Every mom deserves respectful and responsive care during pregnancy and delivery.
Maternal death rates in the U.S. rose from 2018 to 2021. More than 80% of pregnancy-related deaths are preventable. Native Hawaiian and Pacific Islander, Black, and American Indian and Alaska Native women have the highest rates of pregnancy-related death.
Women from some racial and ethnic minority groups are also more likely to have negative healthcare experiences during pregnancy and delivery that impact the quality of care and health outcomes.
Twenty percent of those surveyed reported experiences of mistreatment during maternity care. Thirty percent of Black, 29% of Hispanic, and 27% of multiracial women reported mistreatment.
The most common types of mistreatment reported 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.
Better communication is needed during maternity care
Almost half (45%) of moms reported holding back from asking questions or sharing concerns during their pregnancy or delivery. The top reasons included:
Thinking, or being told by friends or family, what they were feeling was normal.
Not wanting to make a big deal about it or being embarrassed to talk about it.
Thinking their healthcare provider would think they’re being difficult.
Thinking their healthcare provider seemed rushed.
Not feeling confident that they knew what they were talking about.
To improve the quality of maternity care:
Healthcare systems can support care that is respectful and considers the patient’s values, needs, and desires (i.e., patient-centered care) equally for all mothers.
Maternity care providers can ensure patients are engaged in their health care and feel heard and respected.
Communities can raise awareness of respectful care and promote health equity.
Challenges
Bias and discrimination in maternity care settings impact care.
Mistreatment by maternity care providers was reported most often by Black, Hispanic, and multiracial moms. People with no insurance or public insurance experienced more mistreatment during maternity care than people with private insurance.
About 29% of women experienced discrimination while receiving maternity care. Reports of discrimination were highest among Black (40%), multiracial (39%), and Hispanic (37%) women.
While satisfaction with maternity care overall was high (90%), satisfaction among moms who reported mistreatment was considerably lower (75%). Mistreatment and discrimination impact experiences of care.
Poor communication can worsen maternal health outcomes
Sometimes it is hard for pregnant women to ask questions or share concerns. Maternity care providers can improve communication by creating an environment of trust.
Providers can take time to really hear women’s concerns and have an open conversation to make sure any issues are adequately addressed.
When there is good communication about health concerns between moms and providers, it is more likely there will be accurate, timely diagnoses and treatment for potentially life-threatening pregnancy complications.
What Can Be Done To Advance Health Equity
Differences in respectful maternity care are rooted in discrimination and stigma based on factors that include race and insurance coverage. Research has shown the connection between pregnancy complications and experiences of racism or discrimination. Greater diversity in the healthcare workforce can help address racial and ethnic disparities in health care by improving patients’ experiences, increasing patient satisfaction, and improving access to care for underserved patients.
CDC is advancing birth equity by:
Improving understanding of the leading causes of pregnancy-related deaths.
Supporting state networks of teams working to improve the quality of care for mothers and babies.
Improving communication between healthcare providers and pregnant and postpartum women and their support networks.
Partners are advancing birth equity by:
Making respectful care part of patient safety bundles, which are standard approaches for use in maternity settings to ensure that every patient gets the same, high-quality care.
Developing toolkits to promote respectful care in maternity settings.
Providing ongoing training to maternity care teams about unconscious bias and culturally appropriate care.
Training providers in settings that serve communities with higher rates of pregnancy-related complications and deaths.
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