Black, Hispanic Mothers Report More Pain After Delivery but Get Less Pain Medication

By Lisa Rapaport

November 14, 2019

(Reuters Health) - White mothers may receive more pain assessments after delivery and have better access to painkillers than women from other racial and ethnic groups, two new studies suggest.

For one study, researchers examined data on postpartum pain scores and pain management for 9,900 women. When women rated their pain on a scale of 1-10, with 10 being the worst, Hispanic women were 61% more likely to report scores of 5 or higher and black women were more than twice as likely to report high pain scores, this study found.

Despite reporting higher pain scores, black and Hispanic women received significantly fewer morphine milligram equivalents (a measurement of opioids) than white women and were significantly less likely to receive a prescription for an opioid when they went home after giving birth.

"Our study shows black and Hispanic women experience disparities in pain management in the postpartum setting," said study leader Dr. Nevert Badreldin from Northwestern University Feinberg School of Medicine in Chicago.

"These disparities cannot be explained by less perceived pain," Badreldin said in a statement.

Just 4.2% of white women reported pain scores of 5 or higher, compared with 7.7% of Hispanic women and 11.8% of black women, researchers reported November 4 online in Obstetrics & Gynecology.

However, half of the white mothers received at least 24.8 morphine milligram equivalents a day of pain relief. By contrast, half of Hispanic women received no more than 19.4 morphine milligram equivalents a day, and half of black women received no more than 23.5 morphine milligram equivalents a day.

And almost 47% of white mothers received opioid prescriptions when they were discharged from the hospital, compared with 39% of Hispanic mothers and 45% of black mothers.

Following delivery, women commonly use pain medication to manage pain associated with cramping, vaginal lacerations, and surgical and musculoskeletal pain.

A second study in the same journal examined how often 1,701 mothers got pain assessments after delivery and what scores they reported.

In this study, 28% of black mothers reported pain scores of at least 7 out of 10, compared with 22% of Hispanic women, 20% of white mothers, and 15% of Asian women.

Over the first 24 hours after birth, white women were asked about their pain levels an average of 10.2 times, compared with 8.4 to 9.5 assessments for other mothers.

"Any disparities in the care that women receive require urgent attention," Dr. Brian Bateman of Brigham and Women's Hospital and Harvard Medical School in Boston and Dr. Brendan Carvalho of Stanford University School of Medicine in California write in an editorial accompanying the studies.

Further research is also needed to better understand what's contributing to these disparities and what interventions might eradicate any racial and ethnic imbalances in postpartum care, Bateman and Carvalho write. But, they add, "we caution against responding to these differences by increasing opioid prescribing."

SOURCE: http://bit.ly/34XQ13Y and http://bit.ly/34WSuff

Obstet Gynecol 2019.

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