Socio‐Ecological Factors Influencing Access to and Utilization of Perinatal Healthcare Services Among Women With Disabilities: A Systematic Review
Maria Noemi Paradiso, Fabrizio Santoniccolo, Francesca Giampaoli, Tommaso Trombetta, Luca RollèBackground
Disability is an essential dimension of human experience, resulting from the interaction between individual and contextual factors. Despite global commitments to inclusive and respectful healthcare, women with disabilities still face persistent barriers in accessing and using maternal healthcare during the perinatal period.
Objective
This systematic review examines access and utilization of maternal care among women with different types of disabilities.
Methods
Following PRISMA guidelines, a systematic search was conducted up to October 2025 across EBSCO, PubMed, and Web of Science, including English‐language original papers on women with disabilities, and examining factors influencing access to and utilization of perinatal healthcare services. Risk of bias was assessed using the JBI CAT, and the MMAT, as appropriate. A total of 53 studies were included. Findings were organized using the socio‐ecological model as an analytical framework.
Results
Findings indicate that access to and utilization of maternal healthcare are associated with factors operating across individual, interpersonal, and healthcare system levels. At the individual level, informational barriers, internalized stigma, and limited pregnancy‐related knowledge hindered early engagement with care. At the interpersonal level, communication difficulties, exclusion from decision‐making, and discriminatory attitudes reduced participation in care. At the healthcare system level, structural and organizational barriers contributed to delayed entry into maternal care and increased reliance on acute services.
Conclusions
Access and use of maternal healthcare among women with disabilities reflect socio‐ecological barriers rather than inevitable consequences of impairment. Promoting a disability‐informed and person‐centered approach throughout the perinatal period is essential to guarantee equitable and respectful care.