
Approximately 20% of women endure unfavorable patient experiences in maternity care, often involving mistreatment by providers. This issue disproportionately affects women of color, with 30% of Black, 29% of Hispanic, and 27% of multiracial women reporting mistreatment. Common problems include a lack of respectful care, threats of treatment denial, and inadequate privacy protection. Such experiences hinder effective patient-provider communication and contribute to poor maternal outcomes. CDC recommends healthcare organizations promote respectful care, address biases, and foster inclusive maternity care to prevent adverse events and elevate maternal health.
One out of every five women encounters a distressing patient experience within the realm of maternity care. These encounters often involve unsettling instances such as threats of treatment denial or the imposition of undesired treatments.
The maternal health predicament transcends the escalating maternal mortality rate in the country. Fresh data from the Centers for Disease Control & Prevention (CDC) paints a concerning picture—nearly twenty percent of women have undergone unfavorable patient experiences characterized by ill-treatment from their maternity care providers.
Significantly, these unfavorable patient-provider dynamics are more prevalent among women of diverse backgrounds, particularly women of color, who also tend to grapple with subpar maternal health outcomes. The CDC report, derived from data acquired from the Porter Novelli View Moms survey, underscores that one in three Black, Hispanic, and multiracial women recount instances of mistreatment by maternity care providers.
The CDC defines mistreatment as the absence of respectful care during maternity services, encompassing the provision of care that preserves dignity, privacy, and confidentiality, and shields against harm and mistreatment while fostering informed decision-making and continuous support throughout labor and childbirth.
The survey, involving 2,407 mothers, highlights the disconcerting reality of maternity care often falling short of this definition of respect. Overall, twenty percent of mothers reported encountering mistreatment during maternity care for their youngest child. The instances of subpar patient experiences were even more pronounced among women of color, with thirty percent of Black women, twenty-nine percent of Hispanic women, and twenty-seven percent of multiracial women expressing dissatisfaction with their maternity care.
Furthermore, four out of ten women from these groups reported instances of healthcare discrimination.
The most prevalent forms of mistreatment encompassed:
1. Non-response to pleas for assistance
2. Verbal chastisement or shouting
3. Insufficient protection of physical privacy
4. Threats of treatment denial or imposition of unwanted treatment
These unsatisfactory experiences prompted many women to withhold their thoughts in their interactions with healthcare providers. Nearly half (45 percent) of the women confessed to refraining from posing questions or voicing concerns during pregnancy or childbirth. In certain instances, women believed their feelings were commonplace, often influenced by family perceptions. Others were apprehensive about appearing overly concerned about minor issues, or they felt uncomfortable addressing their concerns.
Some women also harbored concerns about how their healthcare providers would perceive them, worrying that they might be labeled as problematic patients. There were instances where women lacked confidence in their understanding of medical matters. Additionally, some women abstained from raising concerns due to the perceived time constraints faced by their providers.
These accounts of distressing maternity experiences are deeply troubling, especially given the nation’s existing challenges in maternal health outcomes. Between 2018 and 2021, the maternal mortality rate in the United States surged by almost double, from 17.4 to 32.9 per 100,000 live births. Certain demographics, such as Native Hawaiian and other Pacific Islander, Black, and American Indian/Alaska Native individuals, experienced even more dire maternal mortality rates.
Remarkably, the United States demonstrates the worst maternal outcomes and maternal health equity among developed nations, according to The Commonwealth Fund.
However, the CDC emphasized that as much as 80 percent of maternal deaths are preventable. Improving the maternal mortality rate necessitates not only pivotal changes in processes and patient safety but also the cultivation of healthier patient-provider relationships. Enhanced perceptions of respectful care have the potential to bolster access to maternity care, a pivotal factor in mitigating poor maternal outcomes.
Moreover, fostering better communication between patients and providers during maternity care could serve to identify potential patient safety concerns early on, preventing their escalation.
The CDC report unveiled an unsettling truth—women often feel apprehensive about voicing their concerns. It is incumbent upon healthcare providers to instill a sense of empowerment in all women, encouraging them to express concerns and raise questions when something doesn’t seem right.
The CDC underscored the significance of healthcare organizations establishing formalized and standardized channels to educate healthcare providers on implicit biases and cultural awareness. These initiatives should draw insights from community advocacy groups, patients, and their family members, the CDC advised.