Online Program

Prevalence of current pregnancy among u.s. women with and without chronic mobility disabilities

Wednesday, November 6, 2013 : 9:15 a.m. - 9:30 a.m.

Lisa Iezzoni, MD, MSc, Mongan Institute for Health Policy, Harvard Medical School, Massachusetts General Hospital, Boston, MA
Jun Yu, MSc, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA
Amy Wint, MSc, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston
Suzanne C. Smeltzer, RN, EdD, FAAN, College of Nursing, Villanova University, Villanova, PA
Jeffrey Ecker, MD, Department of Obstetrics and Gynecology, Harvard Medical School, Massachusetts General Hospital, Boston, MA
Background: The number of U.S. women of childbearing age who have chronic mobility disabilities (CMD) is increasing. However, little is known about their reproductive experiences. Objectives: To explore the national prevalence of current pregnancy among women with and without CMD; and after controlling for sociodemographic characteristics, examine differences in current pregnancy prevalence between these two groups of women. Research Design: Cross-sectional, nationally-representative National Health Interview Survey data from 2006-2011. Subjects: 47,629 civilian, noninstitutionalized women ages 18-49 Measures: NHIS asks about various mobility difficulties and asks women ages 18-49 if they are currently pregnant. We used responses from 8 movement difficulty and other questions to identify women with CMD. Results: 6,043 (12.7%) women report CMD. Compared with other women, women with CMD are significantly older; more likely to be black and less likely to be Asian or Hispanic; more likely to be divorced or separated; more likely to have less than a high school education; less likely to be employed; and have much lower incomes. Across all women, 3.5% report being currently pregnant: 3.8% of women without CMD and 2.0% with CMD. Multivariable regression analysis indicates women with CMD, including the most severely disabled group, have comparable adjusted odds of being currently pregnant as do nondisabled women. Conclusions: Women with mobility disabilities have historically confronted stigmatized attitudes about their reproductive choices. Our findings concerning current pregnancy among women with chronic mobility disabilities highlight the importance of today's obstetrical practitioners understanding and considering the special needs and concerns of these women.

Learning Areas:

Administer health education strategies, interventions and programs
Advocacy for health and health education
Assessment of individual and community needs for health education

Learning Objectives:
Describe current pregnancy rates of women with versus without mobility disabilities and associations of pregnancy with sociodemographic characteristics

Keyword(s): Pregnancy, Disability

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Lisa Iezzoni has conducted extensive research on risk adjustment for setting health-based payments and measuring quality of care. She has edited Risk Adjustment for Measuring Health Care Outcomes (fourth edition, 2013). With funding from the National Institutes of Health and private foundations, she also studies health care quality, delivery system, and policy issues relating to persons with disabilities. Dr. Iezzoni is a member of the Institute of Medicine in the National Academy of Sciences.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.