ArticlePregnancy (Hoboken, N.J.)2025
Neuraxial labor analgesia use among racial and ethnic groups in the United States, 2016-2022.
Article in Pregnancy (Hoboken, N.J.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Neuraxial analgesia is the most effective modality for pain relief during labor; yet utilization varies considerably among racial and ethnic groups in the United States-representing a health disparity. Little is known about how maternal and obstetric characteristics may contribute to these differences and whether variation exists among a larger number of racial and ethnic groups. The objective of our study was to evaluate differences in neuraxial labor analgesia use among racial and ethnic groups in the United States. Methods: We analyzed vital statistics data from in-hospital spontaneous vaginal births of singletons during 2016 to 2022 in the United States ( Results: The rate of neuraxial labor analgesia use was 74% among 15,373,550 spontaneous vaginal, singleton births in the United States. White individuals had the highest rate (78%), and NHOPI and American Indian and Alaska Native (AI/AN) individuals had the lowest rates (58% and 61%, respectively) of use. After adjustment for covariates, the RR of using neuraxial labor analgesia was lowest in NHOPI individuals (0.78; 95% CI, 0.77-0.79) and AI/AN individuals (0.82; 95% CI, 0.82-0.82) compared with White individuals. The fully adjusted RRs were 0.93 (95% CI, 0.93-0.93) for Hispanic individuals, 0.98 (95% CI, 0.98-0.98) for Asian individuals, 0.96 (95% CI, 0.96-0.96) for Black individuals, and 0.97 (95% CI, 0.97-0.98) for multiracial individuals. In a secondary analysis, utilization ranged from 70% to 82% among Asian subgroups, 60% to 69% among NHOPI subgroups, and 64% to 81% among Hispanic subgroups. Conclusions: Neuraxial labor analgesia use in the United States was lowest among NHOPI and AI/AN individuals, independent of measured maternal and obstetric characteristics. Efforts are needed to understand and address disparities in contemporary practice with a particular focus on healthcare access and NHOPI and AI/AN communities.
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