About 1 in 5 women reported experiences of mistreatment and discrimination during pregnancy and delivery care, according to a new report from the Centers for Disease Control and Prevention (CDC), with the highest rates reported by Black, Hispanic and multiracial women.
The types of mistreatment most commonly reported by women were being verbally abused, having their requests for help go unanswered, having their physical privacy infringed upon and receiving threats to withhold treatment.
According to the report, about 30 percent of Black, Hispanic and multiracial women said they had been mistreated, and 40 percent of Black and 39 percent of multiracial women said they experienced discrimination.
Almost 1 in 3 women who responded said they felt they were discriminated against because of factors like age, weight or income.
“As a health care community we have to do better in providing unbiased and respectful maternity care equally to all mothers,” said Debra Houry, the CDC’s chief medical officer. “We’ve heard too many heartbreaking stories of women, particularly Black women, who knew something wasn’t right with their pregnancy. And voiced it, but were not heard and died as a result.”
The findings come as maternal deaths increased in the United States during 2018-21, with documented racial disparities. Native Hawaiian and other Pacific Islander, Black, American Indian and Alaska Native people have the highest rates of pregnancy-related deaths. Studies have shown nearly 80 percent of the deaths are preventable.
The CDC’s report analyzed data from about 2,400 respondents using a survey of mothers with children younger than 18, administered April 24-30 of this year. The survey was not nationally representative.
While most of the survey respondents reported overall satisfaction with the maternity care they received, satisfaction was lower among those who experienced mistreatment.
In addition, most women were reporting on experiences they had during the pregnancy or delivery of a child who was older than 5, so their responses might not represent more recent experiences.
The survey found differences in insurance were also a factor. Women with public or no insurance said they experienced more mistreatment during delivery than women with private insurance.
Pregnant women were also afraid to discuss their worries. Nearly half of women reported holding back from asking questions or discussing concerns with their provider during maternity care.
Many said they did not want to make a big deal about it or were embarrassed to talk about it. Others said they thought, or were told by friends and family, that what they were experiencing was normal, or they were afraid of being seen as “difficult” by their provider.
“We know that discrimination during prenatal care may be associated with reductions in seeking care,” said Wanda Barfield, director of the CDC’s Division of Reproductive Health. “We do know from this study that women are reluctant to report their concerns. And we do know that as a result of not voicing concerns, there may be an increased risk for pregnancy-related complications for both mom and baby.”
