A qualitative meta-synthesis of the perinatal healthcare experiences of people with disability.

BACKGROUND

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.

OBJECTIVE

To synthesize qualitative studies describing the perinatal healthcare experiences of people with physical, sensory, or cognitive disability in the United States and Canada.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.