Poorer women suffer more from labor pain than the rich because they fear discrimination because they cannot tolerate the pain during childbirth
- Women from more affluent areas were 19 percent more likely to have an epidural
Wealthy women are much more likely to need an epidural during childbirth, a study shows.
Researchers say women from poorer backgrounds may feel more pressure to tolerate the pain of childbirth or face discrimination.
They examined the care provided to 593,230 women who gave birth between January 2007 and October 2020, excluding planned caesarean sections. Of these, 131,521 (22.2 percent) received an epidural for pain relief.
However, analysis found that women from more affluent areas were 19 percent more likely to receive an epidural than women from more deprived areas.
Where there was a clear documented indication that an epidural was medically necessary, the difference was even greater.
Researchers examined the care provided to 593,230 women who gave birth between January 2007 and October 2020, excluding planned caesarean sections. Of these, 131,521 (22.2 percent) received an epidural for pain relief (stock image)
In such cases, women in the richest 10 percent of areas were 27 percent more likely to experience pain relief than women from the poorest 10 percent.
The study, which used data from women who gave birth on the NHS in Scotland, was published in Anesthesia, the journal of the Association of Anesthetists. Researchers led by Dr Lucy Halliday from the University of Glasgow said: ‘These women (in the poorest groups) may not have knowledge about indications for epidural analgesia; have living conditions that could negatively impact participation in prenatal care; distrust of medical personnel; feeling powerless during childbirth; harbor misconceptions about epidural safety; or have different expectations and societal pressures regarding the pain of childbirth.
‘Differences in the attitudes of health care professionals… could also influence the use of epidurals during labor.’
The authors added: ‘We found that women from areas of greater socio-economic disadvantage were significantly less likely to receive an epidural for pain relief.’
Health Minister Victoria Atkins last month announced £50 million in funding for research to tackle maternal inequality.
She said improving maternity care was “personal” for her, following her own “frightening” experience of childbirth.
Women from more affluent areas were 19 percent more likely to need an epidural than women from more deprived areas, analysis shows (Stock Image)
A separate study in the same journal looked at pain and length of hospital stay after caesarean sections in different ethnic groups, using data from 1,000 patients across 107 NHS labor units in England over a two-week period in October 2021.
Data from 1,000 patients undergoing caesarean section with information on ethnicity and deprivation were included in this analysis.
White patients had a shorter hospital stay after delivery, at 35 hours, compared to Asian and black patients, who had 44 hours and 49 hours, respectively.
After 30 days, Asian patients had more than double the risk of moderate or severe pain compared to white patients, with no differences in pain medication use.
There appeared to be no other differences between the patient groups that explained the results.
The authors of the study, conducted by Dr James O’Carroll from University College London Hospital, concluded that further work was needed to understand the factors driving the differences in pain and recovery after childbirth.