Language barriers limit access to postpartum headache treatment

New mothers with limited English proficiency are less likely to receive the standard treatment for painful and debilitating headaches that can occur if the membrane surrounding the spinal cord is accidentally punctured during an epidural for childbirth, according to a study presented at the ANESTHESIOLOGY^® 2026 annual meeting.

The study found patients with limited English proficiency had approximately 70% lower odds of receiving an epidural blood patch, which is the standard treatment for moderate-to-severe postdural puncture headaches. These headaches can occur after epidural or spinal anesthesia when, in rare cases, spinal fluid leaks through a small hole in the membrane surrounding the spinal cord. The headaches can be severe, worsen when sitting or standing and interfere with recovery after childbirth, including caring for the newborn. An epidural blood patch uses a patient's own blood to seal the leak.

Language should never be a barrier to receiving appropriate care. Patients should feel comfortable asking for a professional interpreter and inquiring about treatment options, but the responsibility should not fall on them. Healthcare teams need to ensure every patient receives the same prompt assessment and treatment, regardless of the language they speak."

Heidi Lightfoot, MBBS, FRCA, study author and instructor of anesthesia, Harvard Medical School and Mass General Brigham, Boston

Using artificial intelligence and manual chart review, researchers analyzed electronic health record data from 556 obstetric patients diagnosed with postdural puncture headache between 2015 and 2025 across a large healthcare system. Of those patients, 500 reported English as their preferred language and 56 preferred another language.

Among English-speaking patients, 372 (74.4%) received an epidural blood patch, while only 26 (46.4%) of those with limited English proficiency did. Patients with limited English proficiency also had fewer anesthesia follow-ups (five vs. seven for English speakers) and shorter follow-up duration (four days vs. five days). The study authors noted the study does not show why these differences occurred, but that language barriers may affect communication, return visits and ongoing follow-up.

"Clear, consistent steps for diagnosing and treating these headaches, uniform documentation, multilingual patient materials and reliable access to professional interpreters are practical steps hospitals can take to close this gap," Dr. Lightfoot said. "These changes can help ensure language differences don't lead to differences in care."