Characteristics and Outcomes Among Asian Birthing People in the American Association of Birth Centers Perinatal Data Registry.

Background: Asian birthing people have the second highest rates of cesarean birth (CB), lowest rates of community (home and birth center), and midwife-attended births compared to other racial and ethnic groups in the United States.

Methods: The American Association of Birth Centers Perinatal Data Registry (PDR) was used to abstract socio-demographic and clinical data. Logistic regression analyses identified the drivers of cesarean birth among Asian birthing people in the overall and community birth eligible samples.

Results: Between 2007 and 2021, 2983 people self-identified as Asian within the PDR. The Asian sample had a lower percentage of birth center births and a higher percentage of hospital births, CB, gestational diabetes, and postpartum hemorrhage compared to the overall sample. The cesarean rate in the Asian sample was 12.4%. Asian multiparous birthing people were at 1.5 greater odds of CB compared to White multiparous birthing people (OR = 1.54; 95% CI, 1.19-2.03; p < 0.01). Asians in the community birth eligible group had higher odds of CB compared to their White counterparts (OR = 1.54; 95% CI, 1.23-1.93; p < 0.01). Asian and White multiparous birthing people admitted to the hospital from the community birth eligible group had five times higher odds of CB compared to the total sample of Asian and White multiparous birthing people (OR = 5.18; 95% CI, 3.77-7.12; p < 0.01).

Discussion: There were lower rates of CB among Asians who birthed in PDR user sites compared to the national average. Future research is needed in community birth outcomes among different Asian ethnicities and Asian birthing people's perspective on community birth.