Project Summary/Abstract
Women with physical disabilities experience stark disparities in pregnancy care, complications, and outcomes,
compared to women without disabilities. Black women and Latinas also experience substantial disparities
related to perinatal care and outcomes, compared to White women. Black women and Latinas with physical
disabilities, thus, are presumably at heightened risk of adverse experiences and outcomes. Nonetheless, no
known studies have investigated the intersection of disability and race/ethnicity in relation to perinatal care and
disparities. Preliminary findings from the investigator team demonstrate that Black women and Latinas with
physical disabilities are at substantial risk for adverse pregnancy outcomes. Efforts to improve their pregnancy
care and experiences while reducing costs require a definitive assessment of these women’s pregnancy risks
and outcomes. The overarching goal of this study is to use a mixed-methods approach to understand
pregnancy experiences, maternal and infant outcomes, related healthcare costs, and unmet perinatal
healthcare needs of Black women and Latinas with physical disabilities and their infants, and examine the
intersecting impacts of disparities from two avenues of marginalization (race or ethnicity, and physical
disability). The specific aims of this study are: 1) Compare perinatal care receipt, pregnancy-related
complications, health outcomes, inpatient healthcare utilization and costs among cohorts of women based on
race, ethnicity, and physical disability status, and determine if the combined effects of being a Black woman or
Latina with physical disabilities are additive or multiplicative; 2) Use linked data from Georgia, California, and
Massachusetts to examine first year health outcomes, healthcare utilization and costs for cohorts of women
based on race, ethnicity, and physical disability and their infants (<1 year old), and determine if the combined
effect of being a Black woman or Latina with physical disabilities is additive or multiplicative; and 3) Identify
unmet needs and barriers to perinatal care for Black women and Latinas with physical disabilities through: (a)
interviews with Black women and Latinas with physical disabilities who are currently pregnant or have recently
given birth, and (b) focus groups with obstetric care providers. This study will lead to a first-ever systematic
understanding of pregnancy and infant health outcomes and pregnancy care costs for Black women and
Latinas with physical disabilities, thus establishing a foundation for development and testing of future
interventions to improve outcomes. This study will fill a critical knowledge gap in understanding of the
pregnancy-related experiences among Black women and Latinas with physical disabilities before, during and
after pregnancy.
