Provider influence and racial disparities in child-birth: examining pressures for labor inductions, epidurals, andcesarean section deliveries

Maternal healthcare inequalities in the United States are pronounced in the pressures Black, Hispanic, Asian, and White womenface to undergo labor induction, epidural analgesia, and cesarean section interventions that perpetuate disparities in autonomy, morbidity, and mortality (Centers for Disease Control and Prevention, 2024; Hoffman et al., 2016; Vedam et al., 2019;). Although these interventions might be necessary in some cases, systemic racism, cultural bias, and structural barriers disproportionately expose women of color to nonconsensual or inadequately explained interventions. For instance, Black women experience C-sections at 36% of births than other women (Huesch et al., 2015). Comparably, Hispanic women experience pressure for medical interventions, such as labor inductions and cesarean delivery, and face a heightened risk of discrimination due to language barriers (Valdez et al., 2023). Similarly, Asian women experience higher odds of cesarean delivery due to failure to progress compared to White women (Okwandu et al., 2021). White women, though privileged by systemic bias, report feeling more pressure to induce labor compared to Latina women (Declercq et al., 2020). Although researchers have suggested an association between race and birth outcomes, more research is needed regarding the specific pressures women face during labor induction, epidural use, and cesarean section and which racial groups experience heightened pressure for specific interventions. The purpose of this study is to explore racial disparities in perceived pressure for these interventions and to highlight how provider practices disproportionately constrain autonomy among Black, Hispanic, Asian, and White women during childbirth.