2026/03/19 by D. N. Lucas, James H. Bamber, Lisa Hinton · 1 voice · 1 citation
Medicine · #Global Maternal and Child Health #Maternal and Perinatal Health Interventions #Maternal and fetal healthcare
paper · doi:10.1111/anae.70208
openalex publication_date 2026/03/19 · openalex created_date 2026/03/20 · openalex updated_date 2026/06/27
We read with interest the study by Macgregor et al. examining ethnic disparities in labour epidural utilisation [1]. The authors present important quantitative evidence of inequity and conclude, appropriately, that further qualitative research is needed to elucidate the underlying drivers of these differences. It is important to recognise that such research is methodologically complex and requires substantial time, expertise and resources [2]. Studies exploring lived experience, beliefs, communication, trust and decision-making in maternity care face well-recognised challenges. These include difficulties in recruiting representative samples, language and translation requirements, recall bias when examining past experiences and the need for careful co-design with communities to avoid inadvertent framing or interpretive bias [3]. These challenges should not be viewed as reasons to avoid this work, quite the opposite. Rather, they underscore the need for thoughtful study design, adequate funding and a willingness from funding bodies to support research where the methods may be less linear or predictable than traditional quantitative designs, but which are essential for addressing questions of equity and access [4]. Qualitative research is sometimes undervalued within traditional hierarchies of medical evidence, which tend to prioritise quantitative and interventional approaches. Yet for questions relating to patient experience, trust, communication and access to care, qualitative methods are not supplementary but essential. They generate different but equally important forms of knowledge, particularly those grounded in lived experience. The disparities highlighted by Macgregor et al. are unlikely to be resolved through epidemiology alone. Understanding why women do or do not access neuraxial analgesia, and how healthcare systems shape those decisions, requires approaches that centre women's voices, contexts and experiences. Supporting such work is not only a scientific imperative, but also a moral one. It is time to move beyond repeatedly documenting ethnic disparities in obstetric anaesthesia and instead invest in understanding their underlying causes, so that meaningful and sustained change can follow [5]. We congratulate the authors for drawing attention to this gap and hope that their work helps create the conditions, including the necessary support and funding, to address it.