Black women in the United States report higher pain during labour but receive pain medication less often than non-Hispanic White women, according to a study of 46,671 births published in the Journal of Clinical Medicine. The disparity held even after researchers adjusted for pain score, age, length of stay and caesarean delivery.
The study is one of several 2025 and 2026 peer-reviewed papers that document birth trauma and the dismissal of Black women’s pain in American maternity care. NPR Health Shots reported on the findings, focusing on how pain is assessed during labour.
In qualitative interviews published in the Journal of Racial and Ethnic Health Disparities, Black mothers described being treated as if they could endure more pain because of their race. One participant told researchers:
“There’s this stigma that Black women are strong and can take anything, so they don’t really listen to our pain or emotions.”
Another participant recalled being sent for surgery without pain medication after giving birth. She said:
“I know that their books say something else, but we really do experience pain, and like I’m not pain-free just because my skin is Brown, okay? So, me coming from a surgery with no pain medicine, yeah, no, that’s not acceptable.”
The same body of research links mistreatment in perinatal care to PTSD-like symptoms among postpartum Black women, including intrusive memories, avoidance and heightened reactivity. A separate review found that PTSD and adverse pregnancy outcomes reinforce each other, increasing risk in both directions.
Family members of Black women who died after pregnancy complications told researchers that being believed about pain could have saved lives. One relative said, “I would have wanted them to accept the fact that Black women do experience pain.”
The studies do not include South African data, so the findings cannot be applied directly to Western Cape maternity units. They do, however, add to international evidence that pain assessment and racial bias can shape obstetric outcomes.
CapeFlats.co.za has not independently verified individual patient accounts in the US studies. What remains unknown is whether comparable patterns exist in South Africa’s public health system, where staffing and protocols differ.
This article will be updated after CapeFlats.co.za checks with local maternal health researchers and the Western Cape Department of Health on Monday. The next check-in will be posted as soon as new information is available.