CDC sounds alarm on pregnant women's doctor visits amid rise in maternal deaths

In a recent survey, 1 in 5 American women reported being scolded, threatened or otherwise mistreated during doctor visits while pregnant, with higher rates of such maternal mistreatment reported by women of color, a new Centers for Disease Control and Prevention report found.

The findings, published Tuesday, emerge at the same time as maternal mortality rates in the U.S. rise during pregnancy, delivery and after giving birth.

"This is unacceptable," Dr. Debra Houry, chief medical officer for the CDC, said on a call with reporters. "We know mistreatment and discrimination can have a negative impact on the quality of maternity care. We have to encourage a culture of respectful maternity care. This should be part of greater efforts to improve quality by standardizing care to reduce complications and deaths related to pregnancy and delivery."

U.S. maternal morality rates have increased in recent years, jumping from 17.4 deaths per 100,000 live births in 2018 to 32.9 in 2021, according to CDC data. The issue is of greater concern for Black and Native women. Non-Hispanic Black women had a death rate nearly three times that of non-Hispanic white women.

The CDC study found more than 80% of all maternal deaths were preventable, with underlying causes of mental health conditions, resulting in deaths by suicide or overdose; hemorrhage, or extreme bleeding; and heart problems.

Birth and death:Meet the Mississippi moms who fear for their lives a year after Roe fell

What the survey showed

In its latest report, CDC researchers analyzed data from 2,400 women surveyed in English in April by consulting firm Porter Novelli's View Moms survey, a voluntary consumer audience panel of U.S. mothers with children 18 years and younger. The survey, which Houry said gave a "national picture," asked respondents from around the country about maternity care experiences during pregnancy or delivery of their youngest child.

The most common types of mistreatment reported were:

• Not receiving any responses to requests for help (9.7%); 
• Being shouted at or scolded (6.7%); 
• Physical privacy violated (5.1%); and
• Threatened to have treatment withheld or made to accept unwanted treatment (4.6%).

Life or death:In rural America, maternal health care is vanishing. These moms are most at risk.

Black, Hispanic and multiracial women reported the highest rates of mistreatment. Women without health insurance also said they experienced more mistreatment, around 28%, similar to those with public insurance, at 26%. In contrast, just 16% of women with private insurance said they experienced mistreatment. 

Discrimination felt more acutely by Black, Hispanic and multiracial women

Women were also asked about discrimination they experienced based on their race, ethnicity, skin color, age or weight. About 40% of Black, Hispanic and multiracial respondents said they felt discriminated against, compared with 29% of all respondents.

The respondents said they experienced discrimination over their:

• Age (10%);
• Weight (10%); and
• Income (6.5%);

Nearly 45% of respondents reported “holding back from asking questions or discussing concerns with their provider.” Common issues cited were thinking what they felt was normal for pregnancy (28.8%); not wanting to make a big deal, or being embarrassed to talk about it (21.5%); or friends and family saying it was a normal part of pregnancy, or that they had the same experience (21.2%).

While researchers stressed the results weren't a direct link to maternal mortality, the data supports evidence that not properly diagnosing issues can put women at risk. There must be greater communication and trust between patients and providers, said report author Dr. Wanda Barfield, the director of the CDC Division of Reproductive Health, who is Black.

"We want patients to be comfortable sharing their health concerns with their providers," she said, pointing to nurses, physician assistants or doctors. "It's critical that we healthcare providers in the room make sure that we're taking the time to build trust, actively listening and being culturally aware of the people we're serving."

How are policymakers responding?

In recent years, lawmakers have sought to champion issues for Black maternal health, even forming a caucus in Congress. In April, the Biden administration proclaimed Black Maternal Health Week.

The recent findings support persistent maternal health issues in American healthcare and underscore the need for respectful care as an important component to reduce pregnancy-related deaths. The report cited improvements in standardized care, along with training on discrimination, stigma and unconscious bias, cultural awareness and communication techniques to better engage patients and providers.

“Every mother deserves to be treated with dignity and respect. Maternal care is a core component of this nation’s health care, and the Biden-Harris Administration is committed to improving maternal health outcomes,” said U.S. Department of Health and Human Services Secretary Xavier Becerra in a statement. “Bias, stigma, and mistreatment have no place in our healthcare systems.”

Eduardo Cuevas covers health and breaking news for USA TODAY. He can be reached at EMCuevas1@usatoday.com.