A recent study from the Columbia University Mailman School of Public Health found that more than one in eight women report feeling mistreated during childbirth. Researchers collected data from nearly 4,500 individuals in various states to examine how often mistreatment occurs, what form it takes, and which demographic and social characteristics are more likely to result in mistreatment. The study found that 7.6% of people reported feeling ignored or that healthcare workers refused their requests for help, 4.1% said they were shouted at or scolded, and 2.3% reported threats to withhold treatment or force unwanted treatment. Mistreatment was more likely for LGBTQ+ individuals, those with substance use disorder or mood disorders, unmarried individuals, those with a history of violence, and those with Medicaid insurance. Unplanned cesarean births were also associated with higher rates of mistreatment. However, the study found ambiguous results regarding variations in mistreatment rates based on race, ethnicity, age, educational level, area, immigration status, and household income.
The lead author of the study, Chen Liu, highlighted the potential influence of pervasive structural social stigma on the birth experience, noting that LGBTQ-identifying individuals were twice as likely to experience mistreatment due to feelings of being forced to accept unwanted care or denied desired treatment. These findings are consistent with previous research showing poorer birth outcomes among sexual minorities. Negative experiences during childbirth, including mistreatment, can have long-term consequences such as post-traumatic stress disorder, negative body image, and changes in future reproductive decisions. To address these issues, healthcare providers should hold staff accountable, and policymakers should develop effective interventions to improve respectful maternity care.
Recent studies have shown a concerning increase in pregnancy-related deaths in the United States, with Black women facing a significantly higher risk compared to other groups. The study emphasizes the importance of establishing patient-centered, multifaceted interventions to address biases and create inclusive clinical settings. It calls for action to implement and evaluate interventions that target structural health system factors contributing to negative birth experiences. The study did not provide specific policy recommendations but urged officials to prioritize the development of interventions to prevent mistreatment during childbirth, which is considered a crucial moment in a person’s life. The findings from this study underscore the need for comprehensive efforts to improve maternal care and support vulnerable populations during childbirth.
