Harkins Sarah E, Hahn Alexandria L, Didier Meghan, Walsh Caroline, Barcelona Veronica, Melton Katherine, George Maureen
Columbia University School of Nursing, New York, NY, United States.
Columbia University School of Nursing, New York, NY, United States.
Disabil Health J. 2025 Jul;18(3):101828. doi: 10.1016/j.dhjo.2025.101828. Epub 2025 Mar 27.
Significant perinatal health disparities exist between people with and without disability in the United States and Canada. However, less is known about the perinatal healthcare experiences of people with different types of disability in those countries. Understanding this experience is crucial for developing tailored interventions to improve perinatal health outcomes.
To synthesize qualitative studies describing the perinatal healthcare experiences of people with physical, sensory, or cognitive disability in the United States and Canada.
We conducted a qualitative meta-synthesis following Sandelowski and Barroso's methods. Four databases and forward and backward citation searching were used to identify relevant studies in March 2024. Studies were appraised based on their reporting of Guba's essential criteria for trustworthy qualitative research. We coded qualitative findings and synthesized results into themes and subthemes. GRADE-CERQual was used to rate the level of confidence in each subtheme.
Twenty-one studies describing the perinatal healthcare experiences of 225 people with disability were the basis of this synthesis. Three themes emerged: (1) Pervasive Ableism, (2) An Uninformed and Unaccommodating Experience, and (3) Resilience in the Face of Ableism.
People with different types of disability shared similar perinatal healthcare experiences, including facing stigma, encountering clinicians with limited knowledge of disability and pregnancy, and demonstrating resilience through self-advocacy and support networks. Accessibility barriers and a lack of disability competency among clinicians were specific to each disability type. Future research should prioritize the development of interventions that promote perinatal health equity for people with disability.
在美国和加拿大，残疾人和非残疾人之间存在显著的围产期健康差异。然而，对于这些国家中不同类型残疾人的围产期医疗保健经历，人们了解得较少。了解这种经历对于制定针对性的干预措施以改善围产期健康结果至关重要。
综合定性研究，描述美国和加拿大身体、感官或认知残疾者的围产期医疗保健经历。
我们按照桑德洛维茨和巴罗斯的方法进行了定性元综合分析。2024年3月，使用四个数据库以及向前和向后的引文检索来识别相关研究。根据古巴关于可信定性研究的基本标准的报告对研究进行评估。我们对定性研究结果进行编码，并将结果综合为主题和子主题。使用GRADE-CERQual对每个子主题的信心水平进行评级。
21项描述225名残疾人围产期医疗保健经历的研究是本综合分析的基础。出现了三个主题：（1）普遍存在的能力主义，（2）信息不足和缺乏适应性的经历，（3）面对能力主义时的复原力。
不同类型的残疾人有着相似的围产期医疗保健经历，包括面临耻辱感、遇到对残疾和怀孕知识有限的临床医生，以及通过自我倡导和支持网络展现出复原力。无障碍障碍和临床医生缺乏残疾方面的能力因残疾类型而异。未来的研究应优先开发促进残疾人士围产期健康公平的干预措施。
