U.S. Perinatal Care Faces Respect Deficit, Providers Reveal inโฃ New Scoping Review
A new scoping review published in BMCโ Pregnancy and Childbirth reveals a concerning gap between stated values of respectful maternity care and theโฃ livedโ experiences ofโ patients within the U.S. healthcare system, โas perceived โby โขperinatal healthcare providers. Theโ study synthesizes findingsโ from 24 qualitative โฃstudies, highlighting systemic issues contributing to disrespectful treatmentโค during pregnancy andโฃ childbirth, including implicit bias, time constraints, and a lack of adequate training on culturally sensitive communication.
The findings arrive at a critical juncture, as โฃtheโ U.S. continues to โคgrapple with stark maternal mortality rates-particularly among women of colour-and โincreasing calls for equitable and patient-centeredโข care. Researchers found providersโฃ frequently identified pressures within theโ healthcareโค system as barriers to providing respectful care, alongside a need for improved accountability mechanisms and a stronger โคemphasis on shared decision-making. The review โunderscores the urgent need for systemic changes โto foster a more supportive and respectful perinatal care environment.
The scoping review identified several keyโ themes. Providers acknowledged the influence of implicit bias onโค patient interactions, with some recognizing their own biases andโ the potential for discriminatoryโค practicesโข [53, 55]. Time constraints and heavy workloadsโ were frequently cited โas obstacles to providing individualized, respectful care [56]. Several studies highlighted instances of dismissive or condescendingโ communication โขfrom providers, contributing to feelings of disempowerment among patients [54].
Furthermore, the review revealed a perceived lackโฃ of accountability for disrespectful behavior, with limitedโ mechanisms for patients to report mistreatment or for providers to receive feedback and training [53]. Doulas were identified asโ potential facilitatorsโ of accountability and bridges toโฃ address gapsโฃ in care [53].Stigma surrounding issues โขlikeโ opioid misuse also contributedโ to disrespectful treatment, as providers โexpressed discomfort or judgment towards affected patientsโ [57].The review also noted the importance of shared decision-making, but acknowledged challenges in implementing this approachโ withinโฃ a complex healthcare environment [56].
