UMass Medical School researchers create framework for improving perinatal health of women with physical disabilities

October 07, 2015

UMass Medical School researchers have created a framework to better examine the health of women with physical disabilities around the time of their pregnancy.

Monika Mitra, PhD, and Linda Long-Bellil, PhD, JD, co-authored a paper on the framework that has been published in the Disability and Health Journal.

“We anticipate that the framework will facilitate enhanced public health surveillance of pregnancy among women with disabilities, future research in understanding the needs, barriers and outcomes of pregnancy among women with physical disabilities and improve perinatal care in this population,” said Mitra, associate professor in UMass Medical School’s Department of Family Medicine and Community Health and a research scientist within the medical school’s Disability, Health and Employment Policy Unit.

“This article provides a context for examining the perinatal care and experiences of women with physical disabilities across the lifespan,” said Long-Bellil, assistant professor in the medical school’s Department of Family Medicine and Community Health. The researchers said women with physical disabilities experience health care disparities before, during and after pregnancy, and that existing perinatal health frameworks don’t address their needs or the barriers they face.

Pregnant women with disabilities are at increased risk of complications and poor outcomes, including low birth weight babies, preterm birth, and prenatal and postpartum depression, according to the paper in Disability and Health Journal. The women often report that their clinicians are not equipped to handle their pregnancies and lack knowledge about their disabilities. They also face such barriers as clinical offices, examination tables and weight scales that may not be accessible to women with disabilities.

Mitra also worked on the first nationwide study of pregnant women with developmental and intellectual disabilities with researchers from Brandeis University. The study, published in September, found the women with intellectual and developmental disabilities had high rates of complications, including fetal death, preeclampsia and preterm birth.

The nationwide study had similar findings to an earlier project that focused on Massachusetts and was published in the December 2014 edition of the American Journal of Preventive Medicine.

About 12 percent of women of child-bearing age reportedly have disabilities as well as a mobility or personal care limitation, according to the paper in Disability and Health Journal. Advances in medical technology, increased community support and destigmatization of disabilities have resulted in more women with disabilities choosing to become pregnant, the paper said.

The researchers said women with disabilities face inaccessibility and disability-related stigma throughout their lives, and that access to health care and the quality of the care they receive are key to improving their perinatal care.

The paper also was co-authored by Suzanne C. Smeltzer, EdD, RN, FAAN, a professor at Villanova University, and Lisa I. Iezzoni, MD, MSc, of the Mongan Institute for Health Policy at Massachusetts General Hospital.