{"id":191235,"date":"2021-02-09T14:08:00","date_gmt":"2021-02-09T19:08:00","guid":{"rendered":"https:\/\/www.bu.edu\/sph\/?post_type=bu-article&#038;p=191235"},"modified":"2021-02-09T11:12:16","modified_gmt":"2021-02-09T16:12:16","slug":"intellectual-developmental-disability-and-pregnancy-childbirth-equity","status":"publish","type":"bu-article","link":"https:\/\/www.bu.edu\/sph\/news\/articles\/2021\/intellectual-developmental-disability-and-pregnancy-childbirth-equity\/","title":{"rendered":"Intellectual\/Developmental Disability and Maternal Health Equity"},"content":{"rendered":"\n<p><\/p>\n\n\n\t<div class=\"wp-block-editorial-leadin sphnews-block-editorial-leadin is-style-side-by-side has-media has-box has-media-focus-center-middle has-light-theme\">\n\t\t<div class=\"container-lockup\">\n\n\t\t\t<div class=\"wp-block-leadin-media\">\n\t\t\t\t\n\t\t\t\t<img width=\"2560\" height=\"1417\" src=\"\/sph\/files\/2021\/02\/IntellectualDevelopmental-Disability-and-Maternal-Health-Equity-scaled.jpg\" class=\"\" alt=\"Intellectual and Developmental Disability and Maternal Health Equity\" loading=\"lazy\" srcset=\"https:\/\/www.bu.edu\/sph\/files\/2021\/02\/IntellectualDevelopmental-Disability-and-Maternal-Health-Equity-scaled.jpg 2560w, https:\/\/www.bu.edu\/sph\/files\/2021\/02\/IntellectualDevelopmental-Disability-and-Maternal-Health-Equity-636x352.jpg 636w, https:\/\/www.bu.edu\/sph\/files\/2021\/02\/IntellectualDevelopmental-Disability-and-Maternal-Health-Equity-1024x567.jpg 1024w, https:\/\/www.bu.edu\/sph\/files\/2021\/02\/IntellectualDevelopmental-Disability-and-Maternal-Health-Equity-768x425.jpg 768w, https:\/\/www.bu.edu\/sph\/files\/2021\/02\/IntellectualDevelopmental-Disability-and-Maternal-Health-Equity-1536x850.jpg 1536w, https:\/\/www.bu.edu\/sph\/files\/2021\/02\/IntellectualDevelopmental-Disability-and-Maternal-Health-Equity-2048x1134.jpg 2048w, https:\/\/www.bu.edu\/sph\/files\/2021\/02\/IntellectualDevelopmental-Disability-and-Maternal-Health-Equity-755x418.jpg 755w, https:\/\/www.bu.edu\/sph\/files\/2021\/02\/IntellectualDevelopmental-Disability-and-Maternal-Health-Equity-1628x901.jpg 1628w, https:\/\/www.bu.edu\/sph\/files\/2021\/02\/IntellectualDevelopmental-Disability-and-Maternal-Health-Equity-900x498.jpg 900w, https:\/\/www.bu.edu\/sph\/files\/2021\/02\/IntellectualDevelopmental-Disability-and-Maternal-Health-Equity-1920x1063.jpg 1920w, https:\/\/www.bu.edu\/sph\/files\/2021\/02\/IntellectualDevelopmental-Disability-and-Maternal-Health-Equity-1200x664.jpg 1200w\" sizes=\"(max-width: 2560px) 100vw, 2560px\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\n\t\t\t\n\t\t\t\t<div class=\"container-words-outer\">\n\n\t\t\t\t\t\n\t\t\t\t\t<div class=\"container-words-inner\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"wp-prepress-tag\">maternal and child health<\/span>\n\t\t\t\t\t\t\t\t<h1 class=\"head\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tIntellectual and Developmental Disability and Maternal Health Equity\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/h1>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"deck\">As their civil rights advance, more women with intellectual and developmental disabilities are starting families. But new research shows they face major disparities in maternal health outcomes and care.<\/h4>\n\t\t\t\t\t\t\n\t\t\t\t\t<\/div>\n\n\t\t\t\t<\/div>\n\n\t\t\t\n\t\t<\/div>\n\n\t\t\n\t<\/div>\n\n\t\n<div class=\"wp-prepress-component-metabar sphnews-prepress-layout-metabar\">\n\t<div class=\"wp-prepress-component-metabar-wrapper\">\n\t\t\t\t\t<div class=\"wp-prepress-component-metabar-date\">February 9, 2021<\/div>\n\t\t\n\t\t\t\t<div class=\"wp-prepress-component-metabar-credits\">\n\t\t\t\t\t\t\t\t<ul data-credit-type=\"By\">\n\t\t\t\t\t\t<li><a href=\"https:\/\/www.bu.edu\/sph\/news\/authors\/michelle-samuels\/\">Michelle Samuels<\/a><\/li>\n\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t\t<\/div>\n\t\t<div class=\"wp-prepress-component-metabar-share js-bu-prepress-share-tools\">\n\t\t\t<span class=\"icon-twitter\"><span>Twitter<\/span><\/span>\n\t\t\t<span class=\"icon-facebook\"><span>Facebook<\/span><\/span>\n\t\t\t<span class=\"icon-action\"><\/span>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\t\n\n\n<p>\u201cThere is an unfortunate history of inequity and injustice surrounding sexual rights and pregnancy for women with intellectual and developmental disabilities,\u201d says <a href=\"https:\/\/www.bu.edu\/sph\/profile\/eric-rubenstein\/\">Eric Rubenstein<\/a>, who recently joined the School of Public Health as an assistant professor of epidemiology.<\/p>\n\n\n\n<p>That history includes, in the United States, the forced sterilization of tens of thousands of women with intellectual and developmental disabilities (IDD) under eugenics laws into the late 20<sup>th<\/sup> century.<\/p>\n\n\n\n<p>\u201cAs their civil rights advance, more women with intellectual and developmental disabilities (IDD) are starting families,\u201d Rubenstein says. \u201cHowever, since women with IDD did not have the opportunity to have children in the past, we know little about the epidemiology of pregnancy in a population that faces a lot of other health risks and disparities.\u201d<\/p>\n\n\n\n<p>A study led by Rubenstein and <a href=\"https:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0241298\" target=\"_blank\" rel=\"noreferrer noopener\">published in the journal <em>PLOS ONE<\/em><\/a> in October shows that, as in many other areas, women with IDD face major disparities in maternal health outcomes and care.<\/p>\n\n\n\n<p>Rubenstein and colleagues looked at data from birth records and Medicaid claims in Wisconsin from 2007 through 2017, identifying over 1,500 live births to women with IDD. Compared to other low income women enrolled in Medicaid, they found that women with IDD were at greater risk of gestational diabetes and hypertension, were more likely to deliver preterm, and were more likely to have a caesarean delivery.<\/p>\n\n\n\n<p>\u201cPeople with disabilities in general, and IDD in particular, are important populations that may be overlooked when thinking about reducing pregnancy disparities,\u201d Rubenstein says.<\/p>\n\n\n\n<p>The public conversation about pregnancy disparities has focused in recent years on how racism affects outcomes and care, particularly for Black women\u2014rightfully, Rubenstein says. But disability needs to be part of that conversation, too, he says, noting that the study found risk of gestational hypertension was higher for Black women with IDD than for Black women without IDD or non-Black women with IDD.<\/p>\n\n\n\n<p>The National Institutes of Health (NIH) does not recognize people with IDD or other disabilities as health disparity groups, but Rubenstein says public health attention is shifting.<\/p>\n\n\n\n<p>\u201cThere is a strong self-advocacy movement where people with IDD are leading the fight for improved healthcare and opportunity,\u201d Rubenstein says, noting that a large cohort of autistic young people, who have driven a lot of media and research attention, are now entering adulthood. \u201cI anticipate the interest will follow once they start families,\u201d he says.<\/p>\n\n\n\t<aside class=\"wp-block-editorial-relatedstories alignright sphnews-block-editorial-relatedstories\">\n\t\t<h3 class=\"wp-block-editorial-relatedstories-title\">Related<\/h3>\n\t\t<ul class=\"wp-block-editorial-relatedstories-list\">\n\t\t\t\t\t\t\t<li class=\"wp-block-editorial-relatedstories-list-item\">\n\t\t\t\t\t<article class=\"wp-block-editorial-relatedstories-article\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"wp-block-editorial-relatedstories-article-category\"><span>adolescents<\/span><\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"wp-block-editorial-relatedstories-article-title\"><a href=\"https:\/\/www.bu.edu\/sph\/news\/articles\/2020\/professor-receives-nih-grants-to-study-alcohol-use-peer-relationships-among-autistic-youth\/\" class=\"wp-block-editorial-relatedstories-article-title-link\">Professor Receives NIH Grants to Study Alcohol Use, Peer Relationships among Autistic Youth<\/a><\/h4>\n\t\t\t\t\t\t\t<p class=\"wp-block-editorial-relatedstories-article-date\">July 2, 2020<\/p>\n\t\t\t\t\t\t\t\t\t\t\t<\/article>\n\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t<\/aside>\n\t\n\n\n<p>Because, Rubenstein says, in and out of the public health community it can be forgotten that children with IDD become adults with IDD. \u201cMuch focus and thought are paid to children with disabilities, but the transition to adulthood is often a cliff rather than a ladder,\u201d he says.<\/p>\n\n\n\n<p>As a result, the state of health and healthcare access for people with IDD \u201ccould be summed up best as \u2018poor,\u2019\u201d he says, with the caveat that people with IDD are a very broad group with many different conditions and circumstances.<\/p>\n\n\n\n<p>\u201cLike health in many populations, a big key to optimal outcomes is access and, in many cases, adults with IDD face extreme barriers to opportunity.\u201d People with IDD can be paid subminimum wage, lose Medicaid benefits if they make more than just $500 a month, and support services such as home health aides are severely underfunded, he says, to name just a few\u2014and there are many, many more.<\/p>\n\n\n\n<p>Rubenstein has seen these \u201cunnecessary obstacles\u201d first hand, which led him to this area of research. \u201cI started out in this \u2018field\u2019 in a literal field coaching Special Olympics baseball when I was 10,\u201d he says. \u201cThe IDD community has been my community since then. As I have grown up with my friends and athletes I coach, I\u2019ve seen how the healthcare system and social disparities can negatively impact health and the major impact that has on a person\u2019s life and well-being.\u201d<\/p>\n\n\n\n<p>However, Rubenstein says he is hopeful, and that much is changing.<\/p>\n\n\n\n<p>\u201cOrganizations like Special Olympics have committed to improving health as a pillar to their missions,\u201d he says. \u201cInclusion, rather than segregation, is becoming the standard practice, which will reduce stigma and improve community.<\/p>\n\n\n\n<p>\u201cI think the future is bright.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>As their civil rights advance, more women with intellectual and developmental disabilities are starting families. But new research shows they face major disparities in maternal health outcomes and care.<\/p>\n","protected":false},"author":10989,"featured_media":191242,"comment_status":"closed","ping_status":"closed","template":"","meta":{"bu_prepress_billboard":"{\"post_id\":169010,\"hed\":\"Professor Receives NIH Grants to Study Alcohol Use, Peer Relationships among Autistic Youth\",\"dek\":\"Next Article\",\"class\":\"wp-block-editorial-billboard sphnews-block-editorial-billboard\",\"backgroundType\":\"image\",\"backgroundOpacity\":\"100\"}","_bu_prepress_primary_term":"maternal and child health","_bu_prepress_primary_term_manual":""},"tags":[1709,2070,3420,2178,2847,506,2166,2332,2547,2372],"bu-publication":[3516],"sphnews-article-category":[3519,3530,3531,3540,3563],"sphnews-topic":[],"bu_edition":[],"media_type":[],"profile_tax":[3509],"_links":{"self":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/191235"}],"collection":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article"}],"about":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/types\/bu-article"}],"author":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/users\/10989"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/comments?post=191235"}],"version-history":[{"count":6,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/191235\/revisions"}],"predecessor-version":[{"id":191248,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/191235\/revisions\/191248"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media\/191242"}],"wp:attachment":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media?parent=191235"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/tags?post=191235"},{"taxonomy":"bu-publication","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-publication?post=191235"},{"taxonomy":"sphnews-article-category","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-article-category?post=191235"},{"taxonomy":"sphnews-topic","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-topic?post=191235"},{"taxonomy":"bu_edition","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu_edition?post=191235"},{"taxonomy":"media_type","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media_type?post=191235"},{"taxonomy":"profile_tax","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/profile_tax?post=191235"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}