Pregnancy Outcomes and Experiences among Deaf and Hard of Hearing Women

失聪和重听(DHH)的女性在适当的选择上遇到了重大障碍 生殖保健服务和健康信息。具体地说，缺乏有效的沟通， 例如手语口译员，阻碍了获得生殖保健服务和信息 DHH的女人。而患有DHH的女性与有其他残疾的女性怀孕的可能性相同 而没有残疾的妇女，几乎没有关于她们怀孕的信息和研究 经验、产妇和分娩结果，以及相关的医疗费用。调查的初步结果 研究小组证明，DHH妇女有很大的不良妊娠结局风险。 在降低成本的同时改善怀孕护理和体验的努力需要明确的评估 这些妇女的怀孕风险和结局。这项研究的首要目标是使用混合- 方法了解妊娠经历、母婴结局、相关卫生保健 DHH妇女及其婴儿的费用和未满足的围产保健需求。这项研究的具体目的 1)比较DHH和非DHH患者的妊娠和分娩并发症、结局和住院费用 DHH妇女使用具有全国代表性的2008-13年度全国医疗费用和利用项目 住院患者样本数据；2)检查DHH的纵向健康结果、医疗保健利用和费用 与其他妇女相比，怀孕前后的妇女及其婴儿(1岁以下) 使用从马萨诸塞州怀孕到早期生活纵向-所有付款人索赔数据库的关联数据； 以及3)通过(A)确定未得到满足的需求和怀孕和围产期护理方面的障碍 与DHH母亲的访谈，(B)关于未得到满足的需求和怀孕和围产期障碍的全国调查 对在过去5年内分娩的DHH母亲的护理，以及(C)与提供 他们的医疗保健。这些信息将被用来产生实践建议，以改善围产期 DHH妇女及其婴儿的健康。我们的研究将首次系统地了解 DHH妇女的妊娠和婴儿健康结果和妊娠护理费用，从而建立 为制定和测试未来干预措施以改善结果奠定基础。这项研究将填补一个关键的 DHH妇女在怀孕前、期间对妊娠相关经历了解的知识差距 在怀孕之后。

Women who are deaf and hard of hearing (DHH) experience significant barriers to appropriate reproductive health care services and health information. Specifically, the lack of effective communication, such as sign language interpreters, hinders access to reproductive health care services and information for DHH women. While women who are DHH are equally likely to be pregnant as women with other disabilities and women without disabilities, there is almost no information and research about their pregnancy experiences, maternal and birth outcomes, and associated healthcare costs. Preliminary findings from the investigator team demonstrate that DHH women are at substantial risk for adverse pregnancy outcomes. Efforts to improve their pregnancy care and experiences while reducing costs require a definitive assessment of these women's pregnancy risks and outcomes. The overarching goal of this study is to use a mixed- methods approach to understand pregnancy experiences, maternal and birth outcomes, related health care costs, and unmet perinatal health care needs of DHH women and their infants. The specific aims of this study are: 1) Compare pregnancy and childbirth complications, outcomes, and inpatient costs among DHH and non- DHH women using nationally-representative 2008-13 Healthcare Cost and Utilization Project Nationwide Inpatient Sample data; 2) Examine longitudinal health outcomes and healthcare utilization and costs of DHH women around the time of their pregnancy and for their infants (up to 1 year of age) compared to other women using linked data from the Massachusetts Pregnancy to Early Life Longitudinal – All Payer Claims Database; and 3) Identify unmet needs and barriers to pregnancy and perinatal care for DHH women through (a) interviews with DHH mothers, (b) a national survey of the unmet needs and barriers to pregnancy and perinatal care of DHH mothers who have given birth in the last 5 years, and (c) interviews with clinicians who provide their health care. This information will be used to generate practice recommendations to improve the perinatal health of DHH women and their infants. Our study will lead to a first-ever systematic understanding of pregnancy and infant health outcomes and pregnancy care costs for DHH women, thus establishing a foundation for development and testing of future interventions to improve outcomes. This study will fill a critical knowledge gap in the understanding of the pregnancy-related experiences among DHH women before, during and after pregnancy.