Citation

Alhusen J, Smeltzer S, Laughon K, Hughes R, Alexander K, Njie-Carr V, Sharps P. J. Adv. Nurs. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, John Wiley and Sons)

DOI

10.1111/jan.15653

PMID

36978208

Abstract

Globally, over one billion people, or more than 15% of our world's population, have a disability (United Nations General Assembly, 2015). Persons with disabilities include those with physical, mental, intellectual, developmental or sensory impairments which, in interacting with environmental and social barriers, may limit their full participation in society (United Nations General Assembly, 2015). Persons with disabilities comprise a heterogeneous group but these structural barriers result in inequities in health care access and outcomes which exist across the type of disability, age, gender, race and ethnicity, and setting. For those with incomes below the poverty level, those living in rural areas, those from oppressed ethnic or racial backgrounds and other marginalized groups these inequities are magnified. Currently, our understanding of these differences is limited by an absence of accurate and comprehensive population-based data that can help identify and evaluate our progress in reducing inequities. We use violence against pregnant and birthing persons with disabilities in the United States as one key example of a significant public health issue that has been largely devoid of data to inform policies and interventions.

In the United States, approximately 12% of reproductive-age persons have a disability (Centers for Disease Control & Prevention, 2009). Persons with disabilities are as likely as non-disabled persons to desire pregnancy yet are at a higher risk for adverse pregnancy and infant outcomes for multiple reasons, including an elevated risk of intimate partner violence (IPV) during the perinatal period (Bloom et al., 2017). Experiencing IPV during the perinatal period is associated with inadequate prenatal care, poor gestational weight gain, higher rates of depression and other mental health sequelae including suicidal ideation, increased risk of low birthweight and preterm birth, and early childhood delays, among other adverse outcomes (Alhusen et al., 2022). Research on IPV during the perinatal period among pregnant and birthing persons with disabilities is limited. One of the earliest studies using population-based data from the Pregnancy Risk Assessment Monitoring System (PRAMS) analysed data from Massachusetts revealed that persons with disabilities were two to four times more likely to report physical abuse either before pregnancy, during pregnancy or both than their non-disabled peers (Mitra et al., 2012). While an important contribution, findings were limited by a relatively small sample of respondents with disabilities (n = 138) as Massachusetts was one of only two states to include a disability screening question in PRAMS...

Language: en