One out of every five mothers in the United States has reported mistreatment by a healthcare professional during pregnancy and childbirth, ranging from ignored cries for help to verbal abuse. The U.S. Centers for Disease Control and Prevention (CDC) conducted a survey involving more than 2,400 new mothers, which revealed that rates of mistreatment during maternity care were notably higher among Black, Hispanic, and multiracial women.
The survey’s findings were published in the CDC’s weekly Vital Signs report. Dr. Debra Houry, the CDC’s chief medical officer, emphasized the significance of maternal health and denounced the mistreatment faced by women during maternity care. She noted that maternal mortality remains a pressing issue in the country, and alongside that, many women have reported instances of mistreatment and discrimination during their maternity care experiences.
Such mistreatment negatively impacts the quality of care, highlighting the need to establish a culture of respectful maternity care. According to the survey, mistreatment rates were particularly elevated among women without insurance or those covered by public insurance, as compared to women with private insurance. Although most respondents (91%) expressed satisfaction with their maternity care experiences, those who reported mistreatment showed lower levels of satisfaction.Â
The study identified various forms of mistreatment, including having requests for assistance ignored or denied (9.7%), facing shouting or scolding from healthcare providers (6.7%), encountering violations of physical privacy (5.1%), and being coerced into unwanted treatment or threatened with treatment denial (4.6%). Curiously, among women who experienced mistreatment, 75.1% were content with the care they received during their pregnancy.Â
The survey also delved into experiences of discrimination during maternity care. Overall, 29% of respondents reported experiencing discrimination, with the most cited factors being age, weight, and income. Disparities were evident among racial and ethnic groups, with Black mothers (40.1%), multiracial mothers (39.4%), and Hispanic mothers (36.6%) reporting higher rates of discrimination. For multiracial respondents, the reasons often included age and disagreements with caregivers about the appropriate care for themselves or their babies.Â
Furthermore, the survey unveiled that nearly half of the participants had refrained from discussing concerns or asking questions with their healthcare providers due to feelings of normalcy, reluctance to make a fuss, embarrassment, or fear of being perceived as difficult by their provider. Other respondents cited their healthcare provider’s rushed demeanour as a deterrent. The survey focused on experiences during pregnancy or childbirth of the participants’ youngest child, and almost two-thirds reported that their youngest child was under the age of 5.Â
Dr. Wanda Barfield, a co-author of the report and the director of the CDC’s Division of Reproductive Health, suggested strategies to foster more respectful care during pregnancy and childbirth. These recommendations include encouraging active listening and cultural awareness among healthcare providers, training professionals to recognize unconscious biases and stigma, and promoting shared decision-making.
Dr. Houry stressed the importance of cultivating a diverse healthcare workforce to address the issues highlighted by the survey. The CDC’s survey sheds light on the distressing mistreatment and discrimination faced by mothers during pregnancy and childbirth in the United States. Acknowledging the prevalence of such mistreatment, particularly among marginalized groups, calls for systemic changes to ensure respectful and equitable maternity care.Â
