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Disparities in Mistreatment During Childbirth
Chen Liu1, Kristen Underhill2, Janice J Aubey3
1Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York, New York.
JAMA Network Open
|April 4, 2024
Summary
Mistreatment during childbirth affects over 1 in 8 individuals in the US. Factors like insurance status and unplanned births are associated with these negative experiences, highlighting a need for improved maternity care.
Area of Science:
- Reproductive Health
- Maternal Healthcare Quality
- Health Disparities Research
Background:
- Lack of respectful maternity care is linked to maternal health disparities.
- Mistreatment during childbirth in the US is underdocumented.
- Understanding prevalence and associated factors is crucial for improving care.
Purpose of the Study:
- To estimate the prevalence of mistreatment during childbirth in a multistate sample.
- To identify patient characteristics associated with mistreatment experiences.
Main Methods:
- Cross-sectional study using 2020 Pregnancy Risk and Monitoring System data from 6 states and NYC.
- Survey data collected 12-14 months postpartum from 4458 individuals.
- Validated Mistreatment by Care Providers in Childbirth scale used to measure experiences.
Main Results:
- Over 13% of individuals reported mistreatment during childbirth.
- Most common mistreatment: being ignored or requests for help denied.
- Associated factors include LGBTQ+ identification, Medicaid insurance, and unplanned cesarean births.
Conclusions:
- Mistreatment during childbirth is a significant issue in the US.
- Patient-centered, systemic interventions are needed to address negative childbirth experiences.
- Further research should explore ambiguous associations with race, ethnicity, and socioeconomic factors.
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