{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:21:22Z","timestamp":1767658882049,"version":"3.48.0"},"reference-count":44,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Increasing the vaginal birth after cesarean (VBAC) rate to 18% was a Healthy People 2020 goal. Detailed data on racial\/ethnic differences in VBAC rates is lacking and can inform efforts to equitably increase VBAC rates. This study aimed to assess racial\/ethnic variation in VBAC rates and to describe group trends in VBAC rates in California between 2011 and 2021.<\/jats:p>\n                  <jats:p>This retrospective cohort study used a database of birth certificates linked to hospital discharge records. We analyzed singleton, term live births among people who had a history of at least one prior cesarean birth, no identified contraindications to a vaginal birth, and self-identified their racial\/ethnic group as Hispanic or non-Hispanic (American Indian-Alaskan Native (AIAN), Asian, Black, Hawaiian\/Pacific Islander, or white). VBAC births were identified from birth certificate records. Differences between VBAC rates were assessed using univariable and multivariable Poisson log-linear regression while adjusting for potential confounders.<\/jats:p>\n                  <jats:p>A total of 607,808 birthing people were included (2,234 AIAN, 84,899 Asian, 34,217 Black, 2,559 Hawaiian\/Pacific Islander, 334,116 Hispanic, 149,783 white). Over the study period, Hawaiian\/Pacific Islander birthing people had the highest average VBAC rate at 11.5% (AIAN, 6.5%; Asian, 8.8%; Black, 8.0%; Hispanic, 7.4%; white, 9.5%). In adjusted models, Black (aRR\u2009=\u20091.06, 95% CI: 1.01\u20131.11) and Hawaiian\/Pacific Islander (aRR\u2009=\u20091.43, 95% CI: 1.27\u20131.61) birthing people were more likely to have a VBAC compared with white birthing people, while Hispanic birthing people were less likely (aRR\u2009=\u20090.96, 95% CI: 0.93\u20130.98). VBAC rates increased significantly (p\u2009&lt;\u20090.001) over time for all groups except AIAN birthing people.<\/jats:p>\n                  <jats:p>VBAC rates increased for most racial\/ethnic groups in California. With the exception of the Hawaiian\/Pacific Islander group, there were small and likely not clinically significant differences in the chances for a VBAC across groups. No group in California met the Healthy People 2020 goal VBAC rate of 18%.<\/jats:p>","DOI":"10.1055\/a-2593-0555","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T19:44:24Z","timestamp":1747079064000},"page":"145-154","source":"Crossref","is-referenced-by-count":0,"title":["Assessing Racial\/Ethnic Variation and Trends in Vaginal Birth after Cesarean in California: A Retrospective Cohort Study Using Linked Birth Certificate and Hospital Discharge Records"],"prefix":"10.1055","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6955-0532","authenticated-orcid":false,"given":"Nicholas","family":"Rubashkin","sequence":"additional","affiliation":[{"name":"Division of Ob\/Gyn Hospital Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco School of Medicine, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. Nicole","family":"Teal","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California at San Diego School of Medicine, San Diego, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca J.","family":"Baer","sequence":"additional","affiliation":[{"name":"California Preterm Birth Initiative, University of California at San Francisco School of Medicine, San Francisco, California"},{"name":"Department of Pediatrics, University of California at San Diego School of Medicine, La Jolla, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saraswathi","family":"Vedam","sequence":"additional","affiliation":[{"name":"Birth Place Lab, Faculty of Medicine, University of British Columbia, Vancouver, Canada"},{"name":"School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Kuppermann","sequence":"additional","affiliation":[{"name":"California Preterm Birth Initiative, University of California at San Francisco School of Medicine, San Francisco, California"},{"name":"Departments of Obstetrics, Gynecology and Reproductive Sciences (Division of Maternal Fetal Medicine) and Epidemiology and Biostatistics, University of California at San Francisco School of Medicine, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Lanouette","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Harvard TH Chan School of Public Health, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura L.","family":"Jelliffe-Pawlowski","sequence":"additional","affiliation":[{"name":"California Preterm Birth Initiative, University of California at San Francisco School of Medicine, San Francisco, California"},{"name":"Department of Epidemiology and Biostatistics, University of California at San Francisco School of Medicine, San Francisco, California"},{"name":"Institute for Global Health Sciences, University of California San Francisco School of Medicine, San Francisco, California"},{"name":"Mory Meyers College of Nursing, New York University, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa G.","family":"Rosenstein","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California at San Francisco School of Medicine, San Francisco, 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