- Socioeconomic gap in pain relief
- Wealth affects epidural accessibility
- Research highlights postpartum pain disparities
A study demonstrates that affluent women are significantly more likely to receive an epidural during labour.
According to researchers, women from disadvantaged socioeconomic backgrounds may experience increased pressure to endure childbirth pain or encounter discrimination.
Excluding scheduled caesarean sections, they analysed the care provided to 593,230 women who gave birth between January 2007 and October 2020. For pain relief, 131,521 (22.2 percent) of these patients received an epidural.
Analysis revealed, however, that women from more affluent areas were 19% more likely to receive an epidural than those from more impoverished areas.
The disparity was even more pronounced in cases where there was unequivocal documentation demonstrating the medical necessity of an epidural.
Wealth Gap Affects Epidural Access
In such situations, there was a 27% greater likelihood that women residing in the wealthiest 10% of regions would obtain pain relief as opposed to those residing in the poorest 10%.
The research, which utilised data from Scottish National Health Service (NHS)-accredited midwives, was published in Anaesthesia, the official journal of the Association of Anaesthetists. A team of researchers, led by Dr Lucy Halliday from the University of Glasgow, made the following observations: “These women [in the poorest groups] may be uninformed about the indications for epidural analgesia; their life circumstances may negatively affect their ability to attend antenatal care; they may mistrust medical staff; they may feel helpless during labour. They may have misconceptions about the safety of epidurals. Or they may have different expectations and societal pressures regarding the pain of childbirth.”
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Additionally, variations in the attitudes of healthcare professionals could impact the utilisation of epidurals during childbirth.
“We found that women from areas of greater socioeconomic disadvantage were significantly less likely to receive an epidural for pain relief,” the authors continued.
£50M to Address Maternal Disparities
Health Secretary Victoria Atkins announced fifty million pounds in funding for research to address maternal disparities last month.
She stated that the need to improve maternity services was “personal” due to her own “terrifying” childbearing experience.
Pain and length of hospital stay following caesarean sections among various ethnic groups were the subject of a separate research published in the same journal in October 2021. The study utilised data from 1,000 patients across 107 NHS labour wards in England over a two-week period.
This analysis comprised data from 1,000 patients who underwent Caesarean section, including information on their ethnicity and level of deprivation.
Asian and black patients spent 44 and 49 hours in the hospital after giving delivery, whereas white patients spent 35.
Compared to Caucasian patients, Asian patients had more than double the risk of moderate or severe pain after 30 days, regardless of pain medication usage.
There were no additional distinctions observed among the patient groups that could account for the obtained results.
Based on the findings of the research, which was led by Dr. James O’Carroll from University College London Hospital, additional investigation is necessary to ascertain the underlying causes of the variations in postpartum pain and recovery.
