Abstract
Background Studies indicate racial and ethnic inequities in pain assessment, management and treatment in maternal and newborn care. Namely, racially and ethnically marginalised womxn are less likely to receive pain relief in labour and the post-partum period, and are more likely to experience severe perinatal outcomes such as uterine rupture. This inequity may be explained by racial/ethnic bias in maternal and newborn care professionals’ pain assessment, management and treatment. The aim of this study was 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 by researching the association between race/ethnicity, language barrier, and response time to pain, and exploring racial thinking and notions of ethnic differences in pain assessment, management, and treatment. Methods This is a mixed methods study. The quantitative part of this study was a prospective, nationwide population-based cohort study in which cases of uterine rupture were collected through the Netherlands Obstetric Surveillance System (NethOSS), retrospectively investigating the association between categories of race/ethnicity, language barrier, the difference in the response time to pain, and maternal and perinatal outcomes up to 28 days post-partum. The qualitative part was an explorative study to investigate racial and ethnic bias in pain assessment, management and treatment among maternal and newborn care professionals using semi-structured interviews and thematic analysis. Results The quantitative results indicated that caesarean section was significantly more frequently performed in more than 180 min after the first complaint of pain in the non-Western category compared to the Western category. †Evelien Overtoom, Bahareh Goodarzi and Syllona Kanu shared first authorship. *Correspondence: Bahareh Goodarzi b.goodarzi@amsterdamumc.nl Full list of author information is available at the end of the article Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence,