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Mistreatment during Pregnancy and Delivery: A Disturbing Reality

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New research released by the Centers for Disease Control and Prevention reveals a disturbing truth – one in five women reported mistreatment during pregnancy and delivery care. This mistreatment includes threatening patients with withholding treatment, violating physical privacy, and shouting or scolding them. The study sheds light on various factors that contribute to this issue.

Disparities in Health Coverage

The study highlights that mistreatment was more prevalent among patients who lacked health coverage at the time of delivery. Shockingly, 28% of uninsured women reported receiving poor treatment, compared to 26% of those with public insurance (such as Medicaid) and 16% of those with private insurance. These disparities in care based on insurance coverage are deeply troubling.

Racial Disparities Persists

Unfortunately, people of color consistently face mistreatment during pregnancy and delivery. The report reveals that poor care was reported by 30% of Black patients, 29% of Hispanic patients, and 27% of multiracial patients, in contrast to 19% of white patients. These alarming statistics underscore the urgent need to address racial disparities in maternal care.

Maternity Care Under Scrutiny

This study adds to the growing scrutiny of maternity care in the United States. With the rising rate of pregnancy-related deaths, concerns regarding the quality of care provided during this crucial period have escalated. In 2021 alone, more than 1,200 women died of maternal causes in the U.S., resulting in a rate of nearly 33 deaths per 100,000 live births. Startlingly, this is an increase from the rate of 17.4 deaths per 100,000 live births recorded in 2018.

Impact of COVID-19 and Systemic Barriers

The COVID-19 pandemic compounded these challenges, contributing to a quarter of total maternal deaths in 2020 and 2021, as reported by the U.S. Government Accountability Office. Beyond the direct impact of the virus, there were disruptions in public transportation, childcare services, and other vital resources, exacerbating the existing barriers to quality care faced by pregnant women.

Preventable Losses

The CDC emphasizes that the majority of pregnancy-related deaths are preventable. However, the pregnancy-related death rate in the United States surpasses the typical rate in high-income countries. In 2020, the global rate was just 12 deaths per 100,000 live births, according to the World Health Organization. Disturbingly, maternal mortality rates among U.S. Black women were even higher, reaching approximately 70 deaths per 100,000 births in 2021, as reported by the CDC.

This research shines a much-needed spotlight on the mistreatment faced by women during pregnancy and delivery. It is imperative for healthcare professionals, policymakers, and society as a whole to take immediate action to rectify these disparities and ensure safe and respectful maternity care for all women.

Improving Maternity Care for Women: A Call for Change

The Centers for Disease Control and Prevention (CDC) is taking significant steps to address the concerning issue of pregnancy-related deaths among women, particularly Black women. Dr. Debra Houry, the CDC chief medical officer, emphasized the need for change during a recent call with reporters.

Perinatal quality collaboratives, which consist of clinical teams, public-health leaders, and other stakeholders, are already working diligently to enhance care for both mothers and babies. However, the CDC plans to further expand these networks later this year.

In their statement, the CDC acknowledged that improving the quality of maternity care is crucial in preventing pregnancy-related deaths. They firmly believe that all women deserve respectful care that upholds their dignity, privacy, and confidentiality. Additionally, shared decision-making should be an integral part of the care process.

A recent survey uncovered various forms of mistreatment experienced by women during maternity care. The most common type was healthcare providers ignoring or refusing patients’ requests for assistance. Verbal abuse also ranked high on the list.

Discrimination played a distressing role as well, with nearly 30% of women reporting incidents during maternity care. This discrimination often stemmed from factors such as age, weight, income, and race. Alarmingly, Black, multiracial, and Hispanic women experienced the highest rates of discrimination.

Dr. Wanda Barfield, director of the CDC’s reproductive health division, highlighted the detrimental effects of racism and discrimination on timely treatment and avoidable deaths. She stressed the urgent need for healthcare providers to receive training on unconscious bias and culturally appropriate care.

A concerning finding from the report was that almost half of women admitted hesitancy in asking questions during their maternity care. This reluctance was sometimes driven by a fear of being perceived as difficult patients.

To improve patient experiences for racial and ethnic minority groups, the report suggests recruiting and retaining providers with diverse backgrounds that reflect the populations they serve. Additionally, incorporating midwifery models of care and including doulas in the care process can have a positive impact.

Change is necessary to ensure that every woman receives the highest quality of care throughout their pregnancy journey. The CDC’s efforts, along with increased awareness and commitment from healthcare providers, bring hope for a safer and more respectful maternity care system.

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