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Our latest @NIH @NICHD_NIH and @CRC_CRC -funded paper is published today in @JAMANetworkOpen, and shows an urgent need for better preconception, prenatal, and postpartum care for women with disabilities: https://bit.ly/39XwWVc A thread on what this paper is about: 1/n
Disability is common in reproductive-aged women. We now know that about 1 in 8 pregnancies in Ontario are in women with disabilities ( https://bit.ly/3oPSaZ4 ), showing the importance of studying their pregnancy-related health and health care experiences. 2/n
Life-threatening pregnancy complications and maternal deaths are rare in Canada, but they have devastating effects on families. 3/n
Women with disabilities are more likely than their peers to experience poverty, diabetes, heart disease, and barriers accessing health care ( https://bit.ly/3azfl4T )—all known risk factors for life-threatening pregnancy complications and maternal death. 4/n
However, while the UN Convention on the Rights of Persons with Disabilities calls for protection of reproductive health ( https://bit.ly/39PFvBr ), the occurrence of these serious pregnancy outcomes in women with disabilities has received minimal research + clinical attention. 5/n
We used @ICESOntario data for the entire province of Ontario, Canada, including over 220,000 women with physical, sensory, and intellectual/developmental disabilities and 1.6 million without disabilities with a birth between 2003 and 2018. 6/n
We found that any life-threatening pregnancy complication or maternal death occurred in 2.4% of women w/ physical disability, 2.1% w/ sensory disability, 3.0% w/ intellectual/developmental disability, and 3.5% w/ multiple disabilities, vs. 1.7% of women without disabilities. 7/n
There were about 14 maternal deaths per 100,000 births among women with disabilities, compared to about 8 deaths per 100,000 births among women without disabilities. 8/n
Importantly, risks for these outcomes were elevated among women with disabilities during pregnancy as well as across the entire first year postpartum. 9/n
These findings have important implications. Pregnancy guidelines do not typically consider the needs of women with disabilities and there are few accessible obstetric programs. A notable exception is the Sunnybrook Accessible Care Pregnancy Clinic: https://bit.ly/2MCxMxw 10/n
Women w/ disabilities need pre-pregnancy + pregnancy supports to address social/medical risk factors for pregnancy complications. Given that risks extended across the first year postpartum, comprehensive care is needed beyond the standard single 6-wk postpartum appointment. 11/n
With co-authors @yonalunsky, Joel Ray, Simon Chen, Astrid Guttmann, Susan Havercamp, @susanparish, @simonevigod, @latarasoff… And with commentary by @e_wallwieler here: https://bit.ly/3cRvrtq 12/12
