Vital Signs: Maternity Care Experiences — United States, April

2023
Yousra A. Mohamoud, PhD1; Elizabeth Cassidy, MPH1; Erika Fuchs, PhD1; Lindsay S. Womack, PhD1; Lisa Romero, DrPH1; Lauren
Kipling, PhD1; Reena Oza-Frank, PhD1; Katharyn Baca, PhD1; Romeo R. Galang, MD1; Andrea Stewart, PhD1; Sarah Carrigan,
MPH1; Jennifer Mullen, MPH1; Ashley Busacker, PhD1; Brittany Behm, MPH1; Lisa M. Hollier, MD1; Charlan Kroelinger, PhD1;
Trisha Mueller, MPH1; Wanda D. Barfield, MD1; Shanna Cox, MSPH1

Summary
What is already known about this topic?
Maternal deaths increased in the United States during 2018–2021, with documented racial disparities.
Respectful maternity care (e.g., preventing mistreatment, communicating effectively, and providing care
equitably) can be integrated into strategies that aim to improve quality of care and reduce pregnancy-related
deaths.

What is added by this report?

Approximately one in five mothers overall, and approximately 30% of Black, Hispanic, and multiracial mothers
reported mistreatment (e.g., violations of physical privacy or verbal abuse) during maternity care. Approximately
40% of Black, Hispanic, and multiracial mothers reported discrimination during maternity care, and 45% of all
mothers reported holding back from asking questions or discussing concerns with their provider.

What are the implications for public health practice?

Approaches to improving respectful maternity care include multilevel interventions involving health systems,
providers, patients, and communities.

Abstract
Introduction: 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.
Methods: 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.
Results: 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.
Conclusions and implications for public health practice: 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.
 Introduction
From 2018 to 2021, the maternal death rate in the United States increased from 17.4 to 32.9 per 100,000 live
births (1). Native Hawaiian and other Pacific Islander, Black, and American Indian and Alaska Native persons
have the highest rates of pregnancy-related deaths.* Approximately 80% of pregnancy-related deaths are
preventable.† Preventing pregnancy-related deaths requires a multilevel approach that includes ensuring quality
care for all pregnant and postpartum persons (2). Standards of quality maternity care include respectful
maternity care (3), defined as “care organized for and provided to all women in a manner that maintains their
dignity, privacy, and confidentiality, ensures freedom from harm and mistreatment, and enables informed
choice and continuous support during labor and childbirth” (4). Respectful, equitable, and supportive care is
included as a component in all Alliance for Innovation on Maternal Health (AIM)§ patient safety bundles to
improve person-centered and equitable care. Negative experiences during maternity care are more prevalent
among women from some racial and ethnic minority groups (5). Maternal mortality review committees have
identified discrimination as one factor contributing to pregnancy-related deaths (6,7). The concepts of
mistreatment, engaging with effective communication, and discrimination have been used to evaluate respectful
maternity care (8). CDC analyzed data from the PN View Moms survey, an opt-in consumer audience panel
survey of U.S. mothers with children aged <18 years living at home. The survey examined maternity care
experiences, including satisfaction with care, experiences of mistreatment and discrimination, and whether
respondents held back from asking questions or discussing concerns with health care providers.

Methods
CDC obtained data from Porter Novelli through a subscription license. No personally identifying information
was included in the data file provided to CDC. The option to complete the PN View Moms survey online was
shared with 7,607 opt-in panel members¶; 2,407 (32%) mothers responded. The survey was administered in
English during April 24–30, 2023. This activity was reviewed by CDC and was conducted consistent with
applicable federal law and CDC policy.** The analysis was conducted using data from 2,402 respondents (five
respondents aged ≥65 years were excluded). Respondent characteristics were described, including respondent
age, race and ethnicity,†† highest level of educational attainment,§§ health insurance during delivery,¶¶ and age of
the youngest child living at home.
Respondents were asked about their maternity care experiences during pregnancy or delivery of their
youngest child. Satisfaction with care was defined as a response of very or somewhat satisfied with maternity
care.*** Any mistreatment during maternity care was measured using seven validated questions to determine
mistreatment (5), such as violations of physical privacy, ignoring requests for help, or verbal abuse. Satisfaction
with care and mistreatment experiences were summarized overall and stratified by race and ethnicity and health
insurance at time of delivery. Respondents were asked about experiences of discrimination while receiving
maternity care and could select multiple reasons for the discrimination they experienced, such as race, ethnicity,
skin color, age, or weight†††; these estimates were tabulated and presented overall and by race and ethnicity.
Holding back from communicating questions or concerns during maternity care was evaluated by asking
“During your pregnancy or delivery of your youngest child, did you hold back from asking questions or
discussing your concerns for any of the following reasons” (with an option to note if they did not hold back).
Respondents could select one or more reasons for holding back from communicating questions or concerns.
Descriptive statistics were calculated using Stata software (version 17.0; StataCorp). No inferential statistical
analyses were performed.

Results
Nearly two thirds of respondents (65.5%) reported that their youngest child was aged ≥5 years (Table 1).
More than two thirds (69.6%) of respondents were White, 10.7% were Black, 10.2% Hispanic, 4.8% Asian,
2.8% multiracial, and 1.5% American Indian, Alaska Native, Native Hawaiian, or Pacific Islander. More than
half of respondents (56.5%) were privately insured, and 32.6% were insured by Medicaid at the time of delivery
of their youngest child. Overall, 90.5% of respondents were satisfied with the care they received during
pregnancy (Table 2). Approximately one in five (20.4%) respondents reported experiencing at least one type of
mistreatment. The most commonly reported experiences of mistreatment were being ignored by health care
providers, having requests for help refused, or not responded to (9.7%); being shouted at or scolded by health
care providers (6.7%); having their physical privacy violated (5.1%); and being threatened with withholding of
treatment or being forced to accept treatment they did not want (4.6%). Among respondents who reported any
mistreatment, 75.1% were satisfied with the care they received during pregnancy. Black, Hispanic, and
multiracial respondents reported the highest prevalences of mistreatment (30.0%, 29.3%, and 27.3%,
respectively). Among insurance categories, 28.1% of respondents with no insurance and 26.1% of those with
public insurance at the time of delivery reported mistreatment.
Overall, 28.9% of respondents reported experiencing at least one form of discrimination during maternity
care (Table 3), with highest prevalences reported by Black (40.1%), multiracial (39.4%), and Hispanic (36.6%)
respondents. Overall, the most commonly reported reasons for discrimination were age (10.1%), weight (9.7%),
and income (6.5%); reasons varied by race and ethnicity. For example, among Black respondents, the most
common reasons were weight (13.2%), race, ethnicity, or skin color (12.9%), and age (12.8%). Among
multiracial respondents, the most common reasons were age (16.7%), difference in opinion with caregivers
about the right care for oneself or one’s baby (12.1%), race, ethnicity, or skin color (10.6%), income (10.6%),
and substance use (10.6%). Among Hispanic respondents, the most common reported reasons for
discrimination were age (11.4%), weight (10.2%), and income (8.9%).
Approximately one half (44.7%) of all respondents reported holding back from asking questions or discussing
concerns with their provider during maternity care (Table 4). The most common reasons included thinking that
what they were feeling was normal (28.8%), feeling embarrassed and not wanting to make a big deal (21.5%),
having someone close tell them it was normal (21.2%), and worrying that their maternity care provider might
think they were being difficult (20.7%).

Discussion
Approximately one in five surveyed women reported mistreatment and approximately 30% reported
discrimination during maternity care. These experiences were more common among Black, Hispanic, and
multiracial mothers. Approximately one half of respondents reported holding back from discussing questions
and concerns during maternity care. These findings highlight the gaps in delivering respectful maternity care
and underscore the need for improvement. Respectful maternity care is a component of quality care and can
be integrated into broader strategies to reduce pregnancy-related deaths (3).
Although approximately 90% of respondents reported satisfaction with maternity care received, this estimate
was lower among those who experienced mistreatment. Women might report satisfaction with the maternity
care received overall and concurrently recall discrete instances of mistreatment. Women who feel safe,
supported, and respected are more likely to have positive pregnancy experiences (9). Higher patient-centered
maternity care scores are associated with lower risk for pregnancy complications (10). Improving respectful
maternity care can improve the experiences of mothers during pregnancy and delivery care.
Negative maternity care experiences might influence health care utilization; for example, experiences of racial
discrimination are associated with less than adequate prenatal care and not receiving a postpartum visit (11).
Evaluation of measures of respectful maternity care, the impact of interventions to improve respectful care,
and the effectiveness of respectful maternity care interventions on maternal health outcomes in U.S. settings is
needed (8). Studies outside of the United States have found that multilevel interventions that include approaches
to improving health system practices and policies, addressing health care provider attitudes and behaviors, and
engaging the local community have significantly improved respectful maternity care (12).
 Health care systems can encourage a culture of respectful maternity care by implementing training for health
care providers on recognizing unconscious bias and stigma, shared-decision making, improving interactions
and communication with patients, and cultural awareness.§§§,¶¶¶,**** The AIM patient safety bundles, which are
standardized practices used in birthing facilities to reduce severe illness and death, all include the provision of
safe, respectful, equitable, and supportive care. Perinatal quality collaboratives, which are state or multistate
networks of teams working to improve the quality of care for mothers and babies, have implemented quality
improvement initiatives to address birth equity and improve respectful care.††††,§§§§ Routine measurement of
patient experiences of respectful care can guide the development, implementation, and evaluation of initiatives
to improve respectful care and their contribution toward improving patient outcomes (8).
Engaging patients with effective communication is a component of respectful care. Nearly one half of
respondents reported holding back from asking questions or discussing concerns with their provider during
maternity care. The most common mistreatment experience reported by mothers was a health care provider
ignoring them, refusing their request for help, or not responding to their request for help. The Hear Her
campaign¶¶¶¶ provides resources for pregnant and postpartum women and their support networks to share
concerns with providers and to recognize urgent maternal warning signs that signal an immediate need to seek
care. The campaign also promotes the need for providers to actively listen to their patients’ concerns and
provide culturally appropriate, respectful care. Clinical organizations representing health care providers have
highlighted the importance of providing respectful maternity care to improve outcomes for mothers and
children by ensuring effective communication and shared decision-making with patients and their families and
strengthening coordinated care teams (13).
This analysis found variation in mistreatment during maternity care by race, ethnicity, and insurance status at
time of delivery. Black, Hispanic, and multiracial mothers reported the highest prevalences of experiencing any
discrimination during maternity care. Experiences of racial discrimination are associated with pregnancy
complications (14), and bias and stigma related to obesity and low income during obstetric care have been
documented (15,16). The equitable delivery of respectful patient-centered maternity care has been proposed as
one strategy to reduce disparities in maternal mortality (17). Recruitment and retention of providers with diverse
backgrounds that mirror the population served, midwifery models of care, and doulas have been shown to
improve patient experiences for racial and ethnic minority groups (2). For example, doula support is associated
with higher levels of respectful care (measured by experiences related to decision-making, support, and
communication during childbirth), particularly for mothers who are publicly insured and identify as members
of certain racial and ethnic groups (18). Engaging community-based organizations can raise awareness of
respectful care and identify opportunities to incorporate respectful care into initiatives aiming to reduce
disparities in pregnancy-related deaths (2,19). Maternal mortality review committees can identify racism and
discrimination during reviews of pregnancy-related deaths and develop recommendations for prevention (20),
providing critical data for centering health equity and reducing disparities.

Limitations
The findings in this report are subject to at least seven limitations. First, the survey was opt-in, did not use
probability sampling, and was not weighted; thus, these data are likely not representative of the U.S. birthing
population. Second, the participation rate was <50%, and some subgroups comprised a small number of
respondents. Third, because experiences were self-reported, the responses are subject to social desirability bias.
Fourth, only maternity care experiences for the youngest child were evaluated, and experiences might have
differed for other births or pregnancy outcomes. Fifth, most women were reporting on experiences during the
pregnancy or delivery of a child aged ≥5 years; such responses are subject to recall bias and might not represent
more recent experiences. Sixth, data for race were collected using a combined category for all American Indian,
Alaska Native, Native Hawaiian, and Pacific Island mothers, precluding further disaggregation. Finally, because
the survey was fielded in English only, these data do not include the maternity care experiences of those not
fluent in English.
Implications for Public Health Practice
Improving respectful care is an important component of strategies to reduce pregnancy-related deaths. Health
care systems can implement quality improvement initiatives to standardize care and support providers with
training on discrimination, stigma and unconscious bias, cultural awareness, and communication techniques in
the context of broader quality improvement initiatives. Health professionals interacting with patients at all
points of maternity care play a role in improving patient experiences during maternity care and providing
respectful maternity care equitably. Health communication campaigns and community engagement can include
the perspectives of patients, families, and communities to raise awareness to incorporate the components of
respectful maternity care, as well as how pregnant and postpartum women and their support system can
communicate their questions and concerns. These campaigns and community engagement can also encourage
providers to listen to and address their patients’ concerns.

Acknowledgments
Euna August, Ada Dieke, Ana Penman-Aguilar, CDC.

Corresponding Author: Yousra A. Mohamoud, [email protected].

1Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of
potential conflicts of interest. No potential conflicts of interest were disclosed.

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* https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm
† https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/data-mmrc.html
§ https://saferbirth.org/patient-safety-bundles/
¶ PN View Moms surveys are designed by Porter Novelli Public Services. They are programmed and fielded by Big Village (https://big-
village.com/insights/caravan-omnibus-surveys/) using opt-in panel members from the Lucid platform (https://luc.id/quality/). Data quality
 checks are incorporated during both sampling and survey administration. Lucid uses a variety of tracking measures to confirm respondent
identity and prevent duplicate responses.
** 45 C.F.R. part 46; 21 C.F.R. part 56; 42 U.S.C. Sect. 241(d), 5 U.S.C. Sect. 552a, 44 U.S.C. Sect. 3501 et seq.
††PN View Moms survey is not a federal data collection. Race and ethnicity data were categorized in the following manner based on the way
data were collected: Hispanic includes all persons who selected Hispanic ethnicity. Race categories are non-Hispanic. White includes White,
Middle Eastern, and North African. Black includes Black or African American, Caribbean American, and African. Asian includes Asian
American, South Asian, East Asian, and Southeast Asian. Porter Novelli collects race data using the category “Indigenous American/First
Nations,” which includes Native American, American Indian, Alaska Native, Pacific Islander, and Native Hawaiian, and is referred to in this
report as “American Indian, Alaska Native, Pacific Islander, or Native Hawaiian.” Multiracial includes respondents that selected more than
one race; another race includes those who did not select any race or ethnicity categories.
§§Highest level of formal education completed at time of survey was defined as less than high school, high school diploma or equivalent, or
more than a high school diploma. More than a high school diploma includes respondents with some college education, an associate degree or
technical school, a bachelor’s degree, a master’s degree, or a professional degree or doctorate.
¶¶Private insurance includes respondents with health insurance from the Healthcare.gov Healthcare Marketplace and Tricare or other military
insurance; public insurance includes those on Medicaid, Medicare, Indian Health Service, or any other tribal insurance; and no insurance
includes respondents who did not have insurance at any time during their youngest child’s birth and those who self-paid.
*** Respondents rated their overall satisfaction with the care they received during their pregnancy or delivery of their youngest child as 1) very
satisfied, 2) somewhat satisfied, 3) neither satisfied nor dissatisfied, 4) somewhat dissatisfied, or 4) very dissatisfied.
††† Respondents were asked, “While getting health care during your pregnancy or delivery with your youngest child, did you experience
discrimination or were you prevented from doing something, hassled, or made to feel inferior because of any of the following?” Reasons
included race, ethnicity or skin color, disability status, immigration status, age, weight, income, sexual orientation, religion, language or accent,
type or lack of health insurance, difference in opinion about right care for mother or baby, substance use, involvement with the justice system
(jail or prison), and other reason.
§§§ Institute for Perinatal Quality Improvement. Speak Up Program. https://www.perinatalqi.org/page/SPEAKUP
¶¶¶ Association of Women's Health, Obstetric and Neonatal Nurses Respectful Maternity Care Implementation Toolkit 2022.
https://www.awhonn.org/respectful-maternity-care-implementation-toolkit/
**** TEAMBIRTH, Ariadne Laboratories. https://www.ariadnelabs.org/delivery-decisions-initiative/teambirth/
†††† Oklahoma Perinatal Quality Improvement Collaborative Team Birth Initiative. https://opqic.org/teambirth/
§§§§ Illinois Perinatal Quality Collaboratives Birth Equity. https://ilpqc.org/birthequity/
¶¶¶¶ https://www.cdc.gov/hearher/index.html

TABLE 1. Sociodemographic characteristics of mothers — PN View Moms survey, United States, April 2023*
Characteristic No. (%)†
Total 2,402 (100.0)
Respondent age group, yrs
<20 6 (0.3)
20–29 346 (14.4)
30–39 1,054 (43.9)
40–49 731 (30.4)
≥50 265 (11.0)
Age group of youngest child, yrs
<1 132 (5.5)
1–4 697 (29.0)
≥5 1,573 (65.5)
Race and ethnicity§
White 1,671 (69.6)
Black 257 (10.7)
Hispanic 246 (10.2)
Asian 115 (4.8)
American Indian, Alaska Native, Pacific Islander, or Native Hawaiian 35 (1.5)
Multiracial 66 (2.8)
Another race 12 (0.5)
Health insurance during delivery¶
Private insurance 1,356 (56.5)
Medicaid 782 (32.6)
Medicare or tribal insurance 200 (8.3)
No insurance 64 (2.7)
Highest level of educational attainment**
Less than high school 83 (3.5)
High school diploma or equivalent 547 (22.8)
More than high school diploma 1,772 (73.8)
 U.S. Census Bureau region††
Northeast 422 (17.6)
Midwest 518 (21.6)
South 835 (34.8)
West 627 (26.1)
* Survey was administered in English during April 24–30, 2023.
†
Percentages might not sum to 100 because of rounding.
§
PN View Moms survey is not a federal data collection. Race and ethnicity data were categorized in the following manner
based on the way data were collected: Hispanic includes all persons who selected Hispanic ethnicity. Race categories are non-
Hispanic. White includes White, Middle Eastern, and North African. Black includes Black or African American, Caribbean
American, and African. Asian includes Asian American, South Asian, East Asian, and Southeast Asian. Porter Novelli collects
race data using the category “Indigenous American/First Nations,” which includes Native American, American Indian, Alaska
Native, Pacific Islander, and Native Hawaiian, and is referred to in this report as “American Indian, Alaska Native, Pacific
Islander, or Native Hawaiian.” Multiracial includes respondents that selected more than one race; another race includes those
who did not select any race or ethnicity categories.
¶
Private insurance includes respondents with health insurance from Healthcare.gov Health Insurance Marketplace and
Tricare or other military insurance; public insurance includes those on Medicaid, Medicare, Indian Health Service, or any other
tribal insurance; and no insurance includes respondents who did not have insurance at any time during their youngest child’s
birth and those who self-paid.
** Highest level of formal education completed at time of survey was defined as less than high school, high school diploma or
equivalent, or more than a high school diploma. More than a high school diploma includes respondents with some college
education, an associate degree or technical school, a bachelor’s degree, a master’s degree, or a professional degree or
doctorate.
††
https://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv.pdf

TABLE 2. Reported satisfaction with and mistreatment during maternity care (pregnancy or delivery) received for youngest
child overall, by race and ethnicity* and insurance coverage† at time of delivery — PN View Moms survey, United States,
April 2023§
Race and ethnicity, % Insurance coverage
American
Indian, Alaska
Native, Pacific
Islander, or
Native
Responses to survey questions All White Black Hispanic Asian Hawaiian Multiracial Private Public None
Total, no. 2,402 1,671 257 246 115 35 66 1,356 982 64
Satisfaction during pregnancy¶
Very or somewhat satisfied 90.5 90.9 91.1 88.6 93.0 94.3 78.8 94.1 86.1 81.3
Neither satisfied nor dissatisfied 4.7 3.9 5.8 8.1 5.2 —** 6.1 2.5 7.2 10.9
Very or somewhat dissatisfied 4.9 5.2 3.1 3.3 1.7 5.7 15.2 3.4 6.7 7.8
Satisfaction during delivery
Very or somewhat satisfied 89.2 89.3 89.1 88.2 94.8 91.4 80.3 92.8 84.6 82.8
Neither satisfied nor dissatisfied 4.6 4.0 5.5 6.9 5.2 2.9 7.6 2.7 6.4 15.6
Very or somewhat dissatisfied 6.2 6.8 5.5 4.9 —** 5.7 12.1 4.5 9.0 1.6
Mistreatment during pregnancy††
Any 20.4 17.8 30.0 29.3 14.8 20.0 27.3 15.9 26.1 28.1
Your private or personal information was 4.0 3.1 7.0 7.7 5.2 2.9 —** 3.3 5.0 3.1
shared without your consent
Your physical privacy was violated (i.e., being 5.1 4.1 7.0 9.8 2.6 8.6 7.6 4.1 6.1 9.4
uncovered or having people in the delivery
room without your consent)
Health care providers (doctors, midwives, or 6.7 6.2 9.0 7.7 5.2 8.6 10.6 5.9 7.8 7.8
nurses) shouted at or scolded you
Health care providers threatened to withhold 4.6 4.1 6.6 3.7 5.2 8.6 7.6 4.4 4.8 6.3
treatment or to force you to accept treatment
you did not want
Health care providers threatened you in any 3.8 2.9 5.8 6.5 4.4 —** 6.1 2.5 5.4 4.7
other way
Health care providers ignored you, refused 9.7 9.0 11.7 13.0 4.4 5.7 19.7 7.6 12.6 9.4
your request for help, or failed to respond to
requests for help in a reasonable amount of
time
You experienced physical abuse (including 3.6 2.8 7.0 6.5 3.5 2.9 1.5 2.4 5.2 4.7
aggressive physical contact, inappropriate
sexual conduct, refusal to provide anesthesia
for an episiotomy, etc.)
 * PN View Moms survey is not a federal data collection. Race and ethnicity data were categorized in the following manner
based on the way data were collected: Hispanic includes all persons who selected Hispanic ethnicity. Race categories are non-
Hispanic. White includes White, Middle Eastern, and North African. Black includes Black or African American, Caribbean
American, and African. Asian includes Asian American, South Asian, East Asian, and Southeast Asian. Porter Novelli collects
race data using the category “Indigenous American/First Nations,” which includes Native American, American Indian, Alaska
Native, Pacific Islander, and Native Hawaiian, and is referred to in this report as “American Indian, Alaska Native, Pacific
Islander, or Native Hawaiian.” Multiracial includes respondents that selected more than one race; another race includes those
who did not select any race or ethnicity categories.
†
Private insurance includes respondents with health insurance from Healthcare.gov Health Insurance Marketplace and
Tricare or other military insurance; public insurance includes those on Medicaid, Medicare, Indian Health Service or any other
tribal insurance; and no insurance includes respondents who did not have insurance at any time during their youngest child’s
birth and those who self-paid.
§
Survey was administered in English during April 24–30, 2023.
¶
Respondents rated their overall satisfaction with the care they received during their pregnancy or delivery of their youngest
child as: Very satisfied, somewhat satisfied, neither satisfied nor dissatisfied, somewhat dissatisfied, and very dissatisfied.
** No respondents.
††
Question was asked as, “Did you experience any of the following issues or behaviors during your pregnancy or delivery of
your youngest child?” https://pubmed.ncbi.nlm.nih.gov/31182118/

TABLE 3. Reported experiences of discrimination* while receiving health care during pregnancy or delivery of youngest child,
overall and by race and ethnicity † — PN View Moms survey, United States, April 2023§
Racial and ethnic group, %
American
Indian, Alaska
Native, Pacific
Islander, or
Native
Responses to questions regarding discrimination All White Black Hispanic Asian Hawaiian Multiracial
Total, no. 2,402 1,671 257 246 115 35 66
Any experience of discrimination 28.9 26.0 40.1 36.6 22.6 31.4 39.4
¶
Reported reason
My race, ethnicity, or skin color 4.0 1.6 12.9 7.3 6.1 8.6 10.6
My disability status 2.3 1.7 3.9 4.1 1.7 2.9 4.6

My immigration status 1.3 0.8 4.3 1.2 3.5 2.9 —**

My age 10.1 9.5 12.8 11.4 7.0 8.6 16.7
My weight 9.7 9.2 13.2 10.2 8.7 14.3 7.6
My income 6.5 5.9 10.1 8.9 2.6 2.9 10.6
My sexual orientation 1.5 1.0 3.1 3.7 1.7 —** —**
My religion 2.3 1.9 4.3 4.1 0.9 2.9 3.0
My language or accent 2.3 1.2 5.8 3.3 8.7 —** 1.5
My type or lack of health insurance 4.6 4.4 6.2 5.3 0.9 2.9 9.1
A difference in opinion with my caregivers about the right 5.6 5.2 9.0 5.7 2.6 —** 12.1
care for myself or my baby
My use of substances (alcohol, tobacco, or other drugs) 3.8 3.8 3.1 3.7 1.7 8.6 10.6
My involvement with the justice system (jail or prison) 1.4 1.0 3.1 2.9 —** —** 1.5
Other 0.6 0.8 0.8 —** —** —** —**
* Respondents were asked, “While getting health care during your pregnancy or delivery with your youngest child, did you
experience discrimination or were you prevented from doing something, hassled, or made to feel inferior because of any of the
following?”
†
PN View Moms survey is not a federal data collection. Race and ethnicity data were categorized in the following manner
based on the way data were collected: Hispanic includes all persons who selected Hispanic ethnicity. Race categories are non-
Hispanic. White includes White, Middle Eastern, and North African. Black includes Black or African American, Caribbean
American, and African. Asian includes Asian American, South Asian, East Asian, and Southeast Asian. Porter Novelli collects
race data using the category “Indigenous American/First Nations,” which includes Native American, American Indian, Alaska
Native, Pacific Islander, and Native Hawaiian, and is referred to in this report as “American Indian, Alaska Native, Pacific
 Islander, or Native Hawaiian.” Multiracial includes respondents that selected more than one race; another race includes those
who did not select any race or ethnicity categories.
§
Survey was administered in English during April 24–30, 2023.
¶
Respondents were allowed to select more than one reason for the discrimination they experienced.
** No respondents.

TABLE 4. Respondent reasons for holding back from asking questions or discussing concerns during pregnancy or delivery of
youngest child (N = 2,402) — PN View Moms survey, United States, April 2023*

Survey responses regarding asking questions or discussion about pregnancy or delivery concerns No. (%)
I did not hold back from talking to a health care provider when I had questions or concerns† 1,329 (55.3)

Any reason selected for holding back from talking to a health care provider when I had questions or concerns 1,073 (44.7)

Reasons for holding back from asking questions or discussing concerns during pregnancy or delivery§

I thought what I was feeling was normal for pregnancy 309 (28.8)

I didn’t want to make a big deal about it or was embarrassed to talk about it 231 (21.5)

My friends or family told me it was a normal part of pregnancy or that they had the same experience 227 (21.2)

I thought my maternity care provider might think I was being difficult 222 (20.7)

My maternity care provider seemed rushed 186 (17.3)

I didn’t feel confident that I knew what I was talking about 186 (17.3)

I forgot to mention it 169 (15.8)

I didn’t think my concern was important enough 162 (15.1)

I was scared to talk about it 155 (14.4)

I didn’t feel comfortable talking about my body or what I was feeling 147 (13.7)

I wanted maternity care that differed from what my maternity care provider recommended 105 (9.8)

I had another reason not listed 84 (7.8)

I didn’t want to spend any more money on health care 75 (7.0)

* Survey was administered in English during April 24–30, 2023.

†
Respondents who selected this option were not asked about reasons for holding back from asking questions or discussing
concerns with a health care provider.
§
Respondents could select more than one reason. Percentages were calculated using the overall number of persons who
reported a reason for holding back from asking questions or discussing concerns with a health care provider (n = 1,073) as the
denominator.