Health Disparities on the Labor Floor

The Agency for Healthcare Research and Quality (AHRQ) defines a disparity as a difference or a gap that exist between two groups, which is both statistically significant, larger than 10%, and indicates poor quality for the minority (non-referent) group. Despite advances in public health initiatives and medicine, disparities in healthcare are persistent. For example, in the United States, maternal mortality ratio has doubled since 1987 to 2009 where African American women were 4 times as likely to die from childbirth. Although there was no observed racial disparity in maternal deaths at University of Alabama Birmingham, there is anecdotal experience that may suggest health disparities do exist on the labor floor when examining neuraxial utilization and effectiveness. This retrospective study will seek to examine the successful extension of labor analgesia for cesarean section as it relates to insurance status.

Study Overview

• Status: Active, not recruiting
• Conditions: Pain; Pregnancy Related
• Intervention / Treatment: Other: Retrospective Electronic Medical Record Review

• Study Type: Observational
• Enrollment (Estimated): 2500

Contacts and Locations

Study Locations

• United States
  • Alabama
    • Birmingham, Alabama, United States, 35249
      • University of Alabama at Birmingham

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

All women admitted to the labor and delivery unit from 1/1/2015 to 12/31/2019, who meet the above defined inclusion and exclusion criteria

Description

Inclusion Criteria:

• Pregnancy
• Age >/= age 18 years

Exclusion Criteria:

• Women less than age 18 will be excluded.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Patients with private insurance	Other: Retrospective Electronic Medical Record Review; Patients will be assessed retrospectively for evidence of successful or failed epidural extension in the setting of need for cesarean section
Patients with public/self-payer insurance	Other: Retrospective Electronic Medical Record Review; Patients will be assessed retrospectively for evidence of successful or failed epidural extension in the setting of need for cesarean section

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Successful extension of labor epidural catheter for cesarean section	labor epidural activation in the setting of cesarean section	from the time of admission to the time of delivery

Collaborators and Investigators

• Sponsor: University of Alabama at Birmingham
• Investigators: Principal Investigator: Patrick Hussey, MD, University of Alabama at Birmingham

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2021
• Primary Completion (Actual): April 1, 2026
• Study Completion (Estimated): April 1, 2027

Study Registration Dates

• First Submitted: November 11, 2020
• First Submitted That Met QC Criteria: November 11, 2020
• First Posted (Actual): November 18, 2020

Study Record Updates

• Last Update Posted (Actual): April 13, 2026
• Last Update Submitted That Met QC Criteria: April 6, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neurologic Manifestations; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain
• Other Study ID Numbers: IRB-300006294; UAB (Other Identifier: UAB)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No