A new report details how frequent and pervasive discrimination can be for Black pregnant women.
From receiving no response, to cries for help, to being verbally abused, the U.S. Centers for Disease Control and Prevention’s weekly Vital Signs reports that 1 in 5 U.S. mothers say they were mistreated by a health care professional during pregnancy and delivery.
According to the survey of more than 2,400 new moms, rates of mistreatment during maternity care were higher among Black, Hispanic and multiracial women.
”The health of moms is the health of our nation,” the CDC’s chief medical officer, Dr. Debra Houry, told reporters during a media briefing.
“Too many women die during and after pregnancy in this country, and many women report mistreatment and discrimination during maternity care,” she said. “This is unacceptable as we know mistreatment can have a negative impact on the quality of maternity care, and we have to encourage a culture of respectful maternity care.”
Women who were uninsured or had public insurance experienced more mistreatment during pregnancy and delivery than their counterparts with private insurance, the survey showed. While 91% of women surveyed were happy with the maternity care they received, satisfaction was lower among those who said they had been mistreated.
Other forms of mistreatment identified included having requests for help refused or ignored (9.7%); being shouted at or scolded by health care providers (6.7%); having their physical privacy violated (5.1%), or being threatened that treatment would be withheld or being forced to treatment they didn’t want (4.6%). Among women who reported any form of mistreatment, 75.1% were satisfied with the care they received during pregnancy.
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The survey also looked at various forms of discrimination. In all, 29% of respondents reported discrimination during maternity care. The most common grounds cited were age, weight and income. Black mothers (40.1%), multiracial mothers (39.4%) and Hispanic mothers (36.6%) reported the highest rates of discrimination. Among multiracial respondents, the most common reasons were age (16.7%) and a difference in opinion with caregivers about the right care for oneself or one’s baby (12.1%).
Nearly half of respondents said they had held back from discussing concerns with their provider or asking questions, because they thought what they were feeling was normal, didn’t want to make a big deal about it, or felt embarrassed. In all, 20.7% said they held back in fear that their health care provider would think they were being difficult. Other respondents did so because their provider seemed rushed.
Report co-author Dr. Wanda Barfield, director of the CDC’s Division of Reproductive Health, said there are ways to promote more respectful care for women during pregnancy and delivery.
“This starts with health care providers engaging in active listening and being more culturally aware,” she said.
“Health care systems can train health care professionals to recognize unconscious bias and stigma and support shared decision making,” Houry added.
In addition, she said, promoting a more diverse workforce can help address some of the issues highlighted in the new survey.