Giving birth in the United States is a radically different experience based on race and income, illustrated most brutally by the Black and Indigenous maternal mortality crisis.
Now, a new study from the Boston University School of Public Health (BUSPH) and the National Partnership for Women & Families finds insurance type itself also plays a role in how mothers are treated, and how much agency they have in maternity decisions.
The study finds that, after adjusting for demographics and health conditions, a mother on Medicaid is three times less likely than a mother on private insurance to feel she had a choice about whether she had a vaginal or cesarean birth, or an episiotomy. Compared to private coverage, coverage by Medi-Cal (California’s Medicaid program) was also associated with being about half as likely to have a choice of prenatal provider or to be encouraged by maternity care staff to make one’s own decisions about labor and birth….
Since birth trauma and its reverberations have strong lifelong effects on the physical and mental health of mother, baby and future babies, as well as marital and family cohesion, you can see the setup for toxic multigenerationally reinforcing feedback loops which will serve to keep poor families poor. The question is what is going on with the medical training of doctors who treat medicaid patients?