Equity of Access to Epidurals

Recent Scottish population-level research has revealed inequities in access to labour epidurals, with women from more socioeconomically deprived areas and certain ethnic minority groups receiving epidural analgesia at lower rates. These disparities suggest complex underlying barriers including potential biases in pain assessment, cultural differences in pain management preferences, language barriers, and systemic inequities in healthcare delivery that require urgent investigation at local level.

Our proposed study will examine patterns of epidural access across NHS Lothian's maternity services, using detailed electronic health records to understand how local practices align with the national picture of inequality. By analysing epidural rates across different socioeconomic and ethnic groups within our health board, we aim to identify specific barriers to equitable pain relief access and determine whether observed disparities reflect patient choice, clinical decision-making, or systemic factors. This research will provide crucial evidence about local equity in labour analgesia provision, potentially informing targeted interventions and policy changes to ensure all women have equal access to effective pain relief during childbirth, regardless of their background or circumstances.