Mistreatment in the maternity ward? Doctors weigh in on a new CDC report: 'Overstretched health system'
CDC report states that one in five women are mistreated as some docs warn of ‘bias’ and ‘oversimplification’
{{#rendered}} {{/rendered}}After a recent CDC report found that up to 20% of women have been mistreated in some way during the labor and delivery process, doctors are sharing their perspectives on the state of U.S. maternity care.
Several expressed concern about various aspects of the study, what it uncovered and even how it was conducted.
An April 2023 Porter Novelli View Moms survey gathered input from 2,402 women about the quality of care they received during childbirth.
{{#rendered}} {{/rendered}}One in five reported some degree of mistreatment.
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Some of the most commonly reported examples included receiving no response to requests for help, being shouted at or scolded, not having their physical privacy protected, being threatened that treatment would be withheld — or being made to accept unwanted treatment, according to the report.
{{#rendered}} {{/rendered}}Racial and socioeconomic factors also came into play, according to the CDC.
A recent CDC report found that up to 20% of women felt they were mistreated in some way during the labor and delivery process. (iStock)
Among the women who reported mistreatment, 30% were Black; 29% were Hispanic; 27% were multiracial; 19% were White; 18% were American Indian, Alaska Native, Native Hawaiian or Pacific Islander; and 15% were Asian.
Also, 28% said they had no insurance, 26% said they had public insurance and 16% said they had private insurance.
{{#rendered}} {{/rendered}}Here is what doctors — plus the CDC — shared with Fox News Digital about the study.
Results are ‘very concerning': New York doctor
Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, said the CDC’s findings "need to be taken seriously."
"This study is subjective, because it is a questionnaire, but the overall idea of [women] feeling neglected or overlooked or not having their privacy protected is very concerning — especially during such a stressful and potentially difficult time as pregnancy," Siegel told Fox News Digital.
{{#rendered}} {{/rendered}}"The report reflects not just an overstretched health system, but also continuing health disparities."
"The correlation with minority groups, and those with low or no insurance, is equally concerning," he went on.
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"The report reflects not just an overstretched health system, but also continuing health disparities."
{{#rendered}} {{/rendered}}Physicians and patients can do better: Florida surgeon
Dr. Brett Osborn, a board-certified neurosurgeon in West Palm Beach, Florida, who also runs a preventative health care and anti-aging facility called Senolytix, said the CDC’s findings go against a physician's duty to "treat every patient equally, regardless of race, creed or religion."
"This similarly applies to those unable to pay and those with government funding, which typically reimburses physicians below Medicare-allowable rates," he told Fox News Digital.
Among the women who reported mistreatment, 30% were Black; 29% were Hispanic; 27% were multiracial; 19% were White; 18% were American Indian, Alaska Native, Native Hawaiian or Pacific Islander; and 15% were Asian, according to the new survey. (iStock)
While most of the surveyed patients expressed satisfaction with their experience, Osborn noted that a disproportionate number of those who did not were either members of a minority or unfunded.
{{#rendered}} {{/rendered}}"I would be surprised if this phenomenon was not pervasive across medical specialties."
"While I cannot comment as an obstetrician, I would be surprised if this phenomenon was not pervasive across medical specialties," he said. "I cannot defend the actions of physicians should there have been a relegation of care commensurate to patients’ insurance or minority status."
He added, "That said, the observed ‘effect’ in the survey cohort may, to a degree, be artifactual — a misperception."
The health of the patient also comes into play, Osborn noted.
{{#rendered}} {{/rendered}}"A healthy individual requires less care and fewer resources than an unhealthy, obese individual with a complicated pregnancy, many of which are unfunded, have limited funding or are a minority," he said.
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He went on, "It is a fact that underserved Americans have more health problems than those with better access to care — in this case, prenatal care."
{{#rendered}} {{/rendered}}When a patient requires more care than a healthy individual, Osborn hypothesized that the physician may seem rushed or short with the patient — "when, in fact, they are simply trying to get the job done."
When a patient requires more care than a healthy individual, Dr. Osborn hypothesized that the physician may seem rushed or short with the patient. (iStock)
"By no means is this an excuse for shouting at or scolding a patient, as reported in the survey," he said.
"However, the conclusions must be viewed from both sides: the physician and the patient."
{{#rendered}} {{/rendered}}Osborn added, "Physicians can do better, but so can patients, by assuming control of their health regardless of their societal status, thereby decompressing an already stressed and overburdened system while secondarily bettering care, outcomes and, of course, patient satisfaction."
Maternity medicine puts ‘profits over people’: New York obstetrician
Dr. Leslie Farrington, a retired obstetrician-gynecologist in Manhasset, New York, has more than 38 years of experience in the field.
For the last several years, she's been promoting health care advocacy education in support of Black mothers and families; she runs an organization called Black Coalition for Safe Motherhood.
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Farrington said in an interview with Fox News Digital she was not surprised by the CDC’s report — the racial component, in particular.
"If you're Black or if you're [of] a low socioeconomic status, or even if you are a White person with a Black partner, you are twice as likely to be mistreated as a White person," she said.
{{#rendered}} {{/rendered}}"If you're Black or if you're [of] a low socioeconomic status, or even if you are a White person with a Black partner, you are twice as likely to be mistreated as a White person," said Dr. Farrington of New York. (iStock)
"Looking at almost every study of discrimination in health care, around a third of African Americans report discrimination in doctors’ offices, including when giving birth."
One of the specific types of maternity mistreatment, Farrington said, is when doctors strip a woman’s membranes (break their water) to try to stimulate labor without asking for consent.
"In this case, they've taken control of the person's care in a way that usurps their self-determination and their bodily autonomy," she said. "Women should know what's happening to their body."
{{#rendered}} {{/rendered}}Beyond physical mistreatment, Farrington said that many doctors speak to women in a condescending manner "like they are children," telling them what they can and can’t do.
"Tell the doctor if something's bothering you, trust your body and don't stop asking questions until you're satisfied with the answers."
"All physicians are trained in a hierarchical culture of disrespect, where the higher-up you are, the more disparaging or dismissive you can be of those who are under you," she added.
{{#rendered}} {{/rendered}}Farrington called for a "major transformation of obstetrical care," which she said is focused on "profits over people." While there are plenty of good doctors, she noted, they're under "a lot of production pressure to move people in and out quickly, which is one of the reasons they're so dismissive."
"It is a fact that underserved Americans have more health problems than those with better access to care — in this case, prenatal care," Dr. Osborn of Florida told Fox News Digital. (iStock)
When Farrington was still practicing, she said they used to have to see 23 people in a three-hour session.
"It's stressful for the doctor and for the patients, who feel like they can't ask questions because they don't want to overburden the doctor," she said.
{{#rendered}} {{/rendered}}Farrington urged women to take control of their birthing experience — to "set the tone" and to speak up if a doctor is disrespectful.
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"Tell the doctor if something's bothering you, trust your body and don't stop asking questions until you're satisfied with the answers," she suggested.
{{#rendered}} {{/rendered}}Women also have the right to refuse recommended treatment, Farrington added. "The pregnant person is the decision-maker for their baby and their body."
Study ‘oversimplifies health care’: Arizona physician
Dr. Shana Johnson, a physical medicine and rehabilitation physician in Scottsdale, Arizona, told Fox News Digital that in her view, the study is "very low-quality and does not represent the U.S. birthing population."
"This study oversimplifies health care, points blame and ignores the real issue that the entire health care system is failing."
The report had several sources of bias, she said.
{{#rendered}} {{/rendered}}The survey was opt-in; it did not use probability sampling; the participant rate was 32%; and subgroups comprised a small number of respondents.
The new report had several sources of bias, said Dr. Johnson of Arizona. The survey was opt-in; it did not use probability sampling; the participant rate was 32%; and subgroups comprised a small number of respondents. (iStock)
"The survey response rate is important for validity," Johnson said.
"If the response rate is low, it skews the results. In this study, almost 70% of people didn't respond. These results are based on the biased sample of 32% of respondents. This may be a group more likely to report mistreatment."
{{#rendered}} {{/rendered}}"These data are likely not representative of the U.S. birthing population."
Additionally, the experiences were self-reported and often occurred over five years ago — which can lead to "recall bias," the doctor noted.
The crux of the issue, Johnson said, is that medical staff are often working in unsustainable conditions and rural areas are underserved.
The crux of the issue, Dr. Johnson said, is that medical staff are often working in unsustainable conditions and rural areas are underserved. (iStock)
"This study oversimplifies health care, points blame and ignores the real issue that the entire health care system is failing," she said.
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"I wish government entities would use taxpayer money to focus on fixing the health care system, rather than pointing blame at struggling health care workers, while the wants of special interests remain top priority," she also said.
Survey had limitations: CDC
Fox News Digital reached out to the CDC for comments on the validity of the study.
{{#rendered}} {{/rendered}}"We acknowledge that these data are likely not representative of the U.S. birthing population due to a number of survey limitations," Dr. Wanda Barfield, director of CDC’s Division of Reproductive Health in Atlanta, Georgia, told Fox News Digital.
"On an individual level, all health care staff can play a role in ensuring high-quality, respectful care to every patient they encounter," said Dr. Wanda Barfield, director of CDC’s Division of Reproductive Health, to Fox News Digital. (iStock)
"While there may be social desirability bias or recall bias in some of the responses, we still believe these data capture the experiences of the respondents in a way that clearly demonstrates more can be done to improve the quality of maternity care in the United States."
In a previous study from 2019, the Giving Voice to Mothers study, a similar share (17%) of women were found to have experienced mistreatment, Barfield pointed out.
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"At the end of the day, this report sheds light on the fact that many women experience mistreatment and discrimination during their maternity care," Barfield went on.
"It is going to take a systems-level approach to encourage a culture of respectful care and promote quality improvement initiatives to make shifts on a population level."
She added, "On an individual level, all health care staff can play a role in ensuring high-quality, respectful care to every patient they encounter."