• Posted December 17, 2025

C-Section Risk Higher Among Sexual Minorities, Study Finds

People who identify as a sexual minority are more likely to undergo a C-section birth, a new study reports.

Overall, sexual minority people had a 7% higher risk of requiring a Cesarean delivery, researchers report in the February 2026 issue of The Lancet Regional Health.

The highest risk was among people who identify as heterosexual but report having prior same-sex experience, researchers found. Those individuals had a 12% risk of C-section.

And if a person required induced labor, the risk of C-section was even higher, rising to 21%, researchers found.

Researchers couldn’t say why sexual minority people have a greater risk of C-section, but noted that use of assisted reproduction for conception might play a role.

Previous studies have linked assisted reproduction technologies with higher odds of C-section compared to spontaneous conception, the team wrote.

“Very little national data captures both detailed sexual-orientation measures and birth outcomes,” lead researcher Dr. Sarah McKetta, an assistant professor of epidemiology at the Columbia University Mailman School of Public Health, said in a news release.

“By combining three rich national surveys, we were able to identify elevated risks among subgroups — particularly heterosexual participants with same-sex experience — who have been largely absent from perinatal research,” McKetta said.

In the U.S., Cesarean births account for more than 1.1 million surgeries performed each year, and make up more than a quarter (26%) of low-risk births, researchers said in background notes.

However, C-sections increase the risk of health problems for both mother and child, and groups like the American College of Obstetricians & Gynecologists has called for a reduction in unnecessary C-sections, researchers said.

For the new study, researchers pooled data from three large, long-running U.S. studies, amounting to more than 102,000 pregnancies among people born between 1947 and 1997.

Sexual minority pregnancies represented about 14% of all pregnancies in the sample, although results showed that less than 1% came from participants identifying as lesbian or gay.

About 8% of pregnancies involved people who identify as heterosexual but who have same-sex experience, researchers said.

The study also found higher rates of induced labor among sexual minority people.

“This is notable because the Cesarean disparity was greatest following induction — raising concerns about potential differences, including provider bias, in decision-making around interventions,” McKetta said.

“Future research should examine individual, interpersonal and structural factors contributing to these disparities so we can design interventions that reduce them,” McKetta said.

“Clinicians should also be mindful of unintentionally lowering the threshold for moving from induction to Cesarean among sexual minority patients, which may worsen existing inequities,” McKetta added. “Reducing unwarranted Cesareans in this population will improve health outcomes and support national goals to decrease primary Cesarean births.”

More information

Harvard Medical School has more on Caesarean section.

SOURCE: Columbia University, news release, Dec. 11, 2025