CDC: Mistreatment During Maternity Care Contributes to Poor Maternal Health

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Despite the heaviest spending on healthcare, the United States has the highest maternal mortality rate among developed nations.

Sadly, this historic trend has worsened over time and impacts many women in overlooked populations.

The reasons for America’s maternal health crisis is multi-faceted, but a new Centers for Disease Control and Prevention (CDC) Vital Signs survey highlights one potential reason for this worsening health trend – mistreatment of women by healthcare workers during pregnancy and delivery care.

Let’s explore the survey results and how mistreatment during maternity care affects Latinas and all women.

Mistreatment During Maternity Care

The survey, which included data from 2,402 women, found that 1 in 5 women (20%) experienced mistreatment by healthcare workers during pregnancy and delivery care.

This mistreatment varied by background.

Black (30%), Latina (29%), and multiracial (27%) women, experienced mistreatment during maternity care at higher levels compared to white women (19%).

This mistreatment may be exacerbated by certain characteristics associated with women from some of these populations.

For instance, Latinos are uninsured more than two times the rate of their white peers, and Latinas are more likely to utilize Medicaid for maternal care due to the cost of private insurance.

Sure enough, survey results revealed that women with no insurance (28%) or public insurance such as Medicaid (26%) at the time of delivery experienced more mistreatment during maternity care than women with private insurance (16%).

What Does Mistreatment During Maternity Care Look Like?

The most common types of mistreatment reported by survey respondents were:

• Receiving no response to requests for help
• Being shouted at or scolded
• Not having their physical privacy protected
• Being threatened with withholding treatment or made to accept unwanted treatment

Researchers further categorized mistreatment data into what survey respondents considered unfair treatment.

A whopping 29% of women reported feeling mistreated during maternity care. The most common reasons for reported mistreatment being age, weight, income, and background. Like general mistreatment, Black (40%), multiracial (39%), and Hispanic (37%) women were impacted the most.

Health leaders emphasized that these findings are unacceptable.

“Every mother deserves to be treated with dignity and respect…Bias, stigma, and mistreatment have no place in our healthcare systems,” said US Department of Health and Human Services Secretary Xavier Becerra.

How Can We Improve Maternity Care Mistreatment?

Women from overlooked populations, including Latinas, suffer the most from mistreatment during maternity care, according to the survey.

These results are concerning considering these same women already suffer the highest rates of poor maternal health outcomes due to compounding health challenges, like living in a maternity care desert.

CDC highlights several ways we can stop mistreatment during maternity care to improve health outcomes among all women.

First, CDC emphasized that everyone can support pregnant and postpartum women in getting the care they need. CDC’s Hear Her campaign has resources to help providers and patients and their support networks recognize maternal warning signs and when to seek care.

Learn more about the Hear Her campaign.

Another solution is to improve patient-provider communication, which is key in building a trusted relationship. When patients have the confidence to confide in their providers, health complications can be avoided.

But to effectively communicate and build rapport with patients, providers must be aware of and address their own involuntary perceptions – or subconscious preferences for white patients over others.

Healthcare systems can help tackle involuntary perceptions by requiring training on background competency and by hiring a more workforce that accurately represents the their patients.

Studies show that more variety in the healthcare workforce can help break down language and background barriers and improve health outcomes for all patients.

“Healthcare provider trainings on [involuntary perceptions] and [background] appropriate care may be a first step in understanding how to provide respectful maternity care to all women,” said CDC Division of Reproductive Health Director Dr. Wanda Barfield.