CDC: Women report mistreatment in maternal care; higher rates among Black, Hispanic mothers 

Almost 30% of Black, Hispanic and multiracial women surveyed report mistreatment from health care providers during pregnancy and delivery, according to a new report released Tuesday from the Centers for Disease Control and Prevention.

The women said they were “shouted at or scolded,” did not receive a response to request for help and were threatened with withholding treatment or made to accept unwanted treatment, the new report said.

Overall, 20% of respondents to the survey reported mistreatment.

“This is unacceptable,” Dr. Debra Houry, the CDC’s chief medical officer, said in a call with reporters to discuss the findings. “We know mistreatment and discrimination can have a negative impact on the quality of maternity care.”

The new data highlights ongoing disparities in health care for women of color, with the backdrop of increasing maternal mortality rates in the U.S. Earlier this year, the CDC reported that 1,201 women died of maternal causes in the U.S. in 2021, a jump from 861 in 2020 and 754 in 2019, with the rates being higher for Black women.

Dr. Dawnette Lewis, director of Northwell Health's Center for Maternal Health based in New Hyde Park said she wasn’t surprised by the study’s findings that Black and Hispanic patients feel discriminated against.

“The (nation's health care) system really was not built to welcome those patients … Black women are not valued as much and not nurtured as much when they're in the health care systems," she said. "And so we think implicit bias training is very important for the workforce. We also think diversity in the workforce is very important.”

The report identifies concerns that advocates have been hearing for years, said Martine Hackett, an associate professor of public health at Hofstra University and co-founder of Birth Justice Warriors, which focuses on infant and maternal mortality.

“There is a disconnect,” said Hackett. “If you asked doctors and nurses they would probably say they aren’t doing anything disrespectful.”

Hackett said that while women are urged to speak up, they are sometimes seen as being aggressive or nonresponsive by clinicians.

“I think health care providers need to be prepared for patients to advocate for themselves and respond to their needs,” she said.

The CDC used data from a survey administered between April 24 and 30. Most of the 2,402 respondents said they were satisfied with their treatment during maternity care. Of the 20% who reported mistreatment, 30% were Black, 29% were Hispanic, 27% were multiracial, 18% were white, 15% were Asian and 20% were American Indian/Alaska Native/Pacific Island/Native Hawaiian.

Women with no insurance or public insurance when they had their deliveries were more likely to report mistreatment than those with private insurance.

Additionally, 29% of women reported discrimination during maternity care, with the top reasons being age, weight and income. Black women reported the most discrimination overall at 40%.

“We have 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,” Houry said.

Dr. Wanda Barfield, director of the CDC’s Division of Reproductive Health, said women who feel they were mistreated were less likely to seek care.

“This can have negative consequences for both mother and baby,” Barfield said.

Lewis said Northwell, which is the state’s largest health care provider, has been working with other leaders on the New York State Birth Equity Improvement Project to tackle the disparities. Part of those efforts have included surveying women about their experiences giving birth and using those perspectives to make improvements in care and services.
Shanequa Levin, CEO and founder of the Long Island-based Women’s Diversity Network, said the group started a Maternal Justice Coalition that encourages pregnant women to advocate for themselves. That includes photographing their own physical symptoms to show doctors and requesting doctors take note in their records if they said certain tests are not needed. They also suggest pregnant women work with doulas who can help guide and support them.

“Doctors need to take time with patients, it’s not a factory,” Levin said. “Individuals are coming at the most vulnerable times in their life seeing the support of knowledgeable doctors. If they are rushed, they will not be as attentive.”

The CDC made several recommendations for health care systems and clinicians including creating a diverse workforce to help “encourage a culture of respectful maternity care.” In addition, all health care staff should be trained to “recognize unconscious bias and stigma.”

By Lisa L. Colangelo

lisa.colangelo@newsday.com@lisalcolangelo

Lisa joined Newsday as a staff writer in 2019. She previously worked at amNewYork, the New York Daily News and the Asbury Park Press covering politics, government and general assignment.