Inequalities in Access to Obstetric Analgesia in the United Kingdom: A Systematic Literature Review

Linta Nasim1 and Dr Jacqueline Woodman (Supervisor)2

University of Warwick Medical School 2. University Hospital Coventry and Warwickshire

Introduction

Childbirth is often the most intense pain a woman may experience, yet access to pharmacological obstetric analgesia in the UK remains a challenge. Social factors, National Health Service (NHS) strain, and lack of patient awareness contribute to lower anaesthesia use compared to other high-income countries. Recent reports highlight inadequate pain relief and discrimination against women of deprived and ethnic minority backgrounds. Unequal access contributes to poor maternal and neonatal outcomes and reflects NHS-wide failures. Research from countries like the US is often not applicable to the UK due to differences in healthcare systems and population demographics. This review is the first to look at inequality in access to obstetric analgesia in the UK.

Objective

To systematically review the extent of inequality in access to obstetric analgesia, contributing factors, and maternal care experiences in the UK.

Methods

• Medline, Embase, and Cochrane Library were systematically searched on October 31, 2024. After screening 1,401 articles, three studies1-3 met inclusion criteria (Figure 1, Table 1).
• Included studies used observational designs, with two from England and one from Scotland, covering 6.6 million childbirth episodes and 20,633 survey responses.
• Data were extracted using a proforma and synthesised via narrative analysis.