['You think, like, you're neutral but you're not'Racial and ethnic bias in pain management in Dutch maternity care].

OBJECTIVE

To investigate the role of racial/ethnic bias in the assessment, management and treatment of pain among maternal and newborn care professionals in the Netherlands.

DESIGN

Mixed methods study.

METHOD: Quantitative: retrospective assessment of a prospective cohort of uterine ruptures in the Netherlands (NethOSS, 2016-2018) examining associations between race/ethnicity categories and language barrier, and the response time to pain and maternal/perinatal outcomes. Qualitative: thematic analysis of semi-structured interviews with professionals about racial and ethnic bias in pain assessment, management and treatment.

RESULTS

Caesarean section was significantly more frequently performed >180 minutes after the first pain complaint in the non-Western category compared to the Western category (8/15 (53.3%)) vs (1/12 (8.3%))) (OR 12.57, 95% CI 1.28- 123.48). Professionals expressed implicit racial and ethnic bias and stereotypes about pain experience and expression, while mostly perceiving their own practice as unbiased.

CONCLUSION

Racial thinking and notions of ethnic differences in pain assessment, management, and treatment were largely unrecognized.