A report of the Centers for Disease Control and Prevention The CDC reported that, according to a survey, 20 percent of women reported experiences of mistreatment during pregnancy and childbirth.
According to a new CDC Vital Signs report, mistreatment during maternity care was highest among black women (30 percent), Hispanic women (29 percent), and multiracial women (27 percent).
“Every mother deserves to be treated with dignity and respect. Maternal care is a critical component of this nation’s health care, and the Biden-Harris administration is committed to improving maternal health outcomes,” said U.S. Department of Health and Human Services Secretary Xavier Becerra. “Bias, stigma and mistreatment have no place in our health care systems,” he added.
Women without insurance (28 percent) or with public insurance (26 percent) at the time of delivery are more likely to experience mistreatment during maternity care than women with private insurance (16 percent).
The most common types of mistreatment reported were: failure to respond to requests for help, yelling or scolding, failure to protect physical privacy, and threats to withhold treatment or to accept unwanted treatment.
CDC analyzed data from the Porter Novelli View Mothers Survey conducted in English from April 24-30, 2023, to examine the components of respectful care. While the majority of the 2,402 mothers surveyed reported overall satisfaction with the maternity care they received, satisfaction was lower among those who experienced mistreatment.
It is important to note that improving the quality of maternity care is one approach that can prevent pregnancy-related deaths, and all women deserve respectful maternity care that maintains their dignity, privacy and confidentiality, ensures they are free from harm and abuse, includes their participation in decision-making, and provides ongoing support.
“As a health care community, we need to do everything we can to ensure we are providing equitable and respectful care to women during pregnancy and childbirth,” said CDC Chief Medical Officer Debra Houry.
“Health systems, hospitals and providers can take steps to improve care and reduce the risk of pregnancy-related complications and death for all women. These data show that we need to do a better job of supporting moms,” she added.
Additionally, the survey revealed that 29 percent of women reported discrimination during maternity care.
The most common reasons for reported discrimination were age, weight, and income, and varied by race or ethnicity.
In this regard, black women (40 percent), multiracial women (39 percent), and Hispanic women (37 percent) reported the highest rates of discrimination. Experiences of racial discrimination have previously been associated with pregnancy complications.
Nearly half—45 percent—of women reported refraining from asking questions and discussing concerns with their provider during maternity care because they believed what they were feeling was normal, didn't want to make a big deal out of it or felt embarrassed to talk about it, believed the doctor would think they were being disruptive, thought their doctor seemed rushed, or didn't feel confident they knew what they were talking about.
“As a physician, a mother, and a Black woman, I am disheartened to hear how common mistreatment is, and to see the disparities in mistreatment and discrimination during maternity care based on things like race and insurance coverage,” said Wanda Barfield, director of CDC’s Division of Reproductive Health.
“We know that racism and discrimination can lead to delays in treatment and sometimes tragic and preventable deaths. Training on unconscious bias and culturally appropriate care can be a first step in understanding how to provide respectful maternity care to all women,” she stressed.
CDC noted that respectful maternity care can be part of steps taken at many levels to reduce pregnancy-related deaths, so health care systems can promote respectful maternity care by recruiting and maintaining a diverse workforce and training all health care personnel to recognize unconscious bias and stigma.
She also recommended that health care systems can promote quality improvement measures with a focus on increasing respectful maternity care for all women equally, while health care professionals can take steps to make patients feel respected, understood and valued while caring for them.
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