Victoria Bradley is a nurse practitioner, freelance writer, and new mother living with multiple sclerosis. In this article, she explores the added complexities of pregnancy and disability. From navigating healthcare systems to accessing appropriate support, Victoria highlights the importance of inclusive, informed care that respects individual needs throughout the maternity journey for disabled mothers.
Pregnancy and disability
Pregnancy, whether you identify as disabled or not, is a time when making informed choices is very important. However, having a disability can mean there are additional considerations, from the way antenatal care is accessed to the labour and delivery of the baby.
Disability can be defined as a physical or mental impairment that has a substantial and long-term effect on the ability to perform daily activities. Under this definition, those with long-term conditions are also eligible for additional maternity support, even if they don’t identify as disabled.
Prevalence of female disability
Disabled women make up 20% of the women of reproductive age (aged 15-44), equating to 2.9 million people. This age group is one of the largest to be disproportionately living with disabilities.
Autoimmune diseases – conditions where the immune system mistakenly attacks healthy cells within the body, predominantly affect women, approximately 80% of those diagnosed, and are a leading cause of disability.
Data on disability from the UK census shows that statistically, the percentage of women identifying as disabled increases with age, more than males of the same age brackets, starting from 15 years old.
The impact on pregnancy and disability
Maternal pregnancy rates for disabled women are roughly the same compared to those without disabilities, with some data showing the rate of pregnancy in disabled women is increasing. This means there is a large group of women who should be eligible for, and receiving, additional support.
However, recent studies suggest the opposite. A recent report published on disparities in maternity care for disabled women in the UK found that disabled women had worse outcomes compared to non-disabled women, both for mother and baby.
The report found higher chances of stillbirth, longer postnatal stays in hospital and lower rates of breastfeeding amongst disabled mothers.
Another 2021 study on the risk of adverse maternal outcomes in pregnant women with disabilities found that disabled women have a higher risk of haemorrhage, infection, cardiac issues and pregnancy-specific disorders such as gestational diabetes and preeclampsia – a condition that can cause dangerously high blood pressure during pregnancy.
Both studies found that disabled pregnant women are more likely to have interventions during labour, such as being induced or having an assisted delivery via forceps or caesarean section.
The women in these studies are representative of a wide range of disabilities, including physical, learning and sensory, making the impact of the findings more significant.
Gaps in healthcare
Despite there being a large proportion of women who may wish to get pregnant and who are more likely to be impacted by disability, current national guidelines have significant gaps in providing disability specific maternity advice.
The Royal College of Obstetrics and Gynaecology only mention disability in 2 out of the 67 published guidelines, and the National Institute for Health and Care Excellence (NICE) mentions disability in 6 out of 30 in their pregnancy, fertility and childbirth guidelines.
Not all NHS trusts have widely available disability specific maternity information available, if any at all, and finding local policies and resources can prove difficult.
Barriers to accessing antenatal care
Disabled pregnant individuals can face a variety of barriers in accessing antenatal care, including:
- Lack of specialist knowledge from healthcare providers
- Accessibility issues, such as mobility aid access
- Specialist equipment like hoists is not being readily available
- Communication accessibility: information not given in a suitable format
- Limited resources and information are widely available
- Lack of specialist post-natal support
- Not understanding individual rights for additional support
- Negative attitudes or stigma from healthcare professionals
- Affordability – financial implications like the cost of travelling to appointments
Understanding what the barriers are is important in finding solutions to overcome them.
What the law says
Under the Human Rights Act 1998 and the Equality Act 2010, maternity services must adapt to support the needs of pregnant disabled women.
NHS trusts have a responsibility to provide additional support where needed, which can include making reasonable adjustments and liaising with other healthcare providers.
The Nursing and Midwifery Council, the governing body to practise as a registered nurse or midwife in the UK, does have a core component for midwives called “Additional care for women and newborn infants with complications”. While not exclusively disability specific, it does mean that to practice legally as a midwife and meet expected standards of care, additional care and support must be provided to those who need it.
What adjustments can be made?
Reasonable adjustments can include things like:
- Disability friendly access, such as a disabled bathroom
- Longer or more frequent appointments
- Information is available in different formats, such as large print
- Access to any required aids
- An appointed advocate
- More time to tour facilities and try out equipment such as birthing pools
- Support in applying for schemes to help with travel costs
- Use of toolkits such as a maternity passport, outlining the needs of the individual and information about their disability
It is recommended to inform the midwifery team of any disability as soon as possible, so that tailored care can be provided. Reasonable adjustments should always be personalised to the individual and their own specific needs.
What now for pregnant women with disabilities?
Some key recommendations from the studies include:
- Development of further disability specific guidance for maternity care in the UK
- Increased training for healthcare professionals
- Ensuring that reasonable adjustments are provided for disabled women
- Better joint working between midwifery teams and other specialists related to the individual’s disability
Useful resources for prospective disabled mothers
Being aware of individual rights and sources of disability specific maternity advice can help ensure that people can access the care and support they need, and know how to challenge this if their needs are not being met.
Below are some useful sources of disability-specific maternity information and charities
- Accessible Maternity Resources « Learning Disability Network – A range of maternity leaflets developed for individuals with learning disabilities
- Disability and long-term health conditions and maternity care – Birthrights– A charity focused on human rights during pregnancy and birth, with disability-specific factsheets
- Equality Act 2010 – Section 6 outlines disability
- Healthcare Travel Costs Scheme (HTCS) – NHS – How to apply for support with travel costs
- Mothers with Disabilities Network – An online network for disabled mothers
- REMAP – Custom made equipment for disabled people – volunteers create custom-made disability equipment, including baby items
- The Together Project: supporting the delivery of good practice in maternity services for parents with learning disabilities | University of Surrey – Downloadable resources including a maternity passport for individuals with learning disabilities
- UK maternity report — Missing Billion Initiative – The London School of Hygiene & Tropical Medicine’s March 2025 report on the experiences and outcomes of disabled women in the UK accessing maternity care
- Your antenatal care – NHS – NHS advice on how to access antenatal care
Are you a disabled woman who is currently pregnant or a new mum? What has your experience of maternity care been like? Your voice matters. Let us know in the comments box, on social media or contact us to share your personal story.