Key facts
- Women from Black and Asian backgrounds are less likely to receive epidural pain relief during childbirth in the UK.
- Research analyzed over 2.7 million births in the UK over a 10-year period up to 2021.
- Bangladeshi, Pakistani, and Black Caribbean women were significantly less likely to receive epidurals than white women.
- Black Caribbean-British and Black African-British women are more likely to receive general anesthesia during elective C-sections.
- Experts attribute these disparities to racialized assumptions, institutional racism, and a lack of trust in healthcare settings.
- Calls have been made for better data collection on ethnic disparities in pain management.
Women from Black and Asian backgrounds in the UK are significantly less likely to receive epidural pain relief during childbirth compared to their white counterparts, according to new research. The study, published in the journal Anaesthesia and analyzing data from over 2.7 million births between 2011 and 2021, found that women of Bangladeshi, Pakistani, and Black Caribbean descent had a lower likelihood of receiving epidurals during vaginal births.
Furthermore, Black Caribbean-British women were 58% more likely, and Black African-British women 35% more likely, to receive general anesthesia instead of regional anesthesia for elective Cesarean sections. This is concerning as general anesthesia is typically reserved for emergencies and carries higher risks.
Experts and lawmakers have raised alarms about an 'ethnicity pain gap,' suggesting that racialized assumptions and institutional racism lead to pain being dismissed or downplayed for patients of color. Bell Ribeiro-Addy, MP and chair of the all-party parliamentary group on black maternal health, stated that racialized assumptions are a key driver of unequal outcomes, noting that Black people's pain has historically been doubted and dismissed.
Dr. Nuala Lucas, co-author of the study, highlighted the particular concern for women with ill health or premature births who might particularly benefit from effective pain relief. The research also pointed to a 'systemic distrust' between ethnic minority women and healthcare practitioners, impacting their involvement in decisions about pain relief.
This study adds to a growing body of evidence detailing racial inequalities in healthcare, including pain management across different medical settings. Medical royal colleges have called for better data collection to identify and address these disparities, emphasizing the need for improved communication, trust, and a stronger anti-racist culture within healthcare institutions.