Experiences of obstetric anaesthesia care among minoritised ethnic groups in England: a qualitative study

Background: Ethnic inequalities in UK maternity outcomes are well documented, including disparities in access to obstetric analgesia. The factors underlying these differences remain poorly understood. This study explored experiences of obstetric pain relief among women from minoritised ethnic groups in England to inform improvements in care. Methods: Six face-to-face focus groups were conducted with 34 recently postpartum women and 10 birth partners from minoritised ethnic groups, recruited via community organisations. Transcripts were analysed thematically using modified grounded theory, informed by literature on maternity care inequities. Results: Understanding of analgesic options varied, with many participants relying more on community guidance than clinician explanations. Interactions with healthcare professionals were sometimes perceived as dismissive or insufficient, particularly during discussions about neuraxial analgesia. Epidural analgesia was frequently viewed negatively due to concerns about side effects and, for some, perceptions of cultural weakness, although positive experiences were also described. Participants identified a need for clearer and culturally accessible information about pain relief options. Conclusions: There is a mismatch between women's expectations and healthcare professionals’ approaches to communicating and providing obstetric analgesia. Improved communication, kindness, and cultural awareness may enhance trust and support informed decision-making. Further research is required to investigate women's concerns about pain relief alongside healthcare professionals’ attitudes, and how these shape equitable, person-centred anaesthetic care.