Racial disparities in birth satisfaction among nulliparous women

Abstract

Given the known racial disparities in perinatal outcomes, we explored birth satisfaction scores among women of racial and ethnic minorities after implementing Spinning Babies® at our institution. This is a secondary analysis of a prospective cohort study investigating a delivery intervention called Spinning Babies®. Women who delivered between 6/2021 and 6/2022 received either Spinning Babies® labor techniques or standard care. Inclusion criteria were nulliparity, vertex presentation, livebirth, singleton, and gestational age > 37 weeks. We excluded precipitous deliveries (< 3 hours) and contraindications to labor. Consented subjects were asked postpartum to complete a demographic survey and the Birth Satisfaction Scale–Revised. Stress experienced during labor, personal attributes, and quality of care provision are 3 validated sub-measures contributing to the total birth satisfaction score that were further analyzed. Labor characteristics were obtained from the medical record. Of the 504 subjects with complete data, there were racial/ethnic differences in maternal age and social support (Table 1). Asian women had a significantly lower total satisfaction score compared to White, Hispanic, and Black women, though this difference was no longer significant when adjusted for complicating labor factors (Figure 1). There was a significant difference in personal attributes for Hispanic and Asian women compared to Black and White women, and this difference persisted after adjustment. There were no significant differences by racial group in stress experienced and quality of care domains. Women of racial minority groups experienced more negative personal attributes, a score capturing anxiety and lack of control, even when controlling for factors such as induction, prolonged labor or cesarean delivery. Understanding the causes of increased anxiety and lack of control in racial minority groups can help target ways to alleviate these negative experiences and promote improved maternal outcomes for all women.View Large Image Figure ViewerDownload Hi-res image Download (PPT)