Medical indications for primary cesarean delivery in women with and without disabilities

Biel, Frances M.; Darney, Blair G.; Caughey, Aaron B.; Horner‐Johnson, Willi

doi:10.1080/14767058.2019.1572740

Cited by 18 publications

(25 citation statements)

References 29 publications

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“…67,80,81 Findings from a recent populationbased study comparing medical indications for cesarean delivery among women with and without disabilities in California indeed suggests that disability itself may be treated as an indication for cesarean delivery in many cases. 82 Specifically, the authors found that women with disabilities who had prelabor scheduled cesarean deliveries had significantly lower odds of having a medical indication for cesarean delivery, compared with women without disabilities. 82 These individual, provider, and system-level factors should be investigated further to understand reasons for perinatal complications in women with disabilities.…”

Section: Systematic Reviewsmentioning

confidence: 98%

“…82 Specifically, the authors found that women with disabilities who had prelabor scheduled cesarean deliveries had significantly lower odds of having a medical indication for cesarean delivery, compared with women without disabilities. 82 These individual, provider, and system-level factors should be investigated further to understand reasons for perinatal complications in women with disabilities.…”

Section: Systematic Reviewsmentioning

confidence: 98%

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Maternal disability and risk for pregnancy, delivery, and postpartum complications: a systematic review and meta-analysis

Tarasoff

Ravindran

Malik

et al. 2020

American Journal of Obstetrics and Gynecology

103

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O ne in 10 women of reproductive age has a disability. 1 While disabilities vary in their etiology and impact, they can be classified broadly based on common activity limitations. 2,3 Physical disabilities, such as cerebral palsy and spinal cord injuries, are those associated with limits to mobility, flexibility, and dexterity; sensory disabilities include vision and hearing impairments; and intellectual and developmental disabilities, such as Down syndrome, autism spectrum disorder, and fetal alcohol spectrum disorder, are associated with limitations in cognitive and adaptive functioning. In the past, stigma associated with disability and sexuality and medical factors, including risks of medication use in pregnancy, limited childbearing in women with disabilities. 4,5 However, with greater recognition of the reproductive rights of persons with disabilities 6 and medical advances, more women with disabilities now experience pregnancy. In fact, the 2008e2012 US Medical Expenditure Panel Survey showed that similar proportions of

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Section: Systematic Reviewsmentioning

confidence: 98%

Section: Systematic Reviewsmentioning

confidence: 98%

Maternal disability and risk for pregnancy, delivery, and postpartum complications: a systematic review and meta-analysis

Tarasoff

Ravindran

Malik

et al. 2020

American Journal of Obstetrics and Gynecology

103

View full text Add to dashboard Cite

show abstract

“…The regression model examining initiation of prenatal care calculated the RR of women in each disability group (compared with those without disabilities) delaying care until the second or third trimester instead of initiating care in the first trimester (reference level). In the regression models of number of prenatal visits, the typically recommended number of visits (11)(12)(13)(14) was the reference level. Two analyses were conducted to calculate the RR of women with disabilities having: (1) fewer visits than recommended (zero to ten vs [11][12][13][14] and (2) more than the typically recommended number of visits (≥15 vs [11][12][13][14].…”

Section: Statistical Analysesmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11] Women with disabilities are also substantially more likely to deliver by cesarean, with the medical necessity of cesarean delivery not always clear. 3,4,[10][11][12][13][14] In addition, women with disabilities are more likely to experience pregnancy complications, such as gestational diabetes and preeclampsia. 2,5,[8][9][10][11]13 The reasons for these adverse outcomes among women with disabilities are not fully understood.…”

Section: Introductionmentioning

confidence: 99%

Differences in Prenatal Care by Presence and Type of Maternal Disability

Horner‐Johnson

Biel

Caughey

et al. 2019

American Journal of Preventive Medicine

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Introduction: Prior studies have found that women with disabilities are less likely to receive adequate prenatal care than women without disabilities. However, little is known about differences in patterns of prenatal care by type of disability. Therefore, this study examined timing and frequency of prenatal care among women with physical, sensory, or intellectual/developmental disabilities compared with women without disabilities. Methods: This was a retrospective cohort study using linked maternal and infant hospital discharge and birth certificate data for all births in California in 2000-2012 (N=6,745,201). Analyses were conducted in 2017-2018. Modified Poisson regression analyses compared women with each type of disability with women without disabilities on trimester of prenatal care initiation and number of prenatal care visits. Results: Women with intellectual/developmental disabilities or with limited hearing had significantly higher RR of delaying prenatal care initiation until the second or third trimester (intellectual/developmental disabilities: adjusted RR=1.21, 95% CI=1.09, 1.33; hearing: adjusted RR=1.11, 95% CI=1.02, 1.21), whereas women with physical disabilities and limited vision had lower risk of delaying care (physical: adjusted RR=0.91, 95% CI=0.88, 0.94; vision: adjusted RR=0.85, 95% CI=0.73, 0.99). Women with limited hearing or vision or intellectual/ developmental disabilities had higher risk of receiving fewer prenatal visits than recommended, compared with women without disabilities. Women with physical disabilities or intellectual/ developmental disabilities had higher RR of receiving more than the typical number of visits. Conclusions: There were key differences in prenatal care utilization by disability type, reflective of particularly pronounced disparities for women with intellectual/developmental disabilities and women with limited hearing.

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“…1,2 Research to date has demonstrated disparities for women with disabilities in prenatal care utilization and satisfaction with prenatal care, preterm birth, having infants small for gestational age, and high rates of cesarean deliveries. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The majority of this research is based on delivery records or surveys like the Pregnancy Risk Assessment Monitoring System (PRAMS), which contain only live birth outcomes and therefore do not reflect early pregnancy loss or miscarriage. Thus, considerably less is known about the association between disability and miscarriage.…”

Section: Introductionmentioning

confidence: 99%

Miscarriage Occurrence and Prevention Efforts by Disability Status and Type in the United States

Dissanayake

Darney

Caughey

et al. 2020

Journal of Women's Health

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Background: Very little is known about early pregnancy loss in women with disabilities. To address this gap, we analyzed nationally representative data on miscarriage and receipt of care focused on miscarriage prevention among women with and without disabilities. Materials and Methods: We used 2011-2015 National Survey of Family Growth data on women with at least one completed pregnancy within the past 5 years. Bivariate and multivariate analyses assessed the association of six disability categories (any, hearing, vision, cognitive, physical, independent living) with miscarriage occurrence and receipt of services intended to prevent miscarriage. Results: Our analytic sample included 3,843 women with 5,776 completed pregnancies within the past 5 years. Overall, 31.63% of women with disabilities and 21.83% of women without disabilities had had a miscarriage within the past 5 years. Compared to women without disabilities, women with any, cognitive, physical, and independent living disability had higher adjusted odds of experiencing miscarriage (any disability aOR = 1.65 [95% CI: 1.21-2.25]). These women also had higher odds of receiving services to prevent miscarriage compared with women without disabilities (any disability aOR = 1.71 [95% CI: 1.20-2.45]). Among women who received services, higher proportions of women with any, vision, physical, or independent living disability received recommendations for bed rest (e.g., 65.007% of women with independent living disability vs. 33.98% of women without disability, p = 0.018). Conclusions: In a representative sample of U.S. women, we found significant differences in the odds of miscarriage and in receipt of care to prevent miscarriage between women with and without disabilities. Further research is needed to understand why women with disabilities are more likely to experience a miscarriage. Such research is important for informing care recommendations.

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Medical indications for primary cesarean delivery in women with and without disabilities

Cited by 18 publications

References 29 publications

Maternal disability and risk for pregnancy, delivery, and postpartum complications: a systematic review and meta-analysis

Maternal disability and risk for pregnancy, delivery, and postpartum complications: a systematic review and meta-analysis

Differences in Prenatal Care by Presence and Type of Maternal Disability

Miscarriage Occurrence and Prevention Efforts by Disability Status and Type in the United States

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