Abstract
People with disabilities experience substantial disparities in perinatal health and outcomes that may be impacted by inequities in health care.
This study assesses how receipt and content of perinatal care varies by extent of disability.
We analyzed 2019–2021 PRAMS data from 22 sites that included the Washington Group Short Set of Questions (n=43,567). We examined association of extent of disability (none, some, a lot) with pre-pregnancy, prenatal, and postpartum health care using multivariable Poisson regression to calculate state-adjusted prevalence ratios (PRs) and sociodemographic-adjusted prevalence ratios (aPRs). Among individuals who received each care type, we calculated PRs and aPRs for content of care, including topics pertaining to maternal health, pregnancy prevention, and preparing for a healthy pregnancy.
Compared to those with no difficulty, respondents with some difficulty were less likely to receive pre-pregnancy care from an OB/GYN (PR=0.93; 95%CI 0.6, 0.98) or a postpartum checkup (PR=0.98; 95%CI 0.98, 0.99); respondents with a lot of difficulty were less likely to receive pre-pregnancy care from an OB/GYN (PR = 0.86; 95%CI 0.74, 1.00), adequate prenatal care (PR=0.92; 95%CI 0.90, 0.95), or a postpartum checkup (PR=0.94; 95%CI 0.90, 0.95). Respondents with any level of difficulty were at least as likely as those with no difficulty to receive education on maternal health topics and pregnancy prevention but less likely to receive care addressing desire for children or preparing for a healthy pregnancy.
Disabled women, particularly those with a lot of difficulty, receive differential perinatal health care. Our findings highlight the need for comprehensive and equitable care.