life-threatening complications or maternal death during pregnancy are almost twice as likely in women with disabilities than those without, according to a university of toronto study that delivers a bundle of bad news for the accessibility of canada’s healthcare system.
the study, which comes amid
sexual and reproductive health awareness week, highlights the barriers to childbirth still encountered by women with disabilities despite the fact the pregnancy rate in this group has steadily grown over the past 20 years and now accounts for one in every eight births.“we need to make health care more accessible but this also raises awareness that women with disabilities have a right to quality health care and good pregnancy outcomes,”
said hilary brown, lead author of the study and an assistant professor in the department of health and society at u of t scarborough.once the ontario health record data from 222,000 women with disabilities (physical, developmental or sensory and intellectual) was compared to that of 1.6 million non-disabled women, discrepancies quickly became apparent, she said. in addition to a higher rate of maternal death or life-threatening complications, women with multiple disabilities encountered double the risk of negative pregnancy outcomes as non-disabled women (3.4 per cent to 1.7 per cent respectively). the study recorded just eight maternal deaths per 100,000 births among non-disabled women compared to 14 per 100,000 among the group with disabilities.while the overall risk of maternal death or other complications from childbirth is not large, it is on the rise in canada and the u.s. and healthcare precautions do not reflect the challenges faced by women with disabilities, said brown. “healthcare guidelines in canada on how to best provide pregnancy-related care to these women has not improved,” she said. “women with disabilities are more likely than their peers to experience social and medical risk factors, but until now rates of life-threatening pregnancy complications or maternal death among this group have been relatively unknown.”
women with disabilities encounter a host of obstacles aside from the disability itself, brown said, making finding employment, housing and consistent access to health care difficult. the study found that even after accounting for these discrepancies — and the risk presented by the disability itself — the disparities between groups persisted.“pregnancy guidelines specific to the needs of canadian women with disabilities do not currently exist and there are few obstetric programs created with the needs of women with disabilities in mind,” she said.these women could be better served through programs tailored to their specific needs, brown said, citing the
accessible care pregnancy clinic — one of the first of its kind — at toronto’s sunnybrook hospital as a model to emulate. it’s also a good place for expecting mothers to learn how to deal with the stigma they frequently encounter simply for having the nerve to get pregnant.“many of the mothers with disabilities that we talk to have faced discriminatory attitudes about their pregnancies and it needs to change,” brown said. “society is shifting to better allow women with disabilities to become pregnant and be mothers. it’s time for us to address how disability shapes access to healthcare and how it interacts with other risk factors, like poverty, to ensure that these life-threatening pregnancy complications and maternal death rates are reduced.”
dave yasvinski is a writer with healthing.cadon’t miss the latest on covid-19, reopening and life. subscribe to healthing’s daily newsletter covid life.
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