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Maternal Health

Why Is Maternal Healthcare So Poor In the United States?

Photo: Courtesy of Ömürden Cengiz

When the White Ribbon Alliance and partners asked “What Women Want” for their maternal and reproductive health care worldwide, the top answer among 1.2 million respondents from 114 countries was respectful and dignified care.

“I knew something was wrong, but no one was listening.” This statement is the through-line in many stories of birthing people’s concerns being ignored and their care delayed. We unfortunately hear all too often from people who have survived a pregnancy-related complication and the family members of those who have lost their lives giving birth that they did not receive the respectful, dignified care they deserve. The consequences of their experiences during pregnancy and childbirth can leave an impact on their families and communities for generations.

Mistreatment and disrespect

Mistreatment and disrespectful care during pregnancy and childbirth is shockingly common, even in the United States. The Giving Voice to Mothers survey found that one in four people giving birth in a U.S. hospital reported experiencing mistreatment or disrespectful care during childbirth, and women of color were twice as likely to experience mistreatment as white women. This included being dismissed and ignored, receiving insufficient information, being subjected to unwanted medical procedures, and the right to decline care not being recognized.

When people giving birth are not listened to by their health care providers, it can lead not only to negative birth experiences, but to their health and lives being put at risk. Disrespect and abuse during pregnancy and childbirth can result in poor health outcomes in the short- and long-terms, including pain, post-traumatic stress disorder, and even maternal deaths.

Getting the respectful and responsive care you deserve

Ultimately, everyone is the expert on their own body and has the right to lead and control decision-making about their care. Effective, open, and honest communication between birthing people and their health care providers can help prevent a problem from occurring or becoming more severe.

It’s important for birthing people to understand their rights and know what questions to ask their providers along the way. This can help them be active and engaged participants in their own care and wellbeing. It can help to find support and advocacy partners for the perinatal experience like a doula or, if that’s not an option, a close friend or family member who can be an additional source of support.

Resources and networks for support can also be found in every community. For example, in New York City and New Jersey, JustBirth Space offers free, responsive, and compassionate perinatal support, all from your phone. People can join a support group for new parents, take a childbirth education class, or text in questions about pregnancy, birth, and postpartum.

Beyond the steps each of us can take for ourselves, we must recognize that the responsibility to ensure respectful and equitable care does not lie solely with the individual. Our entire maternity care system must shift to recognize the importance of treating everyone with respect and dignity, as people with rights and a voice.

We need health systems to be held accountable for the highest quality of respectful care, and providers need to be trained in topics such as bodily autonomy, respect, anti-racism, human rights, consent, trauma-informed care, and implicit bias. These are the first steps on the way to transforming our maternity care system towards prioritizing equity and respect, which will help us end preventable maternal deaths and ensure that everyone is able to access the birth experience they want.

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