CDC study: Respectful care can support healthy pregnancies
==========================================================

* Minoli Ediriweera

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/53/9/5.1/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/53/9/5.1/F1)

Photo by SolStock, courtesy iStockphoto

> “That general power imbalance leads to mamas feeling ignored or making requests that are disregarded.”
> 
> *— Carmen Green*

Maternal deaths among women of color in the U.S. have reached crisis levels. A recent study from the Centers for Disease Control and Prevention says that improving respectful care toward patients could help reduce those and other pregnancy-related deaths.

A CDC survey of more than 2,400 U.S. mothers found that 1 in 5 women report being mistreated during their maternity care. Common problems included being ignored, refused help, shouted at and scolded. Some also said their physical privacy had been violated.

Women of color, particularly Black women, reported higher rates of negative interaction and subpar care from their providers. And about 40% of Black women and multiracial women and 36.6% of Hispanic women said they experienced racial or ethnic discrimination. Overall, nearly 29% of all respondents reported discrimination based on race or ethnicity.

Almost half of all respondents in the study, which was published Sept. 1 in *Morbidity and Mortality Weekly Report*, said they were reluctant to ask questions or share concerns with their health care provider.

Patients can sometimes feel they are not knowledgeable enough to ask certain questions and are embarrassed to discuss concerns about their care, according to Carmen Green, vice president of research and strategy at Reproductive Health Impact: The Collaborative for Equity & Justice, who was not involved in the study.

“That general power imbalance leads to mamas feeling ignored or making requests that are disregarded,” Green told *The Nation’s Health*. “Another common experience is a sense of overwhelm of information that breaks this general trust in communication.”

Study researchers, who were affiliated with the Division of Reproductive Health at CDC’s National Center for Chronic Disease Prevention and Health Promotion, said the findings “underscore the need for improvement,” particularly in light of growing deaths. Between 2018 and 2021, U.S. maternal death rates nearly doubled, from 17.4 per 100,000 births to 32.9, according to CDC.

“Respectful maternity care is a component of quality care and can be integrated into broader strategies to reduce pregnancy-related deaths,” the study said.

Study authors recommended that healthcare systems implement training for health care providers on unconscious bias, shared decision-making and cultural awareness. Holding discussions and engaging with the local community can build trust among health care professionals and the patients they work with.

It is also crucial to train and hire diverse health care professionals who reflect the demographics of patients, the study said. Having providers with similar backgrounds has been shown to especially improve patient experiences for people of color.

Green advised health care workers take time to be more sensitive to the needs of their patients.

“A bad day for a nurse can turn into a preventable patient death or a preventable infant death,” Green said. “It requires our providers to be hyper-vigilant about their behaviors, about checking their biases over and over, and also creating some opportunities where they’re building a rapport with the patient or understanding what’s going on at home.”

CDC’s Hear Her campaign provides resources to help pregnant and postpartum women raise their concerns with their health providers. The campaign also shares materials to help providers better listen to the concerns of their patients. Specific information is offered for obstetric professionals, pediatricians and other health workers.

For more information, visit [www.cdc.gov/vitalsigns](https://www.cdc.gov/vitalsigns/) and [www.cdc.gov/hearher](https://www.cdc.gov/hearher/).

*   Copyright The Nation’s Health, American Public Health Association