Ethnic differences influence care giver's estimates of pain during labour

The present study compared the childbirth experience of two different ethni c groups living in the same area and sharing the same medical facilities. W e investigated the influence of ethnic differences between patient and care provider on the interpretation of pain. The subjects were 225 Jewish and 1 92 Bedouin parturients, who were prospectively evaluated for their labour p ain experience. The pain intensity level was assessed by the parturient ('s elf-reported pain') and by a Jewish doctor and midwife ('exhibited pain') i n the initial active phase of labour, using the visual analog scale (VAS). On the day after delivery, the women were asked to evaluate the present pai n intensity level. Although the means of the self-assessments of pain inten sity levels at the initial active phase of Jewish and Bedouin parturients w ere similar (8.55 and 8.53 respectively, P = 0.25), the Jewish medical staf f interpreted Bedouin women to experience less pain than Jewish women (6.89 vs. 8.52, P < 0.001). On the day after delivery, the Jewish women's evalua tion of their pain intensity levels again resembled that of the Bedouin wom en (2.02 and 2.11 respectively, P = 0.52). The Pearson correlation coeffici ents between the measures of self-reported and exhibited pain, were higher for Jewish than for Bedouin women (0.74 and 0.63, respectively). In a multi ple linear repression analysis, both self-reported and exhibited pain score s were associated significantly with ethnicity and parity. In the model pre dicting exhibited pain, the level of religious observance was negatively as sociated with pain intensity scores. We conclude that the ethnic background of the care provider is an important determinant in estimating the sufferi ng of the patients. It is important for the clinician to be aware of the wi de spectrum of factors that might influence pain expression and interpretat ion. The knowledge that there are inter-ethnic differences might prevent a stereotyped response to the patient in pain. (C) 1999 International Associa tion for the Study of Pain. Published by Elsevier Science B.V.