Effect of ethnicity and parity on utilisation of labour epidural analgesia

Making Education Easy

Authors:

Macgregor A et al.

August 25, 2026

Summary:

A retrospective study has highlighted ethnic disparities in the utilisation of epidural analgesia at Christchurch Hospital over a 4-year period. The study reviewed 22,970 deliveries, and found an overall epidural rate for vaginal deliveries of 23.1%, with lower rates for Māori (18.4%) and Pacific (9.9%) women. For first births, there was no significant difference in epidural utilisation between Māori and European women. However, for subsequent births, Māori women were less likely to receive an epidural (odds ratio [OR] 0.75, 95% confidence interval [CI] 0.60-0.92, p

Comment:

Further evidence of ethnic inequities in pain management, Māori and Pacific women were less likely to receive labour epidural analgesia after adjusting for other factors. Whether these differences reflect patient preference, access barriers or clinician decision-making, it raises important questions about equitable provision of pain relief. Similar disparities in analgesia have been extensively documented among African-American patients in the US, where unequal pain assessment and treatment have been linked to structural racism and implicit bias.

Reference: Anaesthesia. 2026;81(6):792-800.

Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

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