Pain relief after the birth is also not given equally

The same gap that exists in the operating room continues on the ward.

The disparities in how pain is believed do not stop when the operation ends. In the cohort of 9,900 women, Black and Hispanic women reported more severe pain in the days after birth and received measurably fewer morphine equivalents per day, and were less likely to leave the hospital with a prescription. In 1,701 women after cesarean, severe pain of 7 or more out of 10 was reported by 28% of Black women, 22% of Hispanic women, 20% of white women and 15% of Asian women, while white women had more documented pain assessments.

The authors of the first study stated their conclusion plainly: these are disparities in pain management that cannot be explained by less perceived pain.

What helpsAsk for scheduled acetaminophen and ibuprofen rather than as-needed dosing, ask for your pain score to be recorded each time you report it, and say the number out loud rather than saying you are "okay." A recorded number is harder to overlook than a facial expression.

Where this comes from

Badreldin N, Grobman WA, Yee LM. Racial disparities in postpartum pain management. Obstet Gynecol. 2019;134(6):1147-1153.
Johnson JD, Asiodu IV, McKenzie CP, Tucker C, Tully KP, Bryant K, et al. Racial and ethnic inequities in postpartum pain evaluation and management. Obstet Gynecol. 2019;134(6):1155-1162.
Craig R, Nour SE, Blake L, Carvalho B, Kua J, O'Carroll JE. Racial and ethnic disparities in postpartum pain: a systematic review. Int J Obstet Anesth. 2025;64:104736.

Covered in the class

8Module 8. After: pain relief, the record, and what stays with youPain relief after birth is not given equally, and the record does not always match what happened.

Continue

Read this inside the full program, with the questions to take to your next visit and a record of what you have covered.

Obstetric Anesthesia Preparedness →

More from Being heard

How you are likely to be treated is partly predictableMistreatment in maternity care is measured, and it is not rare. Ask now what happens if you feel pain during the operationThe conversation belongs here, not on the operating table. If your pain is answered with the word "pressure"What to say, in order, when you are not being believed. Pain is not believed equallyThe evidence on this is consistent and uncomfortable.

This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you.