Women's Healthcare - So Much Room to Improve

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Alan Unell Ph.D.

Dec 01, 2023

a woman with a stethoscope talking to another woman — Photo by National Cancer Institute on Unsplash

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Women’s Healthcare

The Kaiser Family Foundation recently reported on women’s healthcare. Here is what they found.

Among women ages 18-64 who have seen a health care provider in the past two years:
- 29% report that their doctor had dismissed their concerns in that time period,
- 15% reported that a provider did not believe they were telling the truth,
- 19% say their doctor assumed something about them without asking,
- 13% say that a provider suggested they were personally to blame for a health problem.
- One in ten (9%) women ages 18-64 say that they have experienced discrimination because of their age, gender, race, sexual orientation, religion, or some other personal characteristic during a health care visit in the past two years.
- While 58% report that in the past two years their provider asked them about what kind of work they do, far fewer report having been asked about their housing situation (30%), their ability to afford food (20%), or access to reliable transportation (20%). Women with Medicaid and those with low incomes are more likely to say they have been asked about these last three indicators than women with private insurance and those with higher incomes.
Communication is an important component of health care quality; however, 21% of women (including 38% of uninsured women), say it is difficult to find a doctor who explains things in a way that is easy to understand.

Just over one-third (35%) of women ages 40-64 say their health care provider ever talked to them about what to expect in menopause.

Bottom line - women are not heard well by the medical profession and not well served.

Conclusion - Better Communication Needed

The role of social determinants on health outcomes has garnered increased recognition in recent years. Providers are increasingly discussing factors with their patients that shape access to health care and health outcomes such as food insecurity and transportation challenges, although ensuring providers have resources with which to connect patients to address these social determinants is still a challenge.

Gender bias and racial discrimination in the health care system can contribute to health disparities and poorer health outcomes.

Maternity Is No Better

We have described how maternal mortality is on the rise, we have described how women are not well heard by medical professionals, we have seen states restrict women’s reproductive health options making them less than full citizens with bodily autonomy. It is not a pretty picture.

The Center for Disease Control has released the results of a survey to discover how women are treated during pregnancy and delivery. The results are atrocious. Here is a link to the summary and the full report is here.

About 20% of women reported mistreatment while receiving maternity care.
About 30% of Black, Hispanic, and multiracial women reported mistreatment.
Almost half (45%) of women held back from asking questions or sharing concerns during their maternity care.

The most common types of mistreatment reported were:

Receiving no response to requests for help.
Being shouted at or scolded.
Not having their physical privacy protected.
Being threatened with withholding treatment or made to accept unwanted treatment.

Bias and discrimination in maternity care settings impact care

Mistreatment by maternity care providers was reported most often by Black, Hispanic, and multiracial moms. People with no insurance or public insurance experienced more mistreatment during maternity care than people with private insurance.
About 29% of women experienced discrimination while receiving maternity care. Reports of discrimination were highest among Black (40%), multiracial (39%), and Hispanic (37%) women.

Better communication is needed during maternity care

Almost half (45%) of moms reported holding back from asking questions or sharing concerns during their pregnancy or delivery. The top reasons included:

Thinking, or being told by friends or family, what they were feeling was normal.
Not wanting to make a big deal about it or being embarrassed to talk about it.
Thinking their healthcare provider would think they’re being difficult.
Thinking their healthcare provider seemed rushed.
Not feeling confident that they knew what they were talking about.

These are signs that women feel vulnerable and threatened, not respected. Is that what anyone wants to convey? I sure hope the answer is no but that’s not what is happening.

Let’s remind ourselves that respectful maternity care:

Maintains dignity, privacy, and confidentiality,
Ensures freedom from harm and mistreatment, and
Allows for shared decision-making and continuous support during labor and childbirth.

Here is an ABC news story on the subject. Fair warning the descriptions of mistreatment are very disturbing.

Conclusion

There is so much room to improve women’s healthcare. I understand doctor’s are rushed to see more patients and to increase billing but that’s no excuse for blaming patients, not believing patients, or threatening patients.

The status of women is at risk and those in the medical profession can be a positive force for change by being active listeners, not jumping to conclusions, and treating their patients with dignity and respect.

I used to manage very large teams of engineers and we were all trained to listen and to make sure we understood what was said to us. It does not come naturally. I want to make sure that you also caught the inherent racial, ethnic, and income bias in all the above. It is present in medicine and it poses health risks. Again, when people are exposed to a diversity of population, they learn that we are all the same and all worthy of respect. That’s one of the reasons that diversity in school and in the medical profession is so important. Removing affirmative action will only make this worse.

Also worth noting that the fee for service environment, private equity needs to squeeze rapid profits from healthcare, and a need to rush through as many patients as possible only makes this worse. Universal healthcare won’t fix all of it, just most of it.

ACTION

Let’s let our members of Congress and Senators know the sad state of Women’s Healthcare and that by implementing Universal Healthcare, with global budgets to cover private healthcare infrastructure we can give doctors the time they need to listen to their patients and change the healthcare culture. Their contact info is in the Resources section below or use RESISTBOT by texting SIGN PLICDK to 50409 to send the email below.

“I am your constituent and I want you to know that women are not well heard by their doctors. The Kaiser Family Foundation and the CDC found rampant discrimination based on race, ethnicity, and income. Moreover almost 30% of women are disregarded by their doctors.

This has serious medical implications for women’s health. By implementing global budgets for the healthcare infrastructure and removing the fee for service pressure to see as many patients as possible, we can help give doctors the time they need to really listen.

I want you to support HR 3421 the improved Medicare for All act because it will implement those global budgets and help women’s health care and improve the healthcare landscape for all of us. Thank you.”

RESOURCES

Healthcare Advocacy (Us)

Website

Our Newsletter resources including reproductive healthcare

Healthcare Advocacy Reading List

Find My Elected Officials

Contact the White House https://www.whitehouse.gov/contact/

Contact State and Federal Representatives

Important Healthcare Resources

League of Women Voters Healthcare Reform Toolkit

Organizations to Contact

National Nurses United Medicare4All

Physicians for a National Health Program

One Payer States

Healthcare Now

Reproductive Health

NARAL - Pro Choice America

Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion

Planned Parenthood

Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.

United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.

Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.