August 24, 2023 – One in five women report abuse by healthcare professionals while pregnant and childbirth – an issue that's much more common amongst people of color, in keeping with a survey published on Tuesday by the CDC.
The latest CDC Vital functions The report relies on a survey of two,400 women who were asked concerning the medical care they received during their last pregnancy. Thirty percent of black women surveyed reported mistreatment, as did 29 percent of Hispanic women, 27 percent of multiracial women, 18 percent of white women, 20 percent of American Indian/Native Hawaiian/Pacific Islander/Alaska Native women and 15 percent of Asian women.
“I have had thousands of experiences and opportunities to witness the care provided to mothers during pregnancy, childbirth and afterward. Not all of that care was respectful,” said Wanda Barfield, MD, of the CDC, during a press conference Tuesday. “As a mother and a black woman, I was fortunate to have an ob-gyn who saved my life and that of my son by respectfully listening to my concerns throughout my pregnancy.”
“However, this report provides evidence that many women are having experiences that are truly unacceptable,” she said.
The abuse described within the report includes yelling or verbal abuse, rejected and unanswered requests for help, threats to withhold treatment, and invasion of privacy. The CDC analyzed data from the Porter Novelli View Moms survey, conducted April 24-30 of this 12 months.
Survey respondents also reported discrimination based on medical insurance status. Twenty-eight percent of girls without medical insurance and 26 percent with public insurance reported receiving inadequate care, while 16 percent with private insurance reported the identical.
“Overall, the most commonly reported reasons for discrimination were age, weight and income, with the most common reason varying by race and ethnicity,” said Barfield, director of the CDC's Division of Reproductive Health on the National Center for Chronic Disease Prevention and Health Promotion.
According to the report, the survey represents only a small a part of a much larger problem – maternal mortality rates within the U.S. that far exceed those of other high-income countries, and people deaths have been on the rise since 2018. according to CDCand in 2021, the death rate was 32.9 deaths per 100,000 live births, up from 23.8 in 2020 and 20.1 in 2019. In 2021, the maternal mortality rate for black women was 69.9 deaths per 100,000 live births.
Shalon Irving, PhD, a renowned CDC epidemiologist, died in 2017 from complications of hypertension, three weeks after giving birth to her daughter. Irving, who was black, was fired by doctors when she insisted something was flawed.
The report's findings will not be surprising, on condition that the U.S. lags behind other developed countries by way of housing for pregnant women, says Catherine Cansino, MD, a clinical professor of obstetrics and gynecology at UC Davis Health.
The average paid maternity leave worldwide is 29 weeks, in keeping with data from the Center for World Policy AnalysisIn the United States, there isn't a federal law that requires paid parental leave of any specific duration.
Most young moms in industrialized countries receive a minimum of half their salary during maternity leave, in keeping with a report by the Organisation for Economic Co-operation and Development (OECD).
“In our society in general, our voices are not necessarily heard as clearly and we have to speak up for ourselves,” Cansino said. “For women and people of color, and especially people who identify in that intersectionality, it's going to be very difficult to navigate.”
The report outlines several measures to enhance obstetric care, including hiring doctors with ethnic and racial backgrounds that match those of the patient population, using doulas and midwives, and providing more intensive training for doctors and nurses.
“As a health care community, we must do better to provide equally unbiased and respectful birth care to all mothers,” said Deborah Houry, MD, CDC chief medical officer, during Tuesday's conference call. “We know that actions such as hiring and retaining a diverse workforce and providing training to health care providers on unconscious bias and stigma can help improve the quality of care.”
D'Angela Pitts, MD, director of maternal health equity at Henry Ford Health in Detroit, said even the smallest changes in doctor-patient interactions could make a giant difference. For example, she encourages residents to ask patients and their support staff, “What questions do you have?” slightly than, “Do you have any questions?” This prevents patients from remaining silent despite their concerns – something nearly half (45%) of survey respondents said they do.
Pitts said it is usually necessary for healthcare professionals to indicate abuse once they see it.
“We need to hold each other accountable as providers,” she said. “If you hear a colleague say something, speak up and say, 'I think I would have done that differently.'”