CDC says 20% of women report mistreatment during pregnancy care
It can be the most exciting, worrisome, exhausting and joyful experience of a woman's life.
But one in five report mistreatment such as being ignored or yelled at by health care providers during pregnancy, a recent U.S. Centers for Disease Control and Prevention study finds.
And the ill treatment is highest among Black and Hispanic patients, as well as women without health insurance, according to more than 2,400 mothers surveyed in April.
“It's definitely a problem that needs to be addressed,” Cook County Health obstetrician/gynecologist Carmen Adams told the Daily Herald.
Pregnancy is “such a critical and important time and there are so many potential complications that can happen throughout the birth process,” Adams said.
If patients feel they aren't being heard, “it can lead to more complications and problems down the line,” she said.
What is mistreatment?
“We're talking about (moms) receiving no response to requests for health, being shouted at or scolded, not having their physical privacy protected, and being threatened with withholding treatment or made to accept unwanted treatment,” CDC Division of Reproductive Health Director Wanda Barfield said at a briefing last week.
Minority moms at risk
The CDC study said 30% of Black women and 29% of Hispanic mothers experienced offensive behavior, compared with 19% of white patients surveyed.
“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,” CDC Chief Medical Officer Debra Houry said at the briefing.
She cited a former CDC colleague and doctor who died in 2017 weeks after delivery due to high blood pressure. “She kept insisting something was wrong and was being dismissed,” Houry said.
In all, 28% of women with no health insurance and 26% with public insurance reported negative experiences, in contrast with 16% of those with private insurance.
“We have to do better in providing unbiased and respectful maternity care equally to all mothers,” Houry said.
The CDC is recommending health care systems hire and retain a diverse workforce, offer training on preventing unconscious bias, and recognize that midwives and doulas can improve a patient's experience.
From 2018 to 2021, the maternal death rate in the U.S. rose from 17.4 to 32.9 per 100,000 live births. But about 80% of pregnancy-related deaths can be prevented, the CDC reported.
Finding the right doctor
Disturbingly, 45% of moms described being reluctant to ask questions or raise concerns. The reasons included thinking what they felt was “normal,” being embarrassed and “not wanting to make a big deal,” and a fear of appearing “difficult.”
It's crucial expectant moms feel empowered to share seemingly minor things such as headaches or swelling with their doctor, Adams said. That's because those could be symptoms of hypertensive disorders like preeclampsia or elevated blood pressures, which can have serious consequences.
“I want you to tell when you have these problems,” Adams said. “I don't want you to feel like you're bothering me or anything.”
Cook County Health has bilingual staff members and uses interpreter services. “Having providers that look like the patient and can speak the same language is very important,” Adams said.
She advises women to find a provider they're comfortable with before pregnancy. Make sure you don't feel rushed or intimidated.
Also, if your current doctor isn't working out, consider switching, Adams said.
“It's OK to say, 'I'm not having a good experience with one provider and I want to try a different doctor.'”
The CDC's Hear Her campaign works to promote health pregnancies. For more information, go to dc.gov/hearher.