Nearly 20% of the reproductive-aged population has a physical, sensory, or developmental disability. The United Nations Convention on the Rights of Persons with Disabilities protects the rights of people with disabilities to found a family and access high-quality reproductive health care. However, people with disabilities often report feeling over-looked in reproductive health care settings. We used linked health records data on all births in Ontario to study pregnancy rates, preconception health, and perinatal outcomes in birthing people with disabilities in Ontario. We also used in-depth interviews with birthing people with disabilities, service-providers, and decision-makers to examine their pregnancy care experiences.
This study has several important findings:
- One in eight births in Ontario were to people with a disability.
- People with disabilities are more likely than those without disabilities to enter pregnancy with risk factors such as poverty or chronic illness.
- Although most pregnancies were healthy, birthing people with disabilities were more likely to experience pregnancy complications.
- Birthing people with disabilities reported significant barriers accessing pregnancy care, including physically inaccessible care spaces, communication barriers with providers, and ableist health care provider attitudes.
- Service-providers and decision-makers reported that lack of clinical guidelines, limited resources and infrastructure, and lack of training limited their ability to provide accessible pregnancy care.
These findings show the importance of modified health care system structures and processes, increased service-provider knowledge and resources, and accessible patient supports that are responsive to the needs of people with disabilities.
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Read more about this research
- Camden A, Sharpe I, Lu H, Brown HK. Abortion ratios after first-trimester exposure to teratogenic medication in people with disabilities. Epidemiology 2025;36(4):e14–e17.
- Evans M, Tarasoff LA, Lunsky Y, Welsh K, Proulx L, Havercamp S, Parish S, Brown HK. Disability justice and collective access to labour and delivery care: A qualitative study. BMC Pregnancy & Childbirth 2024;24:832.
- Grant C, Lunsky Y, Guttmann A, Vigod SN, Sharpe I, Brown HK. Maternal disability and newborn discharge to social services: A population-based study. International Journal of Population Data Science 2024;9(2):05.
- Camden A, De Vera M, Grandi S, Guttmann A, Tailor L, Ray JG, Sharpe I, Vigod S, Lunsky Y, Brown HK. Prescription medication use in pregnancy among people with disabilities: A population-based study. Journal of Women’s Health 2024;33(9):1224–1232.
- Brown HK, Varner C, Ray JG, Scime N, Fung K, Guttmann S, Havercamp S, Vigod SN, Lunsky Y. Comparison of emergency department use between pregnant people with and without disabilities in Ontario, Canada. JAMA Network Open 2023;6(8):e2327185.
- Vainder M, Ray JG, Lunsky Y, Fung K, Vigod SN, Havercamp SM, Parish S, Brown HK. Physical disability and venous thromboembolism during pregnancy and the postpartum period: A population-based cohort study. Journal of Thrombosis and Haemostasis 2023;21(7):1882-1890.
- Brown HK, Taylor C, Vigod SN, Dennis CL, Fung K, Chen S, Guttmann A, Havercamp SM, Parish SL, Ray JG, Lunsky Y. Disability and in-hospital breastfeeding practices and support: A population-based study. The Lancet Public Health 2023;8(1):E47-E56.
- Kassee C, Lunsky Y, Patrikar A, Brown HK. Impact of social, health, and disability-related factors on pregnancy outcomes in women with intellectual and developmental disabilities: A population-based latent class analysis. Disability and Health Journal 2023;16(2):101426.
- Brown HK, Saunders N, Chen S, Leslie K, Vigod SN, Fung K, Guttmann A, Havercamp SM, Parish SL, Ray JG, Lunsky Y. Disability and interpersonal violence in the perinatal period. Obstetrics & Gynecology 2022;140(5):797–805.
- Brown HK, Vigod SN, Chen S, Guttmann A, Havercamp S, Parish S, Ray JG, Lunsky Y. Perinatal mental illness among women with disabilities: A population-based cohort study. Social Psychiatry and Psychiatric Epidemiology 2022;57(11):2217-2228.
- Brown HK, Chen S, Guttmann A, Havercamp S, Parish S, Ray JG, Vigod SN, Tarasoff LA, Lunsky Y. Neonatal outcomes of mothers with a disability. Pediatrics; 2022;150(3):e2021055318.
- Nishat F, Lunsky Y, Tarasoff LA, Brown HK. Continuity of primary care and prenatal care adequacy among women with disabilities in Ontario: A population-based cohort study. Disability and Health Journal 2022;15(3):101322.
- Brown HK, Chen S, Vigod SN, Guttmann A, Havercamp S, Parish S, Tarasoff LA, Lunsky Y. A population-based analysis of postpartum acute care use among women with disabilities. American Journal of Obstetrics & Gynecology: Maternal-Fetal Medicine 2022;4(3):100607.
Nishat F, Lunsky Y, Tarasoff LA, Brown HK. Prenatal care adequacy among women with disabilities: A population-based study. American Journal of Preventive Medicine 2022;62(1):39-49.
Khan M, Brown HK, Lunsky Y, Welsh K, Proulx L, Havercamp S, Tarasoff L. A socio-ecological approach to understanding the perinatal care experiences of people with intellectual and developmental disabilities in Ontario, Canada. Women’s Health Issues 2021;31(6):550-559.
Brown HK, Ray JG, Chen S, Guttmann A, Havercamp S, Parish S, Vigod SN, Tarasoff L, Lunsky Y. Association of pre-existing disability and severe maternal morbidity or maternal mortality in Ontario, Canada. JAMA Network Open 2021;4(1):e2034993.
Tarasoff L, Lunsky Y, Chen S, Guttmann A, Havercamp S, Parish S, Vigod S, Carty A, Brown HK. Preconception health characteristics of women with disabilities in Ontario: A population-based, cross-sectional study. Journal of Women’s Health 2020;29(12):1564-1575.
Tarasoff L, Murtaza F, Salaeva D, Carty A, Hamilton A, Brown HK. Health of newborns and infants born to women with disabilities: A systematic review and meta-analysis. Pediatrics 2020;146(6):e20201635.
Brown HK, Chen S, Guttmann A, Havercamp SM, Parish S, Ray JG, Tarasoff LA, Vigod SN, Carty A, Lunsky Y. Rates of recognized pregnancy in women with disabilities in Ontario, Canada. American Journal of Obstetrics & Gynecology 2020;222(2):189-192.
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People on this project
Principal Investigators: Hilary Brown, Yona Lunsky; Co-Investigators: Astrid Guttmann, Susan Havercamp, Susan Parish, Joel Ray, Simone Vigod
Partners
Anne Johnston Health Station, BC Spinal Cord Injury Perinatal Interest Research Group, Canadian Association for Community Living, March of Dimes Canada, Ontario Ministry of Community and Social Services, Provincial Council for Maternal and Child Health, Spinal Cord Injury Ontario, Springtide Resources
Project funders
National Institutes of Health
