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Poster Session 1

Category: Health Equity/Community Health

Poster Session 1

(309) Labor Management Mediates Racial and Ethnic Disparities in Mode of Delivery among an NTSV cohort

Wednesday, February 11, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Nicola F. Tavella, CPH, MPH (he/him/his)

Clinical Research Program Director
Division of Maternal-Fetal Medicine, Icahn School of Medicine, Icahn School of Medicine at Mount Sinai Hospital
New York, New York, United States

Coauthor(s)

KL

Katie Larratt, BA

Icahn School of Medicine at Mount Sinai
New York, New York, United States
CL

Christina Hope Lefebvre, BA

Icahn School of Medicine at Mount Sinai
New York, New York, United States
HN

Hajer Naveed, BA

Medical Student
Icahn School of Medicine at Mount Sinai
New York, New York, United States
DC

Donessa Colley, BA

Medical Student
Icahn School of Medicine at Mount Sinai
New York, New York, United States
LL

Lily Leibner, BA

Icahn School of Medicine at Mount Sinai
New York, New York, United States
MW

Meghna Wagley, BS

SUNY Downstate Health Sciences University
Brooklyn, New York, United States
TS

Toni Stern, MBA, MD, MS

Professor
Icahn School of Medicine at Mount Sinai
New York, New York, United States
Joanne L. Stone, MD, MS

Professor and Chair, Department of Obstetrics, Gynecology, and Reproductive Science
Icahn School of Medicine at Mount Sinai
New York, New York, United States
AB

Angela T. Bianco, MD

Professor and Division Director, Maternal-Fetal Medicine
Icahn School of Medicine at Mount Sinai
New York, New York, United States

Objective:
Research has previously reported racial and ethnic disparities in labor and delivery management. Despite knowledge of disparate care, these differences persist, and their impacts on maternal and neonatal outcomes are under-studied. However, further rigorous investigations can potentially help reduce perinatal health inequities. This study examined racial and ethnic disparities in labor management and these disparities’ mediating effects on the risk of cesarean delivery (CD).

Study Design:
This was a retrospective study of all NTSV deliveries in 2021 at a single urban academic medical center. We included patients who had nulliparous, term, singleton, and vertex gestations and who were admitted for scheduled induction or spontaneous labor. Individual-level data were abstracted from electronic medical records. Multivariable linear regression models estimated the associations between racial or ethnic identity and labor management while adjusting for individual-level covariates. Mediation analysis examined how differences in labor management mediate the relationship between racial and ethnic identity and mode of delivery.

Results:
A sample of 2,717 laboring patients was included. Hispanic patients had significantly longer times from 1) admission to delivery, 2) admission to full dilatation, 3) admission to epidural, and 4) second stage of labor to delivery, compared to White patients. Asian patients also had longer time from admission to delivery compared to White patients (Table 1). Two of these variables (admission to delivery and admission to full dilatation) mediated a greater risk of unplanned cesarean delivery among Hispanic patients compared to the rest of the cohort. A shorter length of time from admission to delivery for Black patients mediated a lower risk of unplanned CD for this group compared to the rest of the cohort (Table 2).

Conclusion:
This suggest that disparate labor management for different NTSV racial and ethnic groups mediates the causal relationship with unplanned CD. Efforts to improve intrapartum health outcomes would therefore benefit from social equity-focused interventions.