Spanish speaking Hispanic women in the United States are less likely to receive epidurals during childbirth, when compared to English speaking Latinas and non-Hispanic white women, and according to a new study from Northwestern University, language barriers may play a key role in the pain management disparity. This is just one more health disparity observed among the Hispanic population in the U.S.
“Our study was the first to evaluate disparities among English and Spanish-speaking Hispanic women admitted for delivery of their first infant,” said in a statement study author Paloma Toledo, M.D., M.P.H., Department of Anesthesiology and Program for Health Equity, Northwestern University, Feinberg School of Medicine. “We wanted to confirm if language disparities impact whether or not Hispanic women receive an epidural.”
Epidural management affected by language barriers
For the research, the Northwestern University team reviewed electronic medical data on more than 1400 Hispanic women admitted to an urban maternity hospital for childbirth. The researchers took into account other factors which influence a woman’s decision to have an epidural such as age, income, marital status, and medical insurance coverage.
When outside factors were eliminated, the investigators found Hispanic women received epidurals 66 percent of the time compared to non-Hispanic white women who received the pain management injection 81 percent of the time.
The language factor came in when researchers broke down the group into Hispanic women who could speak English at any level and those who were Spanish-speaking only. When language was taken into consideration, Spanish-speaking Latinas had a 40 percent lower chance of using an epidural compared to English-speaking Latinas.
All in all, approximately 96 percent of patients who requested an epidural received one, eliminating the chance the disparity was related to hospital procedures or the inner system of the facility.
“The study is important because it reveals a health care delivery disparity among Hispanic women based on spoken language,” said Toledo. “These findings, along with future research, will help us identify and target interventions, whether they are at the system, provider or patient level, to better educate Spanish-speaking Hispanic women about their pain relief options during labor.”
Epidurals remain one of the most common forms of pain management during childbirth, and the American Pregnancy Association states more than 50 percent of all women in labor request epidural anesthesia.