Identifying Obstetric Mistreatment Experiences in U.S. Birth Narratives: Application of Internationally Informed Mistreatment Typologies.
Hannah J Tello, Dylan J Téllez, Joseph E Gonzales
PMID 35120346WHAT IT FOUND
In interviews with 61 U.S. birth participants, 41 narratives described mistreatment, mostly poor communication, dismissed concerns, and loss of autonomy.
Participants said clearer communication and being heard might have prevented distress.
Key findings
01Of 96 oral birth narratives, 55 had no coded mistreatment and 41 had mistreatment, averaging 3.11 unique instances per affected narrative.
02Poor Rapport accounted for 68.7% of mistreatment codes, followed by Failure to Meet Professional Standards of Care at 22.1%; no Physical or Sexual Abuse instances were identified.
03The most common domain, Poor Rapport, included ineffective communication (71 incidences), loss of autonomy (11 incidences), and lack of supportive care (8 incidences).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Participants were mostly white (88.5%) and mostly from the Northeast (60.7%), so the findings may not represent U.S. birth experiences more broadly. Recruitment used flyers and provider networks, so the sample is not described as a random sample. The median time since birth was 2 years, and the authors note that recall may affect descriptions. Interviews did not ask direct questions about mistreatment, so experiences may be missed unless participants chose to mention them. Coding required participants' own evaluative or affective indication of mistreatment, which may undercount stigma and discrimination. No Physical or Sexual Abuse instances were identified, but that does not prove they did not occur in U.S. births. Results describe perceived mistreatment, not verified clinical errors or harm.
The easy way to misread this
Do not read the 42.7% of narratives with mistreatment as a rate for all U.S. births. It comes from 61 recruited participants and counts only experiences participants themselves perceived as mistreatment.