Addressing Disparities in Care on Labor and Delivery

Purpose of Review This review aims to discuss how racism and discrimination on labor and delivery contribute to disparities in maternal morbidity and mortality, as well as potential levers for improvement. Recent Findings There is a growing body of evidence on effective interventions for reducing the impact of racism and discrimination on labor and delivery. Summary There are significant racial and ethnic disparities in the USA in cesarean rate, maternal morbidity and mortality, as well as neonatal morbidity and mortality. This article focuses on the impact of racism and discrimination on labor and delivery, but it is important to recognize that those effects begin long before a patient presents to deliver. Here, we explore 4 pathways of how racism and discrimination on labor and delivery contribute to disparities in obstetric outcomes: (1) care segregation, (2) care variation, (3) communication and cultural humility, and (4) structural racism/policy. Finally, we describe examples of levers for change at the level of each pathway.