Access and clinical care for women with different disabilities
| Physical condition or illness | Sensory disability | Mental health disability | Learning disability | Multiple disability | No disability | ||
| Pregnancy | |||||||
| First saw a HCP by 12 weeks | n (%) | 833 (97.1) | 153 (92.2**) | 629 (96.3) | 108 (92.3*) | 111 (96.5) | 17 117 (96.1) |
| aOR (95% CI) | 1.46 (0.94 to 2.27) | 0.47 (0.25 to 0.88) | 1.03 (0.66 to 1.60) | 0.45 (0.22 to 0.92) | 0.89 (0.31 to 2.49) | ||
| Booking appointment <13 weeks | n (%) | 753 (92.1) | 132 (84.6**) | 571 (92.7) | 101 (87.1) | 99 (91.7) | 15 555 (91.9) |
| aOR (95% CI) | 1.03 (0.80 to 1.34) | 0.49 (0.31 to 0.75) | 1.13 (0.83 to 1.54) | 0.60 (0.35 to 1.03) | 0.98 (0.49 to 1.94) | ||
| Contact number for a MW | n (%) | 846 (97.5) | 160 (94.7*) | 633 (95.9**) | 115 (94.3) | 110 (94.0) | 17 555 (97.7) |
| aOR (95% CI) | 0.95 (0.59 to 1.53) | 0.43 (0.21 to 0.90) | 0.55 (0.36 to 0.85) | 0.55 (0.23 to 1.28) | 0.43 (0.18 to 1.03) | ||
| Saw same MW each check | n (%) | 286 (34.2) | 66 (40.0) | 231 (35.8) | 54 (45.0) | 50 (44.6) | 6574 (37.1) |
| aOR (95% CI) | 0.90 (0.77 to 1.05) | 1.17 (0.82 to 1.66) | 0.90 (0.76 to 1.07) | 1.29 (0.87 to 1.91) | 1.23 (0.81 to 1.86) | ||
| No choice for place of birth for medical reasons | n (%) | 278 (31.9***) | 25 (14.5) | 112 (17.0***) | 17 (13.5) | 32 (26.7***) | 1660 (8.8) |
| aOR (95% CI) | 4.70 (3.96 to 5.59) | 1.54 (0.95 to 2.51) | 1.85 (1.46 to 2.30) | 1.75 (0.99 to 3.03) | 3.40 (2.14 to 5.40) | ||
| Birth (each mode of delivery compared with all others) | |||||||
| Vaginal birth | n (%) | 411 (47.7***) | 103 (61.3) | 376 (57.1) | 76 (61.8) | 61 (52.1) | 10 704 (59.6) |
| aOR (95% CI) | 0.64 (0.55 to 0.75) | 0.99 (0.69 to 1.42) | 0.83 (0.69 to 0.98) | 0.97 (0.63 to 1.78) | 0.69 (0.46 to 1.04) | ||
| Assisted vaginal delivery | n (%) | 132 (15.3) | 22 (13.1) | 105 (15.9) | 21 (17.1) | 21 (18.0) | 2699 (15.0) |
| aOR (95% CI) | 0.61 (0.85 to 1.29) | 0.91 (0.63 to 1.34) | 0.86 (0.71 to 1.03) | 1.10 (0.66 to 1.70) | 1.27 (0.75 to 2.14) | ||
| Planned caesarean section | n (%) | 158 (18.4***) | 23 (13.7) | 77 (11.7) | 7 (5.7*) | 15 (12.8) | 1983 (11.0) |
| aOR (95% CI) | 1.69 (1.38 to 2.06) | 1.40 (0.90 to 2.30) | 1.07 (0.83 to 1.39) | 0.71 (0.32 to 1.66) | 1.34 (1.17 to 1.55) | ||
| Emergency caesarean section | n (%) | 160 (18.6**) | 20 (11.9) | 101 (15.3) | 19 (15.5) | 20 (17.1) | 2585 (14.4) |
| aOR (95% CI) | 1.30 (1.07 to 1.58) | 0.81 (0.47 to 1.40) | 1.20 (0.95 to 1.53) | 1.09 (0.64 to 1.84) | 1.21 (0.71 to 2.06) | ||
| Postnatal care | |||||||
| Skin to skin after birth | n (%) | 644 (89.2) | 139 (91.4) | 520 (91.9) | 102 (92.7) | 90 (90.9) | 14 843 (91.3) |
| aOR (95% CI) | 0.72 (0.56 to 0.94) | 0.87 (0.48 to 1.58) | 0.98 (0.70 to 1.37) | 0.83 (0.39 to 1.80) | 0.67 (0.32 to 1.41) | ||
| Length postnatal stay >2 days | n (%) | 339 (39.4***) | 54 (32.5) | 245 (37.6***) | 46 (38.0**) | 53 (45.3**) | 4528 (25.6) |
| aOR (95% CI) | 1.86 (1.59 to 2.18) | 1.15 (0.80 to 1.63) | 1.89 (1.58 to 2.26) | 1.51 (1.00 to 2.28) | 2.11 (1.40 to 3.17) | ||
| Home visit by midwife | n (%) | 824 (95.6**) | 164 (97.6) | 642 (97.0) | 118 (95.2) | 112 (96.6) | 17 440 (96.9) |
| aOR (95% CI) | 0.62 (0.43 to 0.89) | 3.42 (0.80 to 14.62) | 0.85 (0.65 to 1.72) | 0.76 (0.31 to 1.94) | 1.45 (0.45 to 4.62) | ||
| Feeding advice always available out of hours | n (%) | 146 (43.3***) | 47 (54.0) | 132 (46.0**) | 45 (65.2) | 33 (49.3) | 3698 (54.5) |
| aOR (95% CI) | 0.61 (0.48 to 0.78) | 0.90 (0.55 to 1.48) | 0.65 (0.50 to 0.84) | 1.56 (0.90 to 2.72) | 0.77 (0.45 to 1.33) | ||
| 5+ visits with MW | n (%) | 191 (23.3) | 43 (26.5) | 183 (29.1***) | 36 (31.6**) | 25 (23.4) | 3645 (21.2) |
| aOR (95% CI) | 1.11 (0.93 to 1.32) | 1.40 (0.95 to 2.05) | 1.55 (1.28 to 1.87) | 1.82 (1.18 to 2.79) | 1.01 (0.62 to 1.63) | ||
ORs and 95% CIs weighted for variation in response rates by trust and adjusted for age, parity and ethnicity compared with women without disability.
Sensory disability: visually impaired, deaf and hearing impaired.
*p<0.05, **p<0.01, ***p<0.001.
aOR, adjusted odds ratio; HCP, healthcare professional; MW, midwife.