Trends Before and After the Removal of Race and Ethnicity from the Vaginal Birth After Cesarean Calculator

Abstract

We conducted a population-based retrospective cohort study and performed interrupted time series analyses to examine whether the removal of race and ethnicity from the vaginal birth after cesarean (VBAC) calculator was associated with changes in rates of trial of labor after cesarean (TOLAC) and VBAC in the United States. After the calculator revision, rates of TOLAC and VBAC in the overall eligible population and among the four largest racial and ethnic groups (Hispanic, non-Hispanic Asian, non-Hispanic Black, and non-Hispanic White) (rate ratios ranged from 0.99 to 1.04, and all 95% CIs included the null) were unchanged. Rates of successful VBAC among Hispanic (75.0%), non-Hispanic Asian (71.0%), and non-Hispanic Black (67.0%) people remained lower compared with non-Hispanic White people (77.2%). More work is needed to address the significant racial disparities that persist for TOLAC outcomes.