{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T11:54:24Z","timestamp":1787918064622,"version":"build-2784847793"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T00:00:00Z","timestamp":1740960000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Non\u2010Hispanic Black individuals have the highest odds of having a nulliparous term singleton vertex (NTSV) cesarean birth out of all racial and ethnic groups, but this disparity is not well understood. This study assesses the factors associated with overall rates of NTSV cesarean delivery, differences in reasons for cesarean births, and door\u2010to\u2010delivery time among individuals who had an NTSV cesarean delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Retrospective analyses assessed\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200931,826 NTSV births from January 1, 2016 to December 31, 2021 at 11 medical centers in North Carolina. For each outcome variable, multivariate regression estimated Black\u2010White disparities while controlling for clinical and social covariates. Models included random intercepts for facility and delivery provider.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After accounting for covariates, non\u2010Hispanic Black patients were more likely to have an NTSV cesarean delivery compared to non\u2010Hispanic White patients (AOR\u2009=\u20091.48, 95% CI 1.47, 1.69). Among those who had an NTSV cesarean delivery, non\u2010Hispanic Black patients were more likely than non\u2010Hispanic White patients to have a cesarean delivery due to fetal intolerance of labor (AOR\u2009=\u20092.10, 95% CI 1.87, 2.42). Non\u2010Hispanic Black patients had a shorter door\u2010to\u2010delivery time for unscheduled NTSV cesarean deliveries than non\u2010Hispanic White patients (\n                      <jats:italic>b<\/jats:italic>\n                      \u2009=\u2009\u22121.80, 95% CI \u22122.50, \u22121.11).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We confirmed the persistence of a racial disparity in cesarean delivery rates after controlling for multiple social and clinical factors. As fetal intolerance of labor has been described as a subjective indicator, and faster door\u2010to\u2010delivery time for cesarean deliveries may indicate faster decision making, our findings indicate a need to better understand decision making around cesarean deliveries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/birt.12906","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T16:51:45Z","timestamp":1741711905000},"page":"618-626","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Racial Disparities in Nulliparous Singleton Term Vertex Cesarean Deliveries: Rates, Reasons, and Time to Delivery"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6497-1530","authenticated-orcid":false,"given":"Kiran","family":"McCloskey","sequence":"first","affiliation":[{"name":"Office of Health Equity and Community Health Novant Health  Winston\u2010Salem NorthCarolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber","family":"Woodard","sequence":"additional","affiliation":[{"name":"Institute of Safety and Quality Novant Health  Winston\u2010Salem NorthCarolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chere","family":"Gregory","sequence":"additional","affiliation":[{"name":"Office of Health Equity and Community Health Novant Health  Winston\u2010Salem NorthCarolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis","family":"Lipscomb","sequence":"additional","affiliation":[{"name":"Women's &amp; Children's Institute Novant Health  Winston\u2010Salem NorthCarolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noellee","family":"Clarke","sequence":"additional","affiliation":[{"name":"Analytics and Informatics Novant Health  Winston\u2010Salem NorthCarolina 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