Vaginal Birth After Cesarean Calculator: Fair or Unfair?

In 2021, the vaginal birth after cesarean (VBAC) calculator was revised to address concerns about equity. This tool was originally designed to estimate the likelihood of successful vaginal birth after a previous cesarean delivery. One of the factors considered by the algorithm was race and ethnicity. This meant that Black and Hispanic patients often received lower probabilities for VBAC. The revision aimed to minimize any potential bias, but the question remains: does using these race-adjusted algorithms still create health inequalities? The calculator's adjustments based on race might seem like a helpful tool in predicting birth outcomes. However, it might also perpetuate deep-seated biases within the healthcare system. By using race as a factor, the algorithm could inadvertently label certain groups as less likely to succeed, potentially leading to discrimination in perinatal care. Moreover, these calculators don't consider individual circumstances or the vast diversity within racial and ethnic groups. They simplify complex health factors into broad categories, which can be misleading. A critical look at such tools reveals that they might not be as fair or accurate as they claim to be. The revision of the VBAC calculator is a step in the right direction, but there's still a long way to go in ensuring equity in healthcare. It's crucial to continuously evaluate and adjust these tools to avoid reinforcing health disparities.