Perspectives of perinatal clinicians when caring for deaf and hard of hearing patients.

BACKGROUND

Deaf and hard of hearing (DHH) patients experience barriers to reproductive healthcare and higher rates of adverse birth outcomes compared to their hearing peers. Furthermore, perinatal clinicians are often ill-prepared to provide appropriate care for this population. This qualitative research study explores the experiences and perspectives of perinatal clinicians who have provided care for DHH patients to better understand barriers and facilitators to providing optimal pregnancy-related healthcare.

METHODS

Interviews were conducted with twelve perinatal clinicians from different specialties with experience caring for DHH patients. This included nine semi-structured individual remote interviews and one in-person focus group with 3 participants. A thematic analysis was conducted.

RESULTS

Eight obstetricians and four midwives participated in the study. Four major themes emerged: (1) communication challenges and solutions, (2) training gaps, (3) implicit bias, audism and patient mistrust and (4) limited resources to support DHH patients. Within each of these major themes, we explored barriers that negatively impacted perinatal care and facilitators that enhanced perinatal care. Communication difficulties were widely reported by clinicians and associated with inconsistencies in how accommodations were provided. Training and resources for recommended communication and care practices for DHH patients were felt critical yet lacking. Observed situations of implicit bias, audism and mistrust adversely affected perinatal care quality and experiences for DHH patients. Lastly, clinicians reported knowledge gaps among their DHH patients that complicated their ability to provide equitable care as providers. Clinicians often struggled to locate accessible DHH perinatal resources.

CONCLUSIONS

Perinatal clinicians need to be more aware of DHH patients' communication and support needs. Health care systems and training programs need to provide tools and training to allow perinatal clinicians to effectively care for this population.