A Continuing Education Intervention to Address Ableism Among Obstetric Clinicians Providing Perinatal Care

PROJECT SUMMARY The notion that disabled people would seek pregnancy and motherhood defies long-held social norms and is fraught with echoes of the eugenics movement of early 20th century America. Nevertheless, pregnancy and parenthood are increasingly common among disabled people. Despite the increasing numbers of disabled women having babies, obstetricians often have little training in how best to provide high quality care to this diverse population, documented through perspectives of both obstetric clinicians themselves and women with disabilities. Disabled women often experience worse maternal and child health outcomes than their nondisabled peers. Barriers to optimal care include lack of training and disability knowledge of obstetric clinicians; lack of professional guidelines for providers; provider unwillingness to care for women with disabilities; inaccessible equipment and facilities, poor communication, and ableist attitudes and practices among obstetric health care providers and staff. Furthermore, emerging research suggests that ableist and discriminatory experiences in reproductive care may disproportionately affect disabled women of color. Research, both with disabled women and obstetricians, has identified recommendations for improving care, however, the critical next step have yet to be taken – designing an educational intervention to address these concerns and prepare obstetricians to provide inclusive care. This study will develop an online continuing education program for practicing obstetricians that addresses ableism and structural ableism in perinatal and postpartum care. The study will first conduct focus groups and key informant interviews to identify essential content and optimal approaches for educating providers about mitigating ableist attitudes, practices, and policies, structural access barriers, and providing perinatal care to a diverse population of disabled patients. Based on these findings, the study team will design an online continuing medical education program and conduct a randomized controlled trial with 200 obstetric providers. Participants will complete assessments prior to training, and at three- and 9-months following completion. The study will measure change in ableist attitudes and clinical policies and practices. Knowledge acquisition, satisfaction with course content, and usability will similarly be evaluated. We will also interview 20 participants about their experiences and revise the program accordingly. We will collaborate with the American College of Obstetricians and Gynecologists (ACOG) to disseminate the final program to practicing obstetricians. This project directly addresses priorities identified by the funding agency to develop and test interventions at a community or health systems level to mitigate adverse health effects of ableism and structural ableism. The expected outcome of this project is an innovative educational intervention to improve provider knowledge to mitigate ableism in perinatal care.