Poorer women endure labour pains more than the rich because they may fear discrimination for not being able to tolerate agony during childbirth

  • Women from more affluent areas were 19 per cent more likely to receive epidural

Wealthy women are much more likely to get an epidural during labour, a study reveals.

Researchers say women from poorer backgrounds may feel under more pressure to tolerate the pain of childbirth or face discrimination.

They examined the care given to 593,230 women who gave birth from January 2007 to October 2020, excluding planned caesareans. Of these, 131,521 (22.2 per cent) received an epidural for pain relief.

However, women from more affluent areas were 19 per cent more likely to receive an epidural than those from more deprived places, analysis found.

Where there was a clear documented indication that an epidural was medically necessary, the difference was even wider.

poorer women endure labour pains more than the rich because they may fear discrimination for not being able to tolerate agony during childbirth

Researchers examined the care given to 593,230 women who gave birth from January 2007 to October 2020, excluding planned caesareans. Of these, 131,521 (22.2 per cent) received an epidural for pain relief (Stock image)

In such cases, women in the richest 10 per cent of areas were 27 per cent more likely to receive the pain relief compared to those from the poorest 10 per cent.

The study, which used data from women who gave birth on the NHS in Scotland, was published in Anaesthesia, the journal of the Association of Anaesthetists. Researchers, led by Dr Lucy Halliday from the University of Glasgow, said: ‘These women [in the poorest groups] may lack knowledge about indications for epidural analgesia; have life circumstances that may adversely impact antenatal care attendance; mistrust medical staff; feel disempowered during labour; hold misconceptions about epidural safety; or have differing expectations and societal pressures regarding the pain of childbirth.

‘Differences in healthcare professionals’ attitudes… might also influence use of epidurals during labour.’

The authors added: ‘We found that women from areas of greater socioeconomic disadvantage were substantially less likely to receive an epidural for pain relief.’

Health Secretary Victoria Atkins last month announced £50million of funding for research to tackle maternal disparities.

She said improving maternity services was ‘personal’ to her after her own ‘frightening’ experience of childbirth.

poorer women endure labour pains more than the rich because they may fear discrimination for not being able to tolerate agony during childbirth

Women from more affluent areas were 19 per cent more likely to receive an epidural than those from more deprived places, analysis found (Stock image)

A separate study in the same journal looked at pain and length of hospital stay after caesareans in different ethnic groups, using data from 1,000 patients across 107 NHS labour wards in England during a two-week period in October 2021.

Data from 1,000 patients who underwent Caesarean delivery with ethnicity and deprivation information were included in this analysis.

White patients had shorter post-childbirth length of hospital stay, 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 usage.

There did not appear to be any other differences in the patient groups which explained the results.

The authors of the study, conducted by Dr James O’Carroll from University College London Hospital, concluded further work was required to understand the factors driving the differences in post-childbirth pain and recovery.

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