Table 1.

Perinatal Health Framework for Women with Physical Disabilities: Individual, Mediating, Maternal and Infant Outcomes and Environmental Context

Individual factors	Example
Demographic	Age Race/ethnicity Income Education Country of origin Marital status Sexual orientation Culture
Health condition	Primary disabling condition Co-morbid conditions (e.g. asthma or diabetes) Secondary conditions (e.g. pressure ulcers, UTIs) Stability of condition
Body structure and function	Structural anomalies (e.g. spinal cord injury, amputation)
Impairments	Limited mobility Limited dexterity
Genetic factors	Inheritable condition like spinal muscular atrophy, achondroplasia
Activities	Self-care including dressing, bathing, eating (ADLs and IADLs)
Participation	Employment Community and social interactions Intimate relationships

Mediating Factors	Example
Access to information and resources	Preconception counseling Prenatal education Assistive technology Access to information on pregnancy Financial support Transportation access Access to nutrition Personal assistance with mothering tasks
Health care-related factors	Physical, communication, programmatic and attitudinal barriers to health care Provider knowledge Health insurance status Reproductive care experiences Sexuality education
Psychosocial factors	Women's knowledge, beliefs and attitudes about childbearing and motherhood Self-efficacy Stress Depression/anxiety Risk for physical abuse
Social support	Family support Family and peer attitude towards pregnancy among women with physical disabilities Relationship with spouse/partner and peers

Maternal and Infant Outcomes	Example
Maternal outcomes	Maternal health Maternal well-being Maternal functioning Cesarean delivery
Infant outcomes	Low birth weight Preterm birth NICU admissions Congenital anomalies Clinical complications Maternal-infant bonding

Environmental Context	Example
Physical	Physical accessibility of woman's home and clinicians' office Accessibility of transportation
Social	Opportunities for intimate relationships Degree of social connectedness
Attitudinal	Attitudes of broader community towards pregnancy among women with physical disabilities
Legal/policy	Americans with Disabilities Act Social Security Act (Medicare, Medicaid, cash benefits) Affordable Care Act Maternal and child health policy