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Vital Signs

African-American Women, Medicaid Moms, Receive Fewer Anesthesia Options

Ethnicity and insurance coverage may determine the kind of anesthesia a woman receives during labor, according to a recent study at the University of New York at Buffalo.

 

The study showed that Medicaid recipients in New York state are less than half as likely to receive epidurals for vaginal delivery than patients with private coverage or an HMO. The ethnicity of the patients also determined the anesthesia they received. The study indicated that white mothers were more likely to receive an epidural for vaginal delivery and a spinal or epidural for a Cesarean delivery than African-American mothers. Disparities were not cited among other ethnic and racial minority groups because they were not well represented in the study.

 

The researchers also found that Medicaid mothers who have Cesarean sections are twice as likely to receive a general anesthesia, which numbs the entire body and causes the mother to lose consciousness. This increases the risks to both baby and mother, according to assistant professor of anesthesiology at the University of Virginia, Paul Ting, PhD. An epidural is a far favorable option during a Cesarean because it has no effect on the baby and allows the mother to stay awake.

Thomas E. Obst, director of the Nurse Anesthesia Program at the University of New York at Buffalo School of Nursing and lead author of the study says, “The research points out the need for a national assessment of the availability of pain control options for obstetrical patients. We need to understand how much patients’ preferences and cultural mores influence the use of a particular anesthesia intervention.”