The Centers for Disease Control and Prevention said "unconscious bias" training is necessary to improve maternal health outcomes in the United States based upon a new report published on Tuesday.

"Making sure there's respectful maternity care requires action from multiple levels, from healthcare systems, healthcare providers, and the community," said Wanda Barfield, the director of CDC's Division of Reproductive Health. "Healthcare systems can encourage a culture of respectful maternity care, training healthcare providers to recognize unconscious bias [and] stigma, support shared decision-making, improve interactions and communication with patients, and be culturally aware."

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In April, the researchers asked approximately 2,400 women about their experience with the healthcare system for their most recent pregnancy in the United States without a time limitation on when the pregnancy occurred.

The survey found that although 20% of respondents reported mistreatment during their prenatal or postpartum care, 30% of black, 29% of Hispanic, and 27% of multiracial respondents reported mistreatment. Women with no health insurance or on public health insurance also reported higher levels of mistreatment.

The study also found that nearly half of respondents were reticent to ask questions of their healthcare providers during prenatal and postpartum 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 study said.

"Despite our technology, despite our advancement, women still are reporting that they're not being listened to and that they're not receiving respectful care," Barefield said. "So it's really important because the utilization of all of the resources really need to happen in the context of respect."

The study was commissioned in part because of the connection to the increasing rates of maternal deaths in the U.S., which is increasing the fastest among black mothers.

In 2018, the CDC reported that the death rate for black mothers was 37.3 per 100,000, compared to the white and Hispanic maternal mortality rates at 14.9 and 11.8, respectively. As of 2021, however, the black maternal mortality rate was 69.9 per 100,000 compared to 26.6 and 28.0 for white and Hispanic mothers, respectively.

Barfield and her colleague, Debra Houry, chief medical officer at CDC, called for greater access to midwifery and doula care in an effort to promote respectful maternal care, particularly in strengthening patient advocacy for women more likely to face discrimination or mistreatment.

"They have an opportunity to speak up," Barfield said, "perhaps having a better perspective on the healthcare system and being an advocate for that particular mom, where this may be a completely unique experience or a different experience [for the patient]."

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"The health of moms reflects the health of our nation," Barfield said. "Every mom deserves respectful and fair and equal care during their pregnancy and delivery."

Last month, the CDC was lambasted by conservative politicians for its guidance on so-called chestfeeding for transgender people.