At Swedish, a historic drop in C-sections among Black mothers
[5 min read]
In this article:
- A recent study at a New Jersey hospital showed that Black mothers are 25% more likely than white mothers to undergo cesarean section.
- Black mothers also report less concern for their pain and significant feelings of being left out of decision-making during childbirth.
- Providence Swedish is committed to ending these inequities and our JUST Birth and TeamBirth initiatives have yielded a historic drop in C-sections and more mothers reporting overall satisfaction with their childbirth experience.
Providence Swedish is having significant success turning around a particularly stark racial disparity among Black women in childbirth: C-section rates. Recently released statistics from Swedish’s First Hill campus show that Providence Swedish’s TeamBirth and Justice Unity Support Trust (JUST) Birth initiatives reduced cesarean section rates among Black, Indigenous and POC mothers to less than 25 percent. The drop is so significant that at Swedish First Hill, C-section rates among Black mothers are now lower than among white mothers.
“When I looked at the data, I just didn’t believe it,” says Tanya Sorensen, M.D., executive director of Providence Swedish’s Women’s and Children’s Institute. “We have been working on this for such a long time and just kept getting beat up by the numbers, which are a result of centuries of institutional racism.”
JUST Birth, launched in 2022, strives to provide our Black and Native patients with an umbrella of culturally connected, authentic care from the start of pregnancy through the postpartum experience — supporting and improving the birthing experiences of Black, African American, African, Native American, Alaskan Native, Native Hawaiian, Pacific Islander, and Latinx people from across the sex and gender identity spectrum. JUST Birth includes dedicated cultural navigators, childbirth educators, and birth and postpartum doulas who provide patients and their families with expert care and guidance throughout their pregnancy and birth.
TeamBirth improves care by ensuring people giving birth and the clinicians caring for them have shared input and understanding during the delivery of care. The program calls for team huddles at key decision points throughout the hospital stay. Huddles happen on admission to the hospital, with any changes to the patient or child’s condition, when decisions are made surrounding delivery and any time the patient or a team member requests a huddle.
Since the implementation of TeamBirth and JUST Birth, patients report of an improved sense of being listened to, pain treatment and having more input into decisions about birth plans. This feedback has been critical, particularly around pain management, says Dr. Sorensen, noting that non-white patients’ pain has historically been unaddressed and under treated.
Additionally, the expansion of Medicaid coverage for doula care will allow JUST Birth to reach more patients, including those who could not previously be covered by the programs grant funding or by other community organizations. This has been a major step forward in providing equitable care.
Black and Brown mothers have long been subject to inequitable treatment in the delivery room, experiencing significant discrepancies in pain management, care team communication and their ability to be listened to when they advocate for themselves. In fact, a study published last year from the National Bureau of Economic Research highlighted the extent of the inequities with its findings that Black women were 25% more likely than white women to undergo an unnecessary c-section, meaning that childbirth is proceeding normally and there are no emergent circumstances.
Dr. Sorensen credits the tireless leadership of JUST Birth Network founder Sauleiha Akangbe and her team with this victory and continuing to change in pregnancy and childbirth care at Swedish.
“So often we see Black families being neglected by caregivers in different race categories, so we’ve put a big focus on how we can be intentional in providing support for those families. My goal and our team’s goal is to continue having these numbers decrease and making sure that we are providing access to culturally congruent care for these families,” says Akangbe. “We want to keep this moving and stick with this program because it works, we see the results, and the families feel the positive impact on their lives and their experiences in our hospitals. We know that [with TeamBirth and JUST Birth] having doulas present and having conversations that empower patients to be in control of their care is a gamechanger.”
Learn more and find physician or advanced practice clinician (APC)
Swedish has three birth centers — First Hill, Issaquah and Edmonds — making it convenient for people who live or work in the Seattle, Eastside and North End areas. Swedish patients can take classes, meet other families, get help with lactation and go for new parents and well-baby checkups at The Lytle Center for Pregnancy & Newborns at our First Hill birth center. You can also get expert advice there and help with wellness. Visit our website to learn more about midwives at Swedish and how they can partner with you to create the most personalized birthing experience possible.
If you need a gynecologist, women's health specialist or primary care doctor, Swedish is here for you. Whether you require an in-person visit or want to consult a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.
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Additional resources
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This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.
