1 in 5 Pregnant Women Experience Mistreatment From Medical Staff

One in five pregnant women in the United States reports experiencing mistreatment from medical staff during pregnancy, labor, or childbirth. This statistic, documented by the CDC in 2023, represents 20% of all women who gave birth recently. The numbers are even more alarming for women of color and those without private insurance, with rates climbing to 30% for Black women and 29% for Hispanic women.

Understanding how mistreatment happens, who is most at risk, and what it means for maternal and infant health can help families recognize when their care falls short of acceptable standards and know when to seek help.

What Does Mistreatment During Pregnancy and Childbirth Look Like?

Mistreatment in maternity care takes many forms, and not all of it is immediately obvious. The CDC identified specific behaviors that constitute mistreatment based on reports from thousands of women nationwide:

• Ignored requests for help – Medical staff failing to respond when a patient asks for assistance or reports symptoms
• Verbal abuse – Being shouted at, scolded, or spoken to in a demeaning manner
• Privacy violations – Physical privacy not being respected during exams, labor, or delivery
• Coerced or denied treatment – Being threatened with withholding care, or having procedures performed without proper consent
• Discrimination – Different treatment based on age, race, ethnicity, weight, income level, or type of insurance

These behaviors can occur during prenatal visits, while in labor, during delivery, or in postpartum care. Some women experience a single incident, while others face repeated mistreatment throughout their pregnancy journey.

Which Women Are Most Likely to Experience Medical Mistreatment During Birth?

Mistreatment during maternity care does not affect all women equally. The 2023 CDC data shows clear disparities based on race, ethnicity, and insurance status.

By Race and Ethnicity:

• Black women: 30%
• Hispanic women: 29%
• Multiracial women: 27%
• White women: 19%
• American Indian/Native Hawaiian/Pacific Islander women: 18%
• Asian women: 15%

By Insurance Status:

• Uninsured women: 28%
• Women with public insurance (Medicaid): 26%
• Women with private insurance: 16%

These statistics reveal that women of color and women with lower incomes face mistreatment at rates nearly double those of white women with private insurance. The intersection of race and economic status creates compounding risk.

How Does Discrimination During Pregnancy Differ From General Mistreatment?

While mistreatment refers to specific negative behaviors, discrimination involves being treated differently or unfairly because of personal characteristics. According to the CDC survey, 29% of women overall reported experiencing discrimination during their maternity care, but this varied dramatically by race:

• Black women: 40%
• Multiracial women: 39%
• Hispanic women: 37%

Discrimination can manifest as assumptions made about a patient’s pain tolerance, credibility, ability to follow medical instructions, or worthiness of certain interventions. It may involve dismissive attitudes when women report symptoms or concerns, or differential access to pain management and support during labor.

Research has documented that Black women’s reports of pain are often taken less seriously than those of white women, and that implicit bias affects clinical decision-making even among well-intentioned providers who consciously reject racist attitudes.

What Medical Complications Can Result From Mistreatment During Birth?

The consequences of mistreatment extend far beyond hurt feelings. When healthcare providers ignore patient concerns, delay responses to requests for help, or create an environment where women feel unable to speak up, serious medical complications can follow.

Direct Medical Risks:

Mistreatment and discrimination are associated with increased risk for pregnancy complications, delays in necessary care, and preventable adverse outcomes. In severe cases, this contributes to maternal deaths, particularly among Black women, who die from pregnancy-related causes at rates three to four times higher than white women.

Communication Breakdown:

Perhaps the most concerning finding from the CDC survey is that 45% of all women said they were hesitant to ask questions or raise concerns with their providers because they feared mistreatment. This silence can be deadly. When a woman doesn’t report symptoms like severe headaches, vision changes, or unusual pain because she fears being dismissed or scolded, conditions like preeclampsia or placental abruption may go unrecognized until it’s too late.

Impact on Birth Outcomes:

Studies show that stress from discrimination and mistreatment can affect birth outcomes including preterm birth, low birth weight, and complications during labor. The physiological stress response triggered by mistreatment can directly impact pregnancy health, while delays in care caused by poor patient-provider relationships can allow treatable conditions to worsen.

Why Do Healthcare Disparities in Pregnancy Affect Women of Color More?

The higher rates of mistreatment among Black, Hispanic, and multiracial women reflect broader systemic racism in healthcare. These disparities persist across income and education levels, meaning even affluent, well-educated women of color experience mistreatment at elevated rates.

Implicit Bias in Medical Settings:

Healthcare providers may hold unconscious biases about race that affect how they perceive and treat patients. Research has documented that many medical professionals incorrectly believe Black people have higher pain tolerance or thicker skin, leading to under-treatment of pain and dismissal of symptoms.

Systemic Factors:

Women of color are more likely to receive care at understaffed hospitals with fewer resources. They may face longer wait times, see more patients per provider, and have less access to specialized care. These structural inequities combine with individual bias to create dangerous gaps in care quality.

Historical Context:

The medical mistreatment of women of color, particularly Black women, has deep historical roots in American medicine, from the exploitation of enslaved women in developing gynecological procedures to the forced sterilization programs of the 20th century. This history creates justified mistrust that is often misinterpreted by providers as non-compliance rather than understood as a reasonable response to documented harm.

Can Medical Mistreatment During Birth Lead to Birth Injuries?

Yes. When medical staff ignore patient concerns, delay necessary interventions, or create an environment where women cannot advocate for themselves or their babies, the risk of preventable birth injuries increases.

Common Scenarios:

• A woman reports decreased fetal movement but is dismissed, delaying recognition of fetal distress
• Signs of oxygen deprivation during labor are not addressed promptly because staff are unresponsive to call buttons
• A woman is not believed when she reports unusual pain, leading to delayed diagnosis of uterine rupture or placental abruption
• Forceps or vacuum extraction is used without proper consent or despite patient objections, causing injury
• A woman’s requests for position changes or alternative pushing positions are refused, contributing to difficult delivery

Birth injuries that can result from delayed or inappropriate care include cerebral palsy, Erb’s palsy, brain damage from oxygen deprivation, skull fractures, and other trauma. While not all birth injuries are preventable, many result from substandard care, and mistreatment that prevents timely recognition and response to complications increases this risk.

What Are Healthcare Organizations Doing to Address Mistreatment in Maternity Care?

The CDC and the American College of Obstetricians and Gynecologists (ACOG) have issued recommendations for hospitals and health systems to address mistreatment and discrimination in maternity care.

Recommended Interventions:

• Anti-racism training for all maternity care staff, including physicians, nurses, and support personnel
• Improved patient-provider communication protocols that emphasize listening and taking patient concerns seriously
• Recruitment and retention of diverse healthcare staff to better reflect patient populations
• Implementation of respectful maternity care standards that explicitly prohibit mistreatment
• Anonymous reporting systems for patients to document mistreatment without fear of retaliation
• Regular assessment of patient experiences through surveys and quality improvement initiatives

Some hospitals have begun implementing these measures, but change is slow and uneven. Many facilities have yet to take meaningful action despite clear evidence of the problem.

How Can Pregnant Women Protect Themselves From Medical Mistreatment?

While the responsibility for providing respectful care lies with healthcare providers and institutions, there are steps pregnant women and their families can take to reduce risk and advocate for appropriate treatment.

Before Delivery:

• Research hospitals and providers, looking for facilities with good outcomes for women who share your background
• Ask potential providers directly about their approach to patient communication and pain management
• Bring a support person (partner, family member, doula) who can advocate on your behalf
• Document your birth preferences in writing and discuss them with your care team in advance
• Know the warning signs of pregnancy complications and when to seek emergency care

During Care:

• Don’t minimize your symptoms or concerns because you fear being seen as difficult
• If you feel dismissed, explicitly state: “I need you to document my concern in my chart”
• Ask for explanations of all procedures before they are performed
• Request a different provider if you feel your current one is not listening or treating you respectfully
• Have your support person take notes on what is said and done

After Experiencing Mistreatment:

• File a formal complaint with the hospital’s patient advocacy office
• Report the incident to your state medical board if a licensed provider was involved
• Document everything in writing while memories are fresh
• Consider consulting with a birth injury attorney if mistreatment led to medical complications

What Should I Do If Mistreatment During Birth Led to My Baby’s Injury?

If you believe that medical mistreatment, delays in care, or ignored concerns during your pregnancy or delivery contributed to your baby’s birth injury, you have the right to seek answers and accountability.

Medical records can reveal whether warning signs were documented but not acted upon, whether your requests for help were noted, and what delays occurred in providing necessary care. An experienced birth injury attorney can review these records, consult with medical experts, and help you understand whether the care you received met accepted standards.

Birth injuries resulting from medical negligence may entitle your family to compensation for medical expenses, ongoing care needs, and other damages. More importantly, holding providers and institutions accountable can drive systemic changes that protect future families from similar harm.

Moving Toward Better Maternal Care

The fact that one in five pregnant women experience mistreatment is not acceptable, and the disparities facing women of color represent a crisis in maternal health. While individual advocacy matters, real change requires institutional commitment to respectful, equitable care for all patients.

If you experienced mistreatment during pregnancy or childbirth, especially if it contributed to complications or injury, speaking up helps document the scope of this problem. Whether through hospital complaints, public health surveys, or legal action when appropriate, your voice matters in pushing for the systemic changes that can save lives and prevent future birth injuries.