The Impact of Birthplace on Neuraxial Labor Analgesia Rates among Hispanic Women in the United States

INTRODUCTION: The Hispanic population in the United States (U.S.) is rapidly growing. Prior research indicates that foreign-born women have lower neuraxial labor analgesia (NLA) rates than U.S.-born counterparts but influence of maternal country of origin remains unclear. This study examines the association between birthplace (foreign-born vs. US-born) and NLA during labor. METHODS: This retrospective cross-sectional study utilized CDC WONDER's Natality Expanded-Results Database (2016-2023) to analyze birth characteristics amongst several populous Hispanic subgroups. A Chi-Square test assessed overall differences in NLA by birthplace, Statistical significance was set at p < .05. RESULTS: The study included 704,913 participants. Rates of NLA in U.S.-born mothers of Mexican origin were significantly higher than their foreign-born counterparts (80.30% and 74.2% respectively; absolute difference 6.1%, 95% CI: 5.9, 6.4). Rates of NLA in U.S.-born mothers of Cuban origin were significantly lower than their foreign-born counterparts (82.30% and 85/70% respectively, absolute difference-3.4, 95% CI: -4.3, -2.5). There was no difference in NLA between U.S.-born and foreign-born women of Dominican origin (81.40% and 76.70% respectively, absolute difference 4.8, CI: -6.0, 15.6). Of all the Hispanic origins, Cubans (both U.S. born and foreign-born) were most likely to use neuraxial labor analgesia (82.3% and 85.7% respectively). There is no significant difference in age of mother, birth weight, BMI, number of prenatal visits, and interval since last live birth between U.S.-born and foreign-born women of the same Hispanic origin (p>.05). CONCLUSION: Intra-racial differences in NLA exist based on maternal birthplace and Hispanic origin, highlighting need for further research on cultural influences in obstetric pain management. These trends should be continuously monitored to formulate tailored public health interventions.