Ethnicity pain gap: the epidural failed and no one believed me – I could feel everything

Ethnicity Pain Gap: The Epidural Failed, and No One Believed Me – I Could Feel Everything

Ethnicity pain gap - Julie Hammond, a 35-year-old mother of three from Kent, recounts a deeply unsettling childbirth experience that left her feeling unheard and undervalued. Her second child was born via emergency caesarean at 35 weeks, a procedure she had initially planned for as an elective one. Yet, despite her efforts to manage the situation, Hammond says the pain she endured was not adequately addressed by the medical team. “It’s hard to explain just how traumatic the experience was,” she says, reflecting on the moment she felt her body being subjected to the full force of the process. “I was constantly panicking, even as I tried to convince myself to stay calm.”

A Personal Battle with Pain

Hammond’s labour was marked by a spinal block, a type of anaesthetic typically used for childbirth. However, she recalls being able to move her legs during the procedure, which she immediately noted to her anaesthetist. “I pointed out that the anaesthetic wasn’t fully working, but they reassured me to just relax,” she explains. “I felt like my concerns were being brushed aside.” The situation escalated when she informed the medical staff that she could still feel her legs and abdomen. Despite her clear communication, the dosage of anaesthetic remained unchanged, leaving her to endure every sensation of the procedure. “I can’t fully capture the intensity of the pain,” Hammond says. “It was like feeling each layer of my skin, fat, and muscle being sliced apart. Every movement, every stretch, was painfully evident.”

"I could literally feel every single part of what was happening to me," Hammond says.

Her experience is not unique, according to a recent investigation by The Guardian. The findings reveal a persistent disparity in pain management for women from minority ethnic backgrounds compared to their white counterparts. This phenomenon, dubbed the “ethnicity pain gap,” suggests that healthcare professionals may underestimate or ignore the pain of people of colour, often attributing their discomfort to personal factors rather than systemic issues. Hammond’s case underscores how this gap can manifest in real-time, with mothers forced to confront their pain without support or understanding.

Systemic Bias in Pain Perception

Research has long pointed to racial biases in medical settings, and a 2016 study highlights how these prejudices begin early in the careers of healthcare professionals. The study found that a significant number of medical students and residents held incorrect beliefs about biological differences between black and white individuals. These beliefs, such as the idea that “Black people’s skin is thicker” or “nerve endings are less sensitive,” shaped their perception of pain and influenced treatment recommendations. The findings suggest that even among those trained to deliver care, stereotypes can lead to underestimating the severity of a patient’s discomfort.

"People who held more false beliefs consistently rated black patients’ pain as lower than white patients’ pain," the study concluded.

Adewole Adamson, an associate professor at the Dell Medical School in the University of Texas, comments on the ongoing nature of this issue. “There has been progress in awareness, which is commendable,” he says. “But the recent research shows that the gap still exists and is slow to close.” Even when pain management protocols are standardized, ethnic disparities persist. A 2023 study revealed that a system designed to reduce postpartum opioid use did not eliminate the differences in how pain was treated among ethnic groups. This indicates that the problem extends beyond individual mistakes, rooted in deeper cultural and systemic assumptions.

Dismissing the Experience

Hammond’s realization of the issue came after her third child’s birth, when she revisited her past experiences with a new perspective. “When I told the consultant about what happened during my previous caesarean, she confirmed that it wasn’t normal and shouldn’t have occurred at all,” she says. This moment of clarity highlighted how her ethnicity might have played a role in the way her pain was perceived. Initially, she had not suspected this, as her anaesthetist was also a person of colour. “At the time, I thought it couldn’t be racism because the doctor was from the same background as me,” she recalls. “I told myself I was just unlucky.”

"We are all taught this Eurocentric idea of how pain manifests," Hammond adds.

The case of Gabriella Sarpong, a 39-year-old public health professional from Ilford, further illustrates the challenges faced by women of colour during childbirth. Sarpong, who laboured for 16 hours in 2023, had to be induced, a process she found physically and emotionally draining. “I felt like my pain was being dismissed multiple times,” she says. “The healthcare team didn’t seem to take my concerns seriously, even when I clearly described the level of discomfort I was experiencing.” Her account aligns with the broader pattern of systemic neglect, where minority women are often left to manage their pain without adequate support.

The implications of this gap extend beyond individual experiences, affecting the overall health outcomes for women of colour. The Guardian’s investigation underscores how these biases can lead to delayed interventions, insufficient pain relief, and a lack of trust in the medical system. For Hammond, the trauma of childbirth was compounded by the feeling that her pain was not being acknowledged. “It was as if I was expected to endure everything,” she says. “Even when I tried to explain how I felt, no one seemed to listen.”

These stories are part of a growing body of evidence that challenges the assumption that pain is experienced uniformly across all individuals. The 2016 study’s findings, combined with recent data, reveal that systemic racism can influence how pain is perceived and treated, even among professionals who may not consciously hold prejudiced views. As Hammond reflects on her journey, she emphasizes the importance of addressing these disparities. “We need to recognize that ethnicity doesn’t just shape how we see the world—it also affects how the world sees us,” she says. “Especially when it comes to something as fundamental as pain management.”

Experts argue that tackling the ethnicity pain gap requires more than awareness; it demands a reevaluation of how pain is assessed and treated in healthcare settings. By challenging the stereotypes that underpin these biases, medical professionals can ensure that all women, regardless of background, receive the care they deserve. For Hammond and Sarpong, the road to understanding and addressing this issue has been long, but their voices are critical in shaping a more equitable future for childbirth experiences. As they continue to share their stories, the hope is that systemic change will follow, ensuring that no woman feels alone in her pain.