Yesterday, local women and families joined thousands of others at 85 locations around the country to call for more respectful treatment of women during childbirth, including their rights to full information and decision-making in their care, according to advocacy group Improving Birth.

The Whidbey Island rally took place Monday morning at the Oak Harbor Farmers Market park as part of Improving Birth’s fourth annual national Rally to Improve Birth, this Labor Day week across the U.S. and Canada.

“We were all horrified, but not surprised, at the anonymous essay recently published in the Annals of Internal Medicine describing degrading treatment of women by their doctors,” said Kim Graves, Whidbey Island’s Improving Birth representative. “We hear about disrespectful behavior towards women in childbirth from our friends around the country all the time— especially from women who are educated about their care and asking questions.”

Research shows it takes an average of 15 to 20 years for best medical evidence to be implemented into practice. In the meantime, the national Cesarean rate of 1 in 3 births is widely acknowledged as too high by national health organizations, many of which have recommended reducing the use of various childbirth interventions that impose additional health risks on mothers and babies. The U.S. is the only developed country with a rising maternal mortality rate, with African-American women four times more likely to die from pregnancy-related causes, the group reported.

In a letter this past week to the American College of Obstetricians and Gynecologists, advocates asked the obstetricians’ organization to join them “as allies” to address such conduct among its members, as “women are losing trust in the industry.” The World Health Organization recently identified “disrespect and abuse during facility-based childbirth” as a pressing global issue , and several U.S.-based organizations that endorsed the WHO statement—Improving Birth, Human Rights in Childbirth, and the Birth Rights Bar Association—have been founded in the past few years to address these systemic issues.

“There’s no real system of accountability,” said Dawn Thompson, founder and president of Improving Birth. “We are appealing to ACOG because women’s complaints to hospitals and medical boards are routinely dismissed and ignored. Doctors and consumers must come together to solve this problem from the inside out.”