Vaginal birth after cesarean more common at Black-serving hospitals – News-Medical

Low-risk patients at hospitals that predominantly serve Black patients are more likely to attempt and successfully complete a vaginal birth after a previous Cesarean section than patients at hospitals serving fewer Black patients, according to new research led by UCLA.

The study, published May 15, 2026, in the peer-reviewed journal Obstetrics & Gynecology, suggests that the specific environment and institutional willingness of a hospital can significantly influence the outcomes of vaginal birth after Cesarean (VBAC) attempts.

Researchers analyzed data from the US National Inpatient Sample spanning 2017 to 2019. The analysis focused on more than 1.7 million patients who had previously undergone cesareans, specifically isolating low-risk deliveries to determine how hospital type impacted success rates.

To conduct the analysis, the research team categorized hospitals into three groups based on the proportion of Black patients they served: high Black-serving hospitals (BSH), medium BSH, and low BSH.

The findings revealed that Black patients at high BSH hospitals had a 72% higher likelihood of a successful VBAC across any hospital type compared to those in other settings.

However, the data also highlighted a persistent racial disparity in maternal health. Regardless of the type of hospital, Black patients were less likely to achieve a successful vaginal birth after a Cesarean than white patients.

Dr. Max Jordan Nguemeni, the study’s lead author and an assistant professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA, noted the systemic challenges facing Black women in the U.S. Healthcare system.

Black women in the United States have a higher rate of cesarean deliveries and already face much higher rates of severe pregnancy complications and death,

Dr. Max Jordan Nguemeni

The research indicates that the location of delivery plays a critical role in whether a patient is supported in their goal to avoid a repeat Cesarean section.

Our findings show that where someone gives birth matters, and that certain hospitals appear better equipped or more willing to support labor after cesarean, even for patients who face higher risks of adverse obstetric outcomes.

Dr. Max Jordan Nguemeni

The results suggest that hospitals serving higher concentrations of Black patients may have protocols or clinical cultures that are more supportive of VBAC for low-risk patients, potentially mitigating some of the risks associated with repeat surgical deliveries.

VBAC is often sought by patients to avoid the increased surgical risks associated with multiple Cesarean sections, though the decision to attempt a vaginal birth after a prior C-section depends on individual health factors and the medical guidance of obstetric providers.