Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.
MMWR Morb Mortal Wkly Rep. 2023 Sep 1;72(35):961-967. doi: 10.15585/mmwr.mm7235e1.
Maternal deaths increased in the United States during 2018-2021, with documented racial disparities. Respectful maternity care is a component of quality care that includes preventing harm and mistreatment, engaging in effective communication, and providing care equitably. Improving respectful maternity care can be part of multilevel strategies to reduce pregnancy-related deaths.
CDC analyzed data from the PN View Moms survey administered during April 24-30, 2023, to examine the following components of respectful care: 1) experiences of mistreatment (e.g., violations of physical privacy, ignoring requests for help, or verbal abuse), 2) discrimination (e.g., because of race, ethnicity or skin color; age; or weight), and 3) reasons for holding back from communicating questions or concerns during maternity (pregnancy or delivery) care.
Among U.S. mothers with children aged <18 years, 20% reported mistreatment while receiving maternity care for their youngest child. Approximately 30% of Black, Hispanic, and multiracial respondents and approximately 30% of respondents with public insurance or no insurance reported mistreatment. Discrimination during the delivery of maternity care was reported by 29% of respondents. Approximately 40% of Black, Hispanic, and multiracial respondents reported discrimination, and approximately 45% percent of all respondents reported holding back from asking questions or discussing concerns with their provider.
Approximately one in five women reported mistreatment during maternity care. Implementing quality improvement initiatives and provider training to encourage a culture of respectful maternity care, encouraging patients to ask questions and share concerns, and working with communities are strategies to improve respectful maternity care.
2018 年至 2021 年期间，美国的孕产妇死亡人数有所增加，且有记录显示存在种族差异。尊重产妇护理是优质护理的一个组成部分，其中包括预防伤害和虐待、进行有效的沟通以及公平提供护理。改善尊重产妇护理可以成为减少与妊娠相关死亡的多层次策略的一部分。
CDC 分析了 2023 年 4 月 24 日至 30 日期间进行的 PN View Moms 调查的数据，以检查以下尊重护理的组成部分：1）遭受虐待的经历（例如侵犯身体隐私、忽略求助请求或言语虐待），2）歧视（例如因种族、族裔或肤色；年龄；或体重），以及 3）在接受产妇（妊娠或分娩）护理时不愿沟通问题或担忧的原因。
在美国，有 18 岁以下孩子的母亲中，有 20%的人在接受最小孩子的产妇护理时报告遭受虐待。约 30%的黑人、西班牙裔和多种族受访者以及约 30%的有公共保险或没有保险的受访者报告遭受虐待。约 29%的受访者报告在分娩期间受到歧视。约 40%的黑人、西班牙裔和多种族受访者报告受到歧视，约 45%的受访者报告不愿向提供者提问或讨论问题。
约五分之一的女性在产妇护理期间报告遭受虐待。实施质量改进举措和提供者培训以鼓励尊重产妇护理文化、鼓励患者提问和分享关切以及与社区合作，是改善尊重产妇护理的策略。
