics and gynecology clinics at Tampa General Genesis Health Park and the University of South Florida: South Tampa Center Clinic. Participants completed the Williams Everyday Discrimination Scale (WEDS), Perceived Ethnic Discrimination Questionnaire (PEDQ), and Experiences in Ambivalent Sexism Inventory (EASI). After delivery, pregnancy and delivery outcomes were abstracted from the patient’s electronic medical record. Logistic regression was used to test associations between cesarean delivery and each discrimination measure. Analyses were also adjusted for NTSV status and race. RESULTS: A total of 206 participants were recruited; 190 had complete data. The overall cesarean delivery rate was 28.42%. The NTSV cesarean delivery rate was 20.45%. There was a positive association between cesarean delivery rate and both WEDS (P=.049) and PEDQ (P=.029). There was no association between cesarean delivery and EASI. CONCLUSION: Lifetime everyday discrimination and ethnic discrimination experiences were associated with higher odds of cesarean delivery. This may reflect that individuals who experience more discrimination may exist in systems with more bias, or that the stress experience of discrimination could affect physiology that leads to increased cesarean rates. More work is needed to further understand how interpersonal, structural, and systemic discrimination influence cesarean delivery rates.