Racial Differences Seen in Discretionary Prenatal Care

For example, Black women less likely to have depression screening, more likely to have urine drug test than White women

By Lori Solomon HealthDay Reporter

THURSDAY, March 23, 2023 (HealthDay News) — Racial disparities in discretionary prenatal care are common, according to a study published online March 22 in Birth.

Mary A. Byrn, Ph.D., R.N., from Loyola University Chicago, and colleagues used electronic medical record data to identify 7,056 patients receiving perinatal care within a large hospital system between January 2012 and September 2018. Differences in perinatal care were examined by race.

The researchers found that for nondiscretionary care (e.g., guideline-based or based on expert recommendations), there were few differences by race. However, for discretionary care, racial differences were observed. For example, compared with non-Hispanic White women, non-Hispanic Black women were less likely to receive a prenatal depression screen (odds ratio, 0.8) and were more likely to have a urine drug test when denying drug use (odds ratio, 1.6). Hispanic (odds ratio, 0.6) and Asian (odds ratio, 0.4) women were less likely to have a urine drug test completed when denying drug use.

“Perinatal care differs by maternal race/ethnicity, particularly when guidelines or expert recommendations are absent,” the authors write. “Greater efforts need to be made to identify and mitigate providers’ implicit and explicit biases; expanded professional guidelines may offer some protections against inequitable, discretionary care.”