When a woman gives birth by cesarean section, a nationally accepted standard typically helps decide whether she’ll need the same procedure next time; but within the University of Maryland Medical System, race and ethnicity will no longer be part of calculations used to determine that.

“This is important for all of the algorithms, practice guidelines and calculators that we’re examining, reexamining here,” said Dr. Joseph L. Wright, vice president and chief health equity officer for UMMS.

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UMMS’ revised Vaginal Birth After Cesarean calculator, known as VBAC 2.0, is endorsed by the American College of Obstetricians and Gynecologists that explains its rationale as follows:

“Given the increasing recognition that differences in outcome by race are not biologically based but rather reflect the impact of systemic racism, social determinants of health, and clinician bias, utilizing race and ethnicity variables in a VBAC (vaginal birth after cesarean) calculator may deter patients and clinicians from TOLAC (trial of labor after cesarean) without biologic cause and thereby reinforce inequity rather than support patient-centered care,” the group’s website states.

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