Yale Economist Discusses Relationship Between Race, C-Section Delivery Decisions

 The KU Economics Department kicked off its prestigious Guest Speaker series for the 2026-27 academic year on September 9 with a special seminar from Professor Janet Currie on her fascinating research regarding race and the extent to which physician discretion comes into play regarding decisions to deliver babies via Cesarean section. (“Doctor Decision-Making and Racial Gaps in C-Sections”)

Professor Currie, a professor of Economics at Yale University and past president of the American Society of Health Economists, also co-directs the Program on Families and Children at the National Bureau of Economic Research (NBER). A pioneer in the economic analysis of child development, her current research focuses on socioeconomic differences in health, environmental threats to health, child mental health, and the long-run impacts of child health. 

Her presentation, drawn from her collaboration with two other prominent health economists (“Drivers of Racial Differences in C-Section” - NBER Working Paper 32891, with Adriana Corredor-Waldron and Molly Schnell) asks the important question as to why US Black mothers with a trial of labor are 25 percent more likely to deliver by C-section than non-Hispanic White mothers. Professor Currie explained that a key part of the reason appears to relate to provider discretion—rather than differences in unobserved medical risk.  The bottom line is that many physicians appear to have a lower threshold for performing intrapartum C-sections on Black mothers.

While Cesarean deliveries can be lifesaving, prior research has shown that unnecessary C-sections increase the costs of medical care and involve a higher risk of maternal complications than vaginal births; that higher rates of C-sections among Black mothers could be a factor in higher rates of Black maternal morbidity; and that Cesarean deliveries are more likely to complicate future pregnancies. Moreover, the children themselves can also be negatively affected - and a recent CDC study in 2023 noted that Black Americans tend to have higher rates of diabetes, hypertension, obesity, asthma, and heart disease compared to White Americans.

The primary data for the study came from 993,165 New Jersey Electronic Birth Certificate (EBC) records for 2008 to 2017. The EBC records include rich information on delivery method, maternal medical risk factors, complications during labor and delivery, hospital of delivery, and attendant provider’s name. The data further include self-identified patient race and other sociodemographic characteristics including education, age, marital status, zip code of residence, and participation in Medicaid.

Fifth-year KU Ph.D. candidate Syeda Marjana Razzak, whose research examines how public policies shape health, labor market, and socioeconomic outcomes, said that she was especially impressed as to how Professor Currie’s presentation underlined the ongoing implications of C-sections.

“Once you have one, it tends to shape how every future pregnancy gets handled. So, a decision made in one delivery room can follow a woman for years. Beyond the research side, it just made me think about how much a woman's body goes through that we don't always talk about outside of a data table,” Syeda said. “As someone interested in health economics, I found the talk really interesting because it connected the research question to something that has such real and lasting effects on women’s lives.”

Third-year doctoral student David Robinow said that Professor Currie’s research was especially important because of the extent to which it asked the relevant questions and then addressed them, “regardless of how uncomfortable they may be to ask.”

David, who had private sector public health research experience during the pandemic prior to transitioning to academia, was especially struck by the seminar, noting that he thought “everyone in the room, from undergrads in other fields to tenured faculty walked away with something because it was presented in such an intuitive form.”

Professor Currie, who was the 2024 President of the American Economic Association, is a member of the U.S. National Academy of Sciences, the National Academy of Medicine, the American Academy of Art and Sciences, and the British Academy, and holds honorary degrees from the University of Lyon, the University of Zurich, and the Università della Svizzera Italiana.  Two of her most recent honors include the Victor Fuchs Award for lifetime contributions to health economics and the Sara McLanahan Award for extraordinary contributions to the study of the well-being of children and families.