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Evidence LibraryPregnancy loss and complicated outcomesWhat not to conclude
Evidence Library · What not to conclude

A bad outcome does not excuse how you were treated

If you were shouted at, ignored, or overruled, that is a separate wrong from whatever else happened, and it stands whatever the outcome was.

This is the distinction that governs everything in this part, and it bites hardest here.

When a birth goes badly, the bad outcome swallows everything around it. Women who were treated badly on the way to that outcome often stop mentioning it, because it feels small next to what happened, or because they think that if they had expected less they would not feel so hurt. Both of those are ways of taking the blame for someone else's conduct.

How you were treated is a separate question from how it turned out. A good outcome does not retire it. A bad outcome does not excuse it. And neither one is evidence that you expected too much.

A US survey with questions written by women themselves asked 2,138 women about specific acts, not general satisfaction. These are the answers.

What happenedNumber of the 2,138 women
Was shouted at or scolded by a doctor, midwife or nurse182 (8.5%)
Was ignored, or had a request for help refused or not answered in a reasonable time166 (7.8%)
Had her physical privacy violated117 (5.5%)
Was threatened with treatment being withheld, or forced to accept treatment she did not want97 (4.5%)
Was threatened in some other way44 (2.1%)
Experienced physical abuse27 (1.3%)
Had personal information shared without consent26 (1.2%)
Any one or more of the above369 (17.3%)

One finding in that study matters more than the headline. Among women who had a difference of opinion with the clinician caring for them, the majority reported one or more of these things: 76.4% of white women and 83.0% of women of colour. Disagreeing was the single strongest thing linked to being mistreated. If you have wondered whether speaking up made it worse, you are describing a documented pattern, not a personal failing.

The same question was asked in the Netherlands, of 12,239 women, in a completely different maternity system. 36.3% reported at least one experience of disrespect or abuse that they found upsetting, with lack of choice, lack of communication, lack of support and rough treatment the leading categories. The design there was better in one way: it separated things that happened from things that happened and were upsetting.

What these numbers areBoth surveys recruited women who chose to take part, mostly through social media, so neither is a picture of the whole country. The US study deliberately included many women who gave birth at home, so its overall figure is not a national rate and should never be quoted as one. What they are good at is the specific acts, which were written by women rather than by researchers, and the fact that two very different health systems produced findings of the same order.
The sentence to keepBeing shouted at, ignored, threatened or uncovered without consent is not an expectation that biology failed to meet. It is a failure of care by people. It does not become acceptable because the baby is well, and it does not become your fault because the birth was difficult.
Naming it, separately from the outcome"I want to talk about two different things. One is what happened medically. The other is how I was spoken to."
"I am not saying the care was wrong. I am saying I was treated badly, and I want that recorded."
Where this comes from:
432. Vedam S, Stoll K, Taiwo TK, Rubashkin N, Cheyney M, Strauss N, et al; GVtM-US Steering Council. The Giving Voice to Mothers study: inequity and mistreatment during pregnancy and childbirth in the United States. Reprod Health. 2019;16(1):77.
544. van der Pijl MSG, Verhoeven CJM, Verweij R, van der Linden T, Kingma E, Hollander MH, et al. Disrespect and abuse during labour and birth amongst 12,239 women in the Netherlands: a national survey. Reprod Health. 2022;19(1):160.

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This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you. If you are worried about a symptom now, see urgent warning signs.