Recent studies on racial disparities in obstetric care in the USA.

We thank Tangel and White [1] for their interest in our paper [2]. We acknowledge that our paper unfortunately inadvertently overlooked their study of a New York State database between 2007 and 2014 which was published in 2020, although we had referenced a similar earlier study of a New York State database between 1998 and 2003 by Glance et al. [3]. Both studies found disparities in labour analgesia provided to black women compared with white women. Similarly, Tangel et al. found that black women were more likely to receive general anaesthesia for caesarean births which had also been previously reported by another US study of multistate data collected between 1999 and 2001 [4]. It is cause for concern to note that in the period between these earlier studies and the study by Tangel et al., there seems to be little or no progress in resolving these disparities. The healthcare system in the USA is very different from that in the UK, with ethnic disparities in how healthcare is accessed and paid for in the USA. We were disappointed to find in our study that there were also similar ethnic disparities in how obstetric anaesthetic care is provided within a healthcare system, the UK National Health Service (NHS), which was founded on egalitarian principles that are enshrined in its constitution [5]. The research and quality improvement imperative for the obstetric anaesthetic community is now to move on from documenting ethnic disparities and instead identify and understand the reasons for the disparities so as to resolve any inequities in care that underpin them. Unfortunately, obstetric anaesthesia is provided in a maternity care environment in which ethnic minority women continue to experience greater adverse maternity outcomes. This issue is brought into sharp focus by the most recent maternal mortality rates reported in the USA and the UK which show black women have, respectively, 2.6 and 3.7 times higher mortality rates than white women [6, 7].