One in five women reported mistreatment during maternity care in the U.S., according to a newly released U.S. Centers for Disease Control and Prevention’s (CDC) Vital Signs report on maternity care experiences.
More than 2,400 respondents completed the Porter Novelli View Moms survey which was conducted from April 24 through 30, 2023 by Porter Novelli. The CDC analyzed the data to examine experiences of mistreatment, instances of discrimination and barriers to patient-provider communication.
“When we talk about mistreatment we’re talking about 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,” said Dr. Wanda Barfield, director of CDC’s Division of Reproductive Health during a media briefing on Aug. 21.
According to CDC findings, mistreatment during maternity care was higher among Black (30%), Hispanic (29%) and multiracial (27%) women.
Earlier this year, the CDC released new data on maternal mortality rates in the U.S. which found that the maternal death rate increased from 17.4 to 32.9 per 100,000 live births between 2018 to 2021 — a 40% increase. According to the World Health Organization, a maternal death is defined as the death of a person while pregnant or within 42 days of termination of pregnancy from any cause related to the pregnancy.
Maternal mortality rates in the U.S. Have increased by 40% in the last four years, from 2018 to 2021, according to the CDC. (Data visual by Breanna Reeves)
The new vital signs report examines types of mistreatment women face during pregnancy, the impact such mistreatment can have on a woman’s pregnancy and health, and how respectful maternity care can be achieved. Roughly 80% of pregnancy-related deaths are preventable.
While the survey noted at least seven limitations including the survey being optional, the data is “likely not representative of the U.S. birthing population,” and was only offered in English, the results of the survey demonstrate that despite innovation in technology and medical advancements, access to respectable and equitable maternity care is not available to everyone.
“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’s own Dr. Shalon Irving was one of these women,” said CDC’s Chief Medical Officer Dr. Debra Houry.
Dr. Irving was a lieutenant commander in the U.S. Public Health Service and advocate for health equity. In 2017, she died weeks after giving birth to her daughter due to high blood pressure. According to Dr. Houry, Dr. Irving consistently visited her health care provider, and kept insisting that something was wrong, but was dismissed.
“Healthcare systems can work to improve cultural awareness among staff and support doula and midwifery models of care that may improve patient experiences,” said Dr. Houry. “They can also engage community-based organizations and find ways to incorporate respectful care.”
Across the Inland Empire, community-based organizations that support Black birthing people and communities of color have grown over the last few years. As more families seek services outside of traditional hospital settings or seek additional support from trained medical professionals such as midwives or culturally trained doulas who provide nonmedical support, health care providers are beginning to recognize the invaluable support they bring.
For communities in the Inland Empire seeking such services and who want to learn more about maternal and reproductive health, following are some of the Black-led community-based organizations and individuals who serve and support the community:
Celest Winfrey, founder of Ivy Midwife, is a licensed midwife, certified professional midwife and international board certified lactation consultant who supports birthing families across the Inland Empire. Winfrey offers a host of supportive services including home births, wellness care, postpartum care and more. In addition to her work as a midwife, Winfrey also hosts Midwife Chats, a platform used to educate the community on different maternal health with expert individuals such as lactation experts, doulas and therapists.
Aiyana Davison is a certified nurse midwife and women’s health nurse practitioner who supports families across Southern California. Founded by Davison, The Village House supports birthing families and offers several services during pregnancy, birth and postpartum, sound healing, placenta encapsulation, and more. In addition to servicing families as a midwife, Davison also uses her online platform, The Vagina Chronicles, to educate the community about reproductive health and “birth empowerment.”
Founder of Tribe Midwifery, Debbie Allen is a licensed midwife and certified professional midwife, and practiced as a doula. Tribe Midwifery offers services such as wellness care (pap smear, pelvic exams, etc.), family planning, childbirth education and a variety of other birthing and postpartum services. Tribe Midwifery serves communities in Los Angeles and the Inland Empire.
This article is published as part of the Commonwealth Fund Health Equity Reporting Fellowship.