Pregnancy and physical disability: A scoping review.

BackgroundWomen with disabilities have a similar desire for pregnancy as their non-disabled peers but experience more ambivalence and doubt about their intention to have a child. While many have healthy pregnancies, they face higher risks and trade-offs in health, function, and independence.ObjectivesTo review the literature on pregnancy in women with physical disabilities to guide interventions and clinical care guidelines.Eligibility criteriaAbstracts were reviewed if they were original research on pregnancy involving adult women with physical disabilities. Both qualitative and quantitative studies were included, with no restrictions on language or publication year.Sources of evidencePubMed, Scopus, and CINAHL Complete and reference lists of eligible articles.Charting methodsAbstracts were eligible for full-text review if they were (1) original research, (2) in humans, (3) about pregnancy, and (4) involved adult women with physical disabilities. Data were extracted by independent reviewers using Covidence software and assessed with a customized critical appraisal guide.ResultsFive major topics characterized 171 reviewed articles: (1) rates of pregnancy, fertility, and termination or loss; (2) pregnancy complications and infant outcomes; (3) effects of pregnancy on physical function disease activity; (4) maternal care; and (5) social and interpersonal dimensions of pregnancy. Most studies were conducted in the Americas and Europe, and high-income countries used a quantitative design and were assessed to have a moderate risk of bias.ConclusionsThis review highlights the need for future research to (1) build a stronger evidence base for tailored maternal care, (2) examine disability discrimination's impact on pregnancy outcomes, (3) develop interventions to reduce disability-related inequities, and (4) improve disability competence among maternal care providers.