Review of Racial/Ethnic Disparities in Obstetrics-Related Anesthesia Administration and Pain Management

Abstract

While racial/ethnic disparities in maternal outcomes including mortality and severe maternal morbidity are well documented, there is limited information on disparities in obstetric anesthesia practices. This paper reviews literature on racial/ethnic disparities in peripartum anesthesia administration and postpartum pain management. Current literature demonstrates racial/ethnic disparities in several aspects of obstetric anesthesia care including neuraxial administration for vaginal labor pain, neuraxial versus general anesthesia for cesarean delivery, post neuraxial anesthesia complications, postpartum pain management and postdural puncture headache treatment practices. However, many studies are dated or have limited data from single institutions or states. More research on nation-wide racial/ethnic disparities in obstetric anesthesia is needed to understand its broader practice and management in the USA.

Variation in Hospital Neuraxial Labor Analgesia Rates in California

“…In line with these findings, a review of previous observational studies examining disparities in obstetric anesthesia reported lower rates of neuraxial analgesia among patients from racial and ethnic minorities, non–English-speaking patients, those without insurance or with government insurance, and those who deliver in nonteaching or rural hospitals. 31 In our study, we observed marked differences in the neuraxial analgesia prevalence across all patient and hospital characteristics between the lowest versus highest tertiles. These findings suggest that system-wide or structural factors may exert a greater influence than patient factors in hospitals with low rates of neuraxial analgesia.…”