One in five U.S. mothers reported mistreatment while receiving maternity care with their most recent pregnancy, the Centers for Disease Control and Prevention reported in a new study Tuesday.
Mothers said health care providers shouted at or scolded them, ignored requests for help or threatened that their treatment would be withheld, the Vital Signs report showed. They also said their physical privacy wasn’t protected.
Experts say it’s a staggering yet unsurprising statistic in a country that has one of the highest maternal mortality rates among its high-income peers. Maternal deaths jumped significantly during the first year of the pandemic, rising from 23.8 deaths per 100,000 live births in 2020 to 32.9 deaths in 2021. In Texas, for one, deaths among new mothers increased at least 40% between 1999 and 2019, the most recent year of available state-level data.
“What seems particularly shocking is that, in the pregnancy and postpartum period, it really is a time when women should receive respectful care,” said Dr. Wanda Barfield, director of the CDC’s Division of Reproductive Health. “I mean, everyone should receive respectful care, but it just seems like, particularly at this time, it’s so important.”
The rate of mothers reporting racial discrimination was even higher. Nearly 30% of mothers with children aged 18 or younger said they experienced discrimination during pregnancy or birth, a rate that increased to 40% when looking at Black, Hispanic and multiracial mothers. About 45% of participants in the study said they held back from asking questions or discussing concerns with their providers.
Mistreatment, discrimination and discomfort in voicing concerns with medical professionals can have dire consequences in the timely treatment of sometimes life-threatening medical conditions, as well as long-term negative effects on mental wellbeing.
“We know that poor treatment of mothers is a significant predictor of poor outcomes during the childbearing process, during labor, and even can influence the health of the infant, especially in when they’re in the first year of life,” said Shane Fernando, a clinical epidemiologist in the Texas College of Medicine’s Department of Pediatrics and Women’s Health.
In Texas, for example, the maternal mortality rate among Black mothers was 83 deaths per 100,000 live births between 2010 and 2019. White mothers experienced a maternal mortality rate of 40 in the same time period.
“What seems particularly shocking is that, in the pregnancy and postpartum period, it really is a time when women should receive respectful care.”
Similarly, Black mothers in the recent CDC study reported mistreatment and discrimination at higher rates — 30% and 40% compared to 20% and 29% overall, respectively. Hispanic mothers also reported higher rates of mistreatment and discrimination.
The study surveyed just over 2,400 mothers, the majority of whom were White. Black people make up nearly 14% of the U.S. population but represented only about 11% of study participants. Hispanic people represent 19% of the U.S. population, but only 10% of study participants.
The most common forms of discrimination reported hinged on age, weight and income. Mothers also reported discrimination in situations where they differed in opinion with caregivers about their right to care for themselves or their babies.
The results describing weight discrimination are emblematic of concerning trends in how overweight or obese patients are treated in the health care setting, Barfield said.
Mothers who had no insurance or public insurance experienced mistreatment at rates about 10% higher than mothers with private insurance. This is particularly alarming when considering the state of Texas, which has the highest rate of uninsurance in the country.
The survey did not break down respondents by state, only region, with the South representing about 35% of mothers included. Questions also did not address treatment during abortion care or access to abortions.
But other recent studies paint a distressing picture of women’s health and reproductive care in Texas. A health system ranking by The Commonwealth Fund ranked the Lone Star State 49th out of the 50 states and the District of Columbia, with access to usual and preventive care heavily contributing to the state’s poor women’s health showing.
The ranking didn’t include the impact of Texas’ abortion bans on women’s health care, but the bans have already had notable effects. The state saw 10,000 more births in the last nine months of 2022 than expected prior to the bans, which make abortion illegal in nearly all cases.
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