The study found that mistreatment during childbirth is a "regular occurrence," according to a news release.
Researchers from the Columbia University Mailman School of Public Health collected survey data from nearly 4,500 people from New York City and the states of Kansas, Michigan, New Jersey, Pennsylvania, Utah and Virginia to examine how often mistreatment occurs, what form it takes, and what demographic and social characteristics are more likely to result in mistreatment.
Among the general population, one in eight people said they experienced mistreatment in childbirth, with 7.6% of people saying that they felt "ignored" or that healthcare workers "refused requests for help" or failed "to respond in a timely manner." Another 4.1% of people said they were "shouted at or scolded" by healthcare providers, and 2.3% of people said that providers threatened to "withhold treatment or force you to accept treatment that you did not want" as part of giving birth.
The likelihood of experiencing mistreatment was higher for individuals who identified as LGBTQ+, had a history of substance use disorder, were diagnosed with a mood disorder, were unmarried, had a history of intimate partner or family violence, or had Medicaid insurance. Additionally, those who underwent unplanned cesarean births were also more prone to facing mistreatment, according to a recent study.
The study aimed to assess whether rates of mistreatment varied based on factors such as race, ethnicity, age, educational level, area, immigration status, and household income, but the results were inconclusive.
"Many of our results indicate that pervasive structural social stigma influences the birth experience and impacts the quality of care received," stated Chen Liu, the lead author of the study and a research associate in Columbia Mailman School's Department of Health Policy and Management. "For instance, we discovered that LGBTQ-identifying individuals were twice as likely to experience mistreatment, primarily due to higher rates of feeling coerced into accepting unwelcome care or being refused desired treatment. These findings are consistent with previous research showing poorer birth outcomes among sexual minorities."
Recent studies have shown a significant increase in the number of pregnancy-related deaths in the United States over the past two decades. Black women are particularly at risk, with a mortality rate in childbirth three times higher than any other group.
The study emphasized that negative experiences, including mistreatment, during childbirth can lead to long-term consequences such as post-traumatic stress disorder, negative body image, and changes in future reproductive choices.
To drive change, healthcare providers must hold their staff accountable, and policymakers should implement effective interventions to enhance respectful maternity care, as stated by senior author and assistant professor of health policy and management, Jamie Daw, in a news release.
The research findings did not provide specific policy suggestions, but emphasized the importance of creating and implementing "patient-focused, comprehensive interventions" to combat biases and promote inclusive healthcare environments.
"It is crucial that individuals do not face discrimination during such pivotal moments in their lives," stated Liu. "This study serves as a catalyst for the adoption and assessment of patient-centered strategies to tackle systemic healthcare barriers that contribute to these adverse encounters."
