(NewsNation) — New data from the Centers for Disease Control and Prevention found one in five pregnant people experienced mistreatment while receiving maternity care, and nearly half held back from asking questions about their care.

Between 2018 and 2021, maternal death rates increased in the U.S., with more than 80% considered preventable. Black and Native patients have the highest rates of pregnancy-related mortality.

The study also found that while one in five pregnant people reported receiving mistreatment overall, that number rose to one in three in Black, Hispanic and multiracial patients.

The most common types of mistreatment included not getting a response when asking for help, being shouted at or scolded, care providers threatening to withhold treatment or forcing patients to accept unwanted treatment and privacy violations.

The CDC also found 45% of pregnant people reported holding back from asking questions. Reasons for holding back included embarrassment, fear they would be seen as difficult, a lack of confidence, thinking what they were experiencing was normal and their provider appearing rushed.

The agency noted the public health implications of the findings, advising the need for health care organizations to recruit racially and culturally diverse providers and explore nontraditional models of maternity care, including the use of midwives or doulas.