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Updated Sept. 29, 2023 | Print
1 in 5
About 20% of women reported mistreatment while receiving maternity care.
1 in 3
About 30% of Black, Hispanic, and multiracial women reported mistreatment.
45%
Almost half (45%) of women held back from asking questions or sharing concerns during their maternity care.

Every mom deserves respectful and responsive care during pregnancy and delivery

Maternal death rates in the U.S. rose from 2018 to 2021.1 More than 80% of pregnancy-related deaths are preventable.2 Native Hawaiian and Pacific Islander, Black, and American Indian and Alaska Native women have the highest rates of pregnancy-related death.2

Women from some racial and ethnic minority groups are also more likely to have negative healthcare experiences during pregnancy and delivery that impact the quality of care and health outcomes.3

Survey finds clear disparities in mistreatment during maternity care

Twenty percent of those surveyed reported experiences of mistreatment during maternity care. Thirty percent of Black, 29% of Hispanic, and 27% of multiracial women reported mistreatment.

The most common types of mistreatment reported were:

  • Receiving no response to requests for help.
  • Being shouted at or scolded.
  • Not having their physical privacy protected.
  • Being threatened with withholding treatment or made to accept unwanted treatment.

Better communication is needed during maternity care

Almost half (45%) of moms reported holding back from asking questions or sharing concerns during their pregnancy or delivery. The top reasons included:

  • Thinking, or being told by friends or family, what they were feeling was normal.
  • Not wanting to make a big deal about it or being embarrassed to talk about it.
  • Thinking their healthcare provider would think they’re being difficult.
  • Thinking their healthcare provider seemed rushed.
  • Not feeling confident that they knew what they were talking about.

To improve the quality of maternity care:

  • Healthcare systems can support care that is respectful and considers the patient’s values, needs, and desires (i.e., patient-centered care) equally for all mothers.
  • Maternity care providers can ensure patients are engaged in their health care and feel heard and respected.
  • Communities can raise awareness of respectful care and promote health equity.
Read the full MMWR
ASL video: English | Spanish
Challenges

Bias and discrimination impact maternity care.

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Advance Equity

More diversity among health workers can help reduce disparities.

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Ensure Respectful Care

Support pregnant and postpartum women in getting the care they need.

hand holding lightbulb icon
blue shape
Challenges

Bias and discrimination impact maternity care.

shield icon
blue shape
Advancing Equity

More diversity among health workers can help reduce disparities.

scales icon
blue shape
Ensure Respectful Care

Support pregnant and postpartum women in getting the care they need.

hand holding lightbulb icon
blue shape

Respectful maternity care:

  • Maintains dignity, privacy, and confidentiality,
  • Ensures freedom from harm and mistreatment, and
  • Allows for shared decision-making and continuous support during labor and childbirth.4

Every mom deserves respectful and responsive care during pregnancy and delivery

Maternal death rates in the U.S. rose from 2018 to 2021.1 More than 80% of pregnancy-related deaths are preventable.2 Native Hawaiian and Pacific Islander, Black, and American Indian and Alaska Native women have the highest rates of pregnancy-related death.2

Women from some racial and ethnic minority groups are also more likely to have negative healthcare experiences during pregnancy and delivery that impact the quality of care and health outcomes.3

Survey finds clear disparities in mistreatment during maternity care

Twenty percent of those surveyed reported experiences of mistreatment during maternity care. Thirty percent of Black, 29% of Hispanic, and 27% of multiracial women reported mistreatment.

The most common types of mistreatment reported were:

  • Receiving no response to requests for help.
  • Being shouted at or scolded.
  • Not having their physical privacy protected.
  • Being threatened with withholding treatment or made to accept unwanted treatment.

Better communication is needed during maternity care

Almost half (45%) of moms reported holding back from asking questions or sharing concerns during their pregnancy or delivery. The top reasons included:

  • Thinking, or being told by friends or family, what they were feeling was normal.
  • Not wanting to make a big deal about it or being embarrassed to talk about it.
  • Thinking their healthcare provider would think they’re being difficult.
  • Thinking their healthcare provider seemed rushed.
  • Not feeling confident that they knew what they were talking about.

To improve the quality of maternity care:

  • Healthcare systems can support care that is respectful and considers the patient’s values, needs, and desires (i.e., patient-centered care) equally for all mothers.
  • Maternity care providers can ensure patients are engaged in their health care and feel heard and respected.
  • Communities can raise awareness of respectful care and promote health equity.

Respectful maternity care:

  • Maintains dignity, privacy, and confidentiality,
  • Ensures freedom from harm and mistreatment, and
  • Allows for shared decision-making and continuous support during labor and childbirth.4
Read the full MMWR
ASL video: English | Spanish
Challenges
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Bias and discrimination in maternity care settings impact care

  • Mistreatment by maternity care providers was reported most often by Black, Hispanic, and multiracial moms. People with no insurance or public insurance experienced more mistreatment during maternity care than people with private insurance.
  • About 29% of women experienced discrimination while receiving maternity care. Reports of discrimination were highest among Black (40%), multiracial (39%), and Hispanic (37%) women.
  • While satisfaction with maternity care overall was high (90%), satisfaction among moms who reported mistreatment was considerably lower (75%). Mistreatment and discrimination impact experiences of care.

Poor communication can worsen maternal health outcomes

  • Sometimes it is hard for pregnant women to ask questions or share concerns. Maternity care providers can improve communication by creating an environment of trust.
  • Providers can take time to really hear women’s concerns and have an open conversation to make sure any issues are adequately addressed.
  • When there is good communication about health concerns between moms and providers, it is more likely there will be accurate, timely diagnoses and treatment for potentially life-threatening pregnancy complications.

One in 5 Women Reported Mistreatment While Receiving Maternity Care

Mistreatment was reported most often by Black, Hispanic, and multiracial moms and those with public insurance or no insurance.

Infographic: One in 5 Women Reported Mistreatment While Receiving Maternity Care
View Larger

Moms Deserve Respectful and Equal Maternity Care

Respectful maternity care is free from harm and mistreatment, maintains privacy, confidentiality, and dignity, and allows for shared decision-making and continuous support.

Infographic: Moms Deserve Equitable and Respectful Maternity Care
View Larger

What Can Be Done

To Advance Health Equity

Differences in respectful maternity care are rooted in discrimination and stigma based on factors that include race and insurance coverage. Research has shown the connection between pregnancy complications and experiences of racism or discrimination.5 Greater diversity in the healthcare workforce can help address racial and ethnic disparities in health care by improving patients’ experiences, increasing patient satisfaction, and improving access to care for underserved patients.

CDC is advancing birth equity by:

Partners are advancing birth equity by:

  • Making respectful care part of patient safety bundles, which are standard approaches for use in maternity settings to ensure that every patient gets the same, high-quality care.
  • Developing toolkits to promote respectful care in maternity settings.
  • Providing ongoing training to maternity care teams about unconscious bias and culturally appropriate care.
  • Training providers in settings that serve communities with higher rates of pregnancy-related complications and deaths.
Collage of a group of doctors having a discussion, puzzle pieces being put together, speech bubbles, and a doctor speaking with a mother holding a child.

Differences in respectful maternity care are rooted in discrimination and stigma based on factors that include race and insurance coverage. Research has shown the connection between pregnancy complications and experiences of racism or discrimination.5 Greater diversity in the healthcare workforce can help address racial and ethnic disparities in health care by improving patients’ experiences, increasing patient satisfaction, and improving access to care for underserved patients.

CDC is advancing birth equity by:

Partners are advancing birth equity by:

  • Making respectful care part of patient safety bundles, which are standard approaches for use in maternity settings to ensure that every patient gets the same, high-quality care.
  • Developing toolkits to promote respectful care in maternity settings.
  • Providing ongoing training to maternity care teams about unconscious bias and culturally appropriate care.
  • Training providers in settings that serve communities with higher rates of pregnancy-related complications and deaths.
Collage of a group of doctors having a discussion, puzzle pieces being put together, speech bubbles, and a doctor speaking with a mother holding a child.

To Ensure Respectful, Patient-Centered Maternity Care

Healthcare systems

Healthcare systems can encourage a culture of respectful, patient-centered maternity care. All healthcare staff play a role in improving patient experiences.

  • Hire and keep a diverse workforce and provide trainings to all healthcare staff on unconscious bias and respectful care.
  • Encourage patient communication and support through doulas and midwifery models of care.
  • Promote actions to improve quality with a focus on providing respectful and responsive maternity care equally.
  • Engage communities to raise awareness of respectful care.
Maternity care providers

Healthcare professionals can take steps to make patients feel respected, understood, and valued during their care. Engaging patients in their health care can lead to improvements in safety, quality, and satisfaction.

  • Listen to your patients and ask questions to create trust.
  • Recognize unconscious bias and improve cultural awareness in yourself and in your office.
  • Address any concerns your patients may have.
  • Help your patients, and those accompanying them, understand urgent maternal warning signs and when to seek medical attention right away.
Everyone

All of us can support pregnant and postpartum women in getting the care they need.

  • If you are pregnant or gave birth within the last year, it’s important to talk to your healthcare provider about anything that doesn’t feel right.
  • Listen to the concerns of pregnant and postpartum women.
  • Encourage women who are pregnant or postpartum to seek medical help if something doesn’t feel right, and attend medical visits with them.
  • Make sure if someone is experiencing an urgent maternal warning sign, they get medical care right away.
Healthcare systems

Healthcare systems can encourage a culture of respectful, patient-centered maternity care. All healthcare staff play a role in improving patient experiences.

  • Hire and keep a diverse workforce and provide trainings to all healthcare staff on unconscious bias and respectful care.
  • Encourage patient communication and support through doulas and midwifery models of care.
  • Promote actions to improve quality with a focus on providing respectful and responsive maternity care equally.
  • Engage communities to raise awareness of respectful care.
Maternity care providers

Healthcare professionals can take steps to make patients feel respected, understood, and valued during their care. Engaging patients in their health care can lead to improvements in safety, quality, and satisfaction.

  • Listen to your patients and ask questions to create trust.
  • Recognize unconscious bias and improve cultural awareness in yourself and in your office.
  • Address any concerns your patients may have.
  • Help your patients, and those accompanying them, understand urgent maternal warning signs and when to seek medical attention right away.
Everyone

All of us can support pregnant and postpartum women in getting the care they need.

  • If you are pregnant or gave birth within the last year, it’s important to talk to your healthcare provider about anything that doesn’t feel right.
  • Listen to the concerns of pregnant and postpartum women.
  • Encourage women who are pregnant or postpartum to seek medical help if something doesn’t feel right, and attend medical visits with them.
  • Make sure if someone is experiencing an urgent maternal warning sign, they get medical care right away.

VITAL SIGNS RESOURCES