Louise Marie Roth and Megan Henley, “Unequal Motherhood: Racial-Ethnic and Socioeconomic Disparities in Cesarean Sections in the United States,” Social Problems, May 2012

Ain’t Too Posh to Push

Privileged moms like Victoria Beckham and Tori Spelling, with four cesareans each, have given rise to the idea that some women are “too posh to push,” scheduling their births instead.

Not so, say Louise Marie Roth and Megan Henley (Social Problems, May 2012), who examined data from 3.7 million U.S. births in 2006.  At first pass, higher levels of education appeared to be associated with greater odds of cesarean birth. But once race, age, pregnancy characteristics (pre-term birth, multiples, low birth weight, etc.), and complications of labor and delivery were taken into account, white women with greater privilege were shown to be the least likely to have surgical births. Other studies have shown that highly educated white women also choose home birth more than any other group.

Roth and Henley suggest class and race play a big role in the quality of medical care women receive. C-sections, which now make up one-third of all U.S. births, are associated with increased maternal deaths and other post-surgical complications. Minority women of lower socioeconomic status are more likely to have cesareans for less urgent reasons, suggesting that what looks like “posh” medical treatment on the surface might actually be a sign of low quality maternity care. Apparently, with privilege comes the ability to exercise more control in the delivery room and avoid, rather than choose, surgical delivery.

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