Conditions Causing Disability and Current Pregnancy Among US Women With Chronic Physical Disabilities

Abstract

Background Growing numbers of reproductive-age U.S. women with chronic physical disabilities (CPD) are becoming pregnant. Little is known about the health conditions causing their CPD. Objectives To identify health conditions causing CPD among reproductive-age women and specifically among currently pregnant women. Research Design Cross-sectional, nationally-representative National Health Interview Survey data from 2006–2011. Subjects 6,043 civilian, noninstitutionalized women ages 18–49 with CPD Measures NHIS asks about various movement difficulties and their underlying causes and about current pregnancy. We used responses from 8 movement difficulty and other questions to identify women with mobility difficulties caused by chronic physical health conditions. Results Among women with CPD, 2.0% report current pregnancy, with pregnancy rates falling monotonically as CPD severity rises. Regardless of pregnancy, 20.8% report 2 causes for their CPD, and 12.7% report 3+ causes; the most common causes are arthritis, back or neck problems, and other musculoskeletal conditions. Compared with nonpregnant women, currently pregnant women report fewer causal conditions: 15.8% report 2 causes and 8.0% 3+ causes; back or neck problems are reported most frequently, followed by musculoskeletal problems and arthritis. Multivariable logistic regression analyses predicting current pregnancy controlling for age category and individual common causes of CPD found that no cause was significantly associated with higher or lower adjusted odds of pregnancy. Conclusions Almost one-quarter of currently pregnant women with CPD report more than one cause for their disability. Further research will need to examine how obstetrical needs vary for depending on the cause of a pregnant woman’s disability.

General health, health conditions, and current pregnancy among U.S. women with and without chronic physical disabilities

“…As noted above, elsewhere we explore the underlying conditions reported by interviewees as causing their CPD and associations of these conditions with current pregnancy. 7 In an appendix to this article, we cross-tabulate the reported causal conditions with the 13 health conditions for women with CPD. Substantial – but not complete – overlap exists between conditions reported as causing CPD and clinically similar (or identical) health conditions.…”

“…2 We have also identified the conditions underlying women’s CPD and the associations of different causal conditions with current pregnancy. 7 Here, we compare women’s self-reported general overall health status and common health conditions, again examining women by pregnancy status and CPD. Others have found that persons with disabilities have worse self-reported general health than do other individuals.…”

Mothers With Physical Disability: Child Care Adaptations at Home

“…We designed a semistructured, open-ended interview protocol for this qualitative descriptive study. The interview protocol (available on request) covers eight topic areas: nature of disability and attitudes toward disability (Iezzoni, Yu, Wint, Smeltzer, & Ecker, 2014); attitudes toward pregnancy and disability (Iezzoni et al, 2015a); getting pregnant; reactions of family, friends, and strangers to the pregnancy (Iezzoni, Wint, Smeltzer, & Ecker, 2015b); pregnancy, labor, and delivery experiences, including complications and clinical care; physical accessibility of health care facilities (Iezzoni, Wint, Smeltzer, & Ecker, 2015c); overview of postpartum experiences; and sociodemographic characteristics. This article focuses on the women's postpartum experiences, particularly how mothers with physical disability experienced caregiving for a new infant.…”

Effects of disability on pregnancy experiences among women with impaired mobility

“…Less is known about how women's functional impairments – defined by the World Health Organization as “problems in body function or structure such as a significant deviation or loss” – are affected by or affect their pregnancies. Although diverse conditions cause mobility disability , the nature or consequences of the physical functional impairments are often similar.…”