Background: Dying in childbirth
is one of the most common causes of death for women. While maternal mortality
rates, defined as deaths per 100,000 live births, have been steadily dropping
in most countries worldwide, maternal mortality rates have doubled in the
United States in the last twenty years. This commentary examines the various contributing
factors to this trend. Methods: A literature review was performed using
the keywords: maternal mortality, United States, disrespectful maternity care,
obstetric violence, provider perspectives, and disparities. Maternal mortality
statistics were obtained from the World Health Organization website.Results: Medical factors associated with maternal mortality include increased
maternal age and cardiovascular conditions. Social factors include barriers to
healthcare access, delays in receiving medical care, reduction in reproductive
health services in some states, and non-obstetrical deaths such as accidents,
domestic violence, and suicide. Racial inequities and disparities of care are
reflected in higher maternal mortality rates for minorities and people of
color. Disrespectful maternity care or obstetric violence has been reported
worldwide as a factor in delay of lifesaving obstetrical care and reluctance by
a pregnant person to access the healthcare system. About one in five US women
has reported experiencing mistreatment, varying from verbal abuse to lack of
privacy, from coerced procedures to neglect
during childbirth. Conclusion: This commentary highlights the importance
of inclusion of providers in research on respectful maternity care. Provider
burnout, moral distress, limited time, and burden of clinical responsibilities
are known challenges to respectful and comprehensive medical care. The
association of disrespectful care with poor maternal outcomes needs to be
studied. Exploring root causes of disrespectful childbirth care can empower
nurses, midwives, and physicians to improve their environment and find
solutions to reduce a potential cause of maternal mortality.
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