{"title":"Removal of the Race-Based Correction in the Vaginal Birth After Cesarean Calculator.","authors":"Summer Sherburne Hawkins","doi":"10.1016/j.jogn.2025.03.006","DOIUrl":null,"url":null,"abstract":"<p><p>In 2007, the Maternal-Fetal Medicine Units Network published a clinical calculator with a race-based correction factor that systematically lowered the predictive probability of a Black or Hispanic woman having a successful vaginal birth after cesarean (VBAC). The ensuing pushback that race is a social construct and not a biological factor led to the removal of race and ethnicity in the updated Maternal-Fetal Medicine Units Network VBAC calculator in 2021. In this column, I provide a brief overview of the inclusion of race in clinical algorithms and the development of VBAC calculators, evaluations of the calculators on VBACs by race and ethnicity, and the implications for research, practice, and policy. I conclude with information from professional organizations and the need for updating clinical guidelines to recommend health care systems and clinicians to adopt the revised VBAC calculator.</p>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jogn.2025.03.006","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
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Abstract
In 2007, the Maternal-Fetal Medicine Units Network published a clinical calculator with a race-based correction factor that systematically lowered the predictive probability of a Black or Hispanic woman having a successful vaginal birth after cesarean (VBAC). The ensuing pushback that race is a social construct and not a biological factor led to the removal of race and ethnicity in the updated Maternal-Fetal Medicine Units Network VBAC calculator in 2021. In this column, I provide a brief overview of the inclusion of race in clinical algorithms and the development of VBAC calculators, evaluations of the calculators on VBACs by race and ethnicity, and the implications for research, practice, and policy. I conclude with information from professional organizations and the need for updating clinical guidelines to recommend health care systems and clinicians to adopt the revised VBAC calculator.
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JOGNN is a premier resource for health care professionals committed to clinical scholarship that advances the health care of women and newborns. With a focus on nursing practice, JOGNN addresses the latest research, practice issues, policies, opinions, and trends in the care of women, childbearing families, and newborns.
This peer-reviewed scientific and technical journal is highly respected for groundbreaking articles on important - and sometimes controversial - issues. Articles published in JOGNN emphasize research evidence and clinical practice, building both science and clinical applications. JOGNN seeks clinical, policy and research manuscripts on the evidence supporting current best practice as well as developing or emerging practice trends. A balance of quantitative and qualitative research with an emphasis on biobehavioral outcome studies and intervention trials is desired. Manuscripts are welcomed on all subjects focused on the care of women, childbearing families, and newborns.
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