Inequalities in cesarean births between American Indian & Alaska Native and White people.

The unadjusted lower cesarean birth incidence observed among American Indian & Alaska Native individuals compared to White individuals may be related to their younger mean age at birth. After adjusting for this demographic difference, we demonstrate that American Indian & Alaska Native individuals undergo cesarean birth more frequently than White individuals with similar risk profiles, particularly within the low-risk Robson group 1 and those with non-cephalic presentations (Robson groups 6 & 9). Racism and bias in clinical decision-making, structural racism, colonialism, or other unidentified factors may contribute to this inequality. This article is protected by copyright. All rights reserved.