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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 disproportionately impacts women of color.
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 for Women of Color
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 race/ethnicity.
Women of color, including 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 of color.
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 discriminatory treatment.
A whopping 29% of women reported feeling discriminated against during maternity care. The most common reasons for reported discrimination being age, weight, income, and race/ethnicity. 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 of color, 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 inequities, 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 equitable 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.
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 implicit bias – or subconscious preferences for white patients over those of color.
Healthcare systems can help tackle implicit bias by requiring training on cultural competency and by hiring a more diverse workforce that accurately represents the diversity of their patients.
Studies show that a more diverse healthcare workforce can help break down language and cultural barriers and improve health outcomes for all patients.
“Healthcare provider trainings on unconscious bias and culturally 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.
Healthcare Workers, Do You Have Implicit Bias?
All women deserve unbiased healthcare.
You can help tackle healthcare worker implicit bias by downloading the free Salud America! Action Pack “Health Care Workers and Researchers: Find If You Have Implicit Bias and What to Do Next.”
“This Action Pack will help you see if you have implicit bias, learn from others who have overcome their own implicit bias, and encourage colleagues to learn about implicit bias, too,” said Dr. Amelie Ramirez, director of Salud America! and its home base, the Institute for Health Promotion Research at UT Health San Antonio.