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Mistreatment during Childbirth: Impact on Maternal Outcomes and Importance of Provider Perspectives

Open Journal of Obstetrics and Gynecology 2024年第2期14卷 227-233页

作者： samantha truong Katherine Lindsey Doughty Mary Greenwald Annekathryn Goodman Department of Obstetrics and Gynecology Massachusetts General Hospital Harvard Medical School Boston USA

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 solutio

关键词： Maternal Mortality United States Disrespectful Maternity Care Obstetric Vi-olence Provider Perspectives Disparities

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Maternal Mortality Rates among Im/Migrant Populations in the United States

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Open Journal of Obstetrics and Gynecology 2024年第8期14卷 1161-1175页

作者： Tessa Peredy Mary Greenwald Katy Doughty Fachon Fiona Danaher Rashmi Jasrasaria samantha truong Annekathryn Goodman University of New England College of Osteopathic Medicine Biddeford ME United States Department of Obstetrics and Gynecology Massachusetts General Hospital Boston Boston MA United States Center for Immigrant Health Massachusetts General Hospital Boston Boston MA United States

Introduction: Maternal mortality rates have more than doubled in the U.S over the last two decades, making it one of the few places in the world where maternal mortality is increasing. Differences in maternal mortality among certain races and ethnicities are known but few studies examine maternal mortality among immigrants. Since immigrants represent 13.7% of the U.S. population, it is essential to examine immigrant subsets to understand maternal mortality among this vulnerable population. Methods: A literature search identified 318 articles on maternal mortality and immigrants, with 12 articles from the U.S. The keywords included maternal mortality, United States, migrants, asylum seekers, immigrants, and disparities. Maternal mortality statistics were obtained from the World Health Organization and Center for Disease Control. Results: Studies analyzed in this review found an overall lower maternal mortality rate among immigrant women compared to U.S.-born women, except for Hispanic immigrant women. Black women had the highest maternal mortality rate, regardless of immigration status. Conclusion: Although the literature points to lower maternal mortality among immigrants, the data is still somewhat mixed, making it challenging to draw comprehensive conclusions. Additional research examining maternal mortality among Im/migrants in the U.S. is needed to guide future training among healthcare professionals and policymakers.

关键词： Maternal Mortality Im/Migrant Reproductive Health United States

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