The Maternal Care Crisis in America - Stories of Mistreatment during Pregnancy and Childbirth
As a Doctor of Public Health, I am troubled by the findings of a recent CDC survey on mistreatment during maternity care in the United States. The survey of 2,400 women exposes shortcomings in our country's maternal healthcare system.
The results show that 1 in 5 mothers reported being mistreated by healthcare providers during pregnancy and childbirth. This mistreatment included having health concerns dismissed or ignored, being shouted at or scolded, and having physical privacy violated. Disturbingly, women of color reported even higher rates of discrimination based on race, ethnicity, income level, and insurance status (Ars Technica, 2023).
These experiences have consequences. Nearly half of the women surveyed said they held back from asking questions or voicing concerns to their provider because of mistreatment. This breakdown in communication and trust can negatively impact the care received by mothers and newborns.
For example, about 40% of Black and multiracial women reported discrimination because of race and ethnicity, income, and type of health insurance (NY Times, 2023).
The most common mistreatments of the 2,400 women survey response included:
· Health concerns ignored or dismissed: 9.7%
· Being shouted at or scolded: 6.7%
· Physical privacy violated: 5.1%
Because of the mistreatment of the surveyed women, 45% reported “holding back from asking questions or discussing concerns with their provider.”
Although there were limitations to the survey, which included that it was not a nationally representative sample of the population giving birth, the researchers say it highlights key areas of the U.S. maternal crisis (CDC, 2023).
Overall, the survey highlights key areas needing improvement in US maternal healthcare, especially for minority women. With the maternal mortality rate rising in recent years to 32.9 deaths per 100,000 live births and research showing that 80% of such deaths are preventable, this is a public health crisis demanding action. As doctors, we must listen to women's voices, address systemic inequities, and provide compassionate, dignified care to all mothers.
References
Amid U.S.’s shameful maternal death rate, a survey finds widespread mistreatment. (2023, August 22). Ars Technica. https://arstechnica.com/health/2023/08/amid-uss-shameful-maternal-death-rate-survey-finds-widespread-mistreatment/
One in five women feel mistreated during maternity care, C.D.C. Reports. (2023, August 22). The New York Times - Breaking News, US News, World News and Videos. https://www.nytimes.com/2023/08/22/health/pregnancy-mistreatment-health-care.html
Pregnancy-related deaths: Data from maternal mortality review committees in 36 US states, 2017–2019. (2022, September 26). Centers for Disease Control and Prevention. https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/data-mmrc.html
TODAY, U.S (2023, August 22). As maternal deaths rise, CDC says pregnant women report negative experiences at Doc visits. USA TODAY. https://www.usatoday.com/story/news/health/2023/08/22/maternal-mortality-rate-american-women/70648124007/
Vital signs: Maternity care experiences — United States, April 2023. (2023, August 16). Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/72/wr/mm7235e1.htm
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