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Fundamental Problems with Maternity Care in the United States

Labels: PregnancyIssue #20
Written by Pathways Magazine   
Monday, 01 December 2008 00:00
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Fundamental Problems with Maternity Care in the United States
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This statement was developed in response to serious and continuing problems with maternity care in the United States, including:

  • The United States is the only wealthy industrialized nation that does not guarantee access to essential health care for all pregnant women and infants. Many women, especially those with low incomes, lack access to adequate maternity care.

  • A large body of scientific research shows that many widely used maternity care practices that involve risk and discomfort are of no benefit to low-risk women and infants. On the other hand, some practices that clearly offer important benefits are not widely available in U.S. hospitals.

  • Many women do not receive adequate information about benefits and risks of specific procedures, drugs, tests, and treatments, or about alternatives.

  • Childbearing women frequently are not aware of their legal right to make health care choices on behalf of themselves and their babies, and do not exercise this right.

We must ensure that all childbearing women have access to information and care that is based on the best scientific evidence now available, and that they understand and have opportunities to exercise their right to make health care decisions. Women whose rights are violated need access to legal or other recourse to address their grievances.


The Twenty Rights of Childbearing Women

  1. Every woman has the right to health care before, during, and after pregnancy and childbirth.

  2. Every woman and infant has the right to receive care that is consistent with current scientific evidence about benefits and risks.* Practices proven safe and beneficial should be used when indicated. Harmful, ineffective, or unnecessary practices should be avoided. Unproven interventions should be used only in the context of research to evaluate their effects.

  3. Every woman has the right to choose a midwife or a physician as her maternity care provider. Both caregivers skilled in normal childbearing and caregivers skilled in complications are needed to ensure quality care for all.

  4. Every woman has the right to choose her birth setting from the full range of safe options available in her community, on the basis of complete, objective information about benefits, risks, and costs of these options.*

  5. Every woman has the right to receive all or most of her maternity care from a single caregiver or a small group of caregivers with whom she can establish a relationship. Every woman has the legal right to leave her maternity caregiver and select another if she becomes dissatisfied with her care.*

  6. Every woman has the right to information about the professional identity and qualifications of those involved with her care, and to know when those involved are trainees.*

  7. Every woman has the right to communicate with caregivers and receive all care in privacy, which may involve excluding nonessential personnel. She also has the right to have all personal information treated according to standards of confidentiality.*

  8. Every woman has the right to receive maternity care that identifies and addresses social and behavioral factors that affect her health and that of her baby.** She should receive information to help her take the best care of herself and her baby and have access to social services and behavioral change programs that could contribute to their health.

  9. Every woman has the right to full and clear information about benefits, risks, and costs of the procedures, drugs, tests, and treatments offered to her, and of all other reasonable options, including no intervention.* She should receive this information about all interventions that are likely to be offered during labor and birth well before the onset of labor.