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They are at greater risk of maternal mortality and more likely to have a wide array of complications. Doctors need to gain more comfort in treating women with disabilities, the study suggests.
Women with disabilities are significantly more likely to have health complications during pregnancy and after childbirth, a new study indicates.
The study, published in Jama Network Open, found women with physical, intellectual or sensory disabilities are all at higher risk for complications.
While the study found few deaths among women with disabilities after childbirth, the study did indicate women with disabilities were 11 times more likely to suffer maternal death.
Researchers at the National Institutes of Health conducted the study.
There hasn’t been much research on the risks of health complications for women with disabilities who are pregnant. With more attention being given to maternal mortality, the authors said it’s important to look at the outcomes for pregnant women with disabilities.
“Additional research is needed to understand the reasons for this increased risk and to develop needed interventions to reduce it,” Jessica L. Gleason, the study’s lead author, said in a statement accompanying the study.
Doctors need to become more comfortable in treating women who have disabilities before and during pregnancy, the authors wrote. One potential factor at play is an “underrecognition of women with disabilities as a population with higher risk pregnancies,” the study noted.
Women with disabilities have a pregnancy rate comparable to women without disabilities. Pregnant women with disabilities often carry more risks for complications. They are more likely to be living in poverty, which is a barrier to getting quality healthcare. Women with disabilities are more likely to smoke, struggle with substance abuse and suffer from depression.
The study compared 2,074 women with disabilities and 221,311 women without disabilities across a wide range of health complications. Women with disabilities showed higher risk for nearly all pregnancy complications, the study found.
Women with disabilities were more likely to suffer cardiovascular events, postpartum hemorrhage, postpartum fever, and sepsis/septicemia.
The study found women with physical disabilities were nearly four times more likely to suffer cardiovascular events. Women with disabilities were also six times more likely to develop blood clots in the lungs or legs. Women with sensory disabilities were six times more likely to have an infection.
It’s possible that doctors are too quick to opt for Cesarean delivery for women with disabilities, the study suggests.
Since Cesarean delivery is a known risk factor for health complications and maternal mortality, such deliveries could be playing a role in the increased adverse health outcomes for women with disabilities, the authors stated.
While pregnant women with disabilities were more likely to suffer complications such as gestational diabetes and preeclampsia, a serious blood pressure condition, there wasn’t a corresponding rise in labor induction. The study said this indicated a potential preference for cesarean delivery.
In addition, cesarean delivery was less likely to be indicated as clinically necessary, which “may reflect a health care practitioner preference to avoid natural labor in women with disabilities,” the authors wrote.
Some pregnant women with disabilities often don’t have a good clinical understanding of some aspects of their disabilities, the study noted.
Pregnant women with disabilities also face other obstacles in getting prenatal care.
“Women with disabilities also report negative reactions toward their pregnancy, which extends to health care practitioners and may affect the quality of care provided and lead to refusal of care for women with disabilities,” the authors wrote.
If women with disabilities are receiving less prenatal care, that could lead to the development of some health complications, such as preeclampsia.
“Our findings may be a direct reflection of the challenges women with all types of disabilities face when accessing and receiving care, which is likely compounded by poorer preconception health,” the authors wrote.
The research was supported by the National Institute of Child Health and Human Development, a division of the NIH, the prime source of federal funds for biomedical research.