Health Care Providers' Experiences, Perceptions, and Challenges in Addressing Perinatal Intimate Partner Violence Among People With Disabilities.

BACKGROUND

People with disabilities experience intimate partner violence (IPV) at two to three times the rate of those without disabilities yet are routinely underscreened and underserved within perinatal health care settings. Health care providers play a critical role in IPV identification and intervention, but limited training, systemic bias, and ableism may hinder effective, equitable care.

OBJECTIVE

We explored health care providers' experiences, perceptions, and challenges in screening and intervening for IPV among people with disabilities during the perinatal period.

METHODS

Semistructured interviews were conducted with 44 nurses, midwives, physicians, and doulas providing perinatal care to people with disabilities across diverse clinical settings in the United States. Interviews were transcribed verbatim and analyzed using inductive content analysis to identify recurrent themes related to IPV screening practices, knowledge gaps, and attitudes toward disability.

RESULTS

Analysis revealed three interrelated themes: 1) lack of awareness and training regarding disability-related abuse; 2) implicit bias and ableist assumptions shaping health care provider perceptions; and 3) discomfort, avoidance, and missed opportunities for IPV inquiry. Participants described uncertainty, time pressures, and systemic barriers that limited effective screening. They also identified ableism as operating across interpersonal and structural levels, including colleagues' devaluing of disabled patients and institutional care environments that remain difficult to navigate, which collectively hindered trauma-informed, disability-inclusive care.

CONCLUSIONS

Discomfort, inadequate preparation, and ableist beliefs among health care providers undermine equitable IPV screening for people with disabilities. Integrating trauma-informed and disability-inclusive approaches into education, policy, and practice will be critical to enhancing identification, trust, and safety in perinatal settings.