Women's College Hospital - Health Care for Women, Revolutionized

Jump to body content

Mothers with intellectual and developmental disabilities need more support postpartum, study suggests

April 24, 2017

By Lindsay Jolivet

An editorial based on research by scientists at Women’s College Research Institute (WCRI) calls for action on healthcare for the growing number of mothers with intellectual and developmental disabilities who face higher risks for complications during pregnancy and postpartum.

Hilary Brown, PhD
Hilary Brown, PhD

The editorial published March 29 in the Journal of Women’s Health cites research led by Hilary Brown, PhD, an adjunct scientist at WCRI, in support of improving care for this population.

About one per cent of adults have an intellectual or developmental disability, a category of conditions that includes fetal alcohol syndrome, autism, Down syndrome and Fragile X syndrome. People with these conditions have cognitive limitations and difficulties with communication, social and practical skills.

Many countries institutionalized and sterilized women with these conditions until the 1970s, but now, more of them are living in the community. Brown previously found that up to 450 babies are born to women with intellectual and developmental disabilities each year in Ontario.

“Until recently, the perinatal health of women with intellectual and developmental disabilities was largely ignored. Given an increasing fertility rate in this population, evidence regarding their health during and after pregnancy was urgently needed so that appropriate healthcare can be provided,” Brown says.

Brown’s recent research, conducted during her postdoctoral fellowship at WCRI supervised by Dr. Simone Vigod, a scientist at WCRI and a psychiatrist at Women’s College Hospital (WCH), has established the largest cohort of pregnant women with intellectual and developmental disabilities to date worldwide. She has found that they have a higher risk for serious pregnancy complications.

Her latest study found they have higher rates of emergency department visits and hospital admissions in the postpartum period, particularly for psychiatric reasons. The researchers analyzed administrative data from the Institute for Clinical Evaluative Sciences for new mothers with and without intellectual and developmental disabilities who gave birth in Ontario between 2002 and 2012.

Women with intellectual and developmental disabilities had higher risks in the following areas:

  • Double the risk of postpartum hospital admissions (2.4 per cent vs. 1.2 per cent), including a nearly ten-fold higher risk of hospital admission for psychiatric reasons
  • Double the risk of postpartum emergency department visits without hospitalization (16.6 per cent vs 7.9 per cent), including a seven-fold higher risk of emergency department visits for psychiatric reasons.

Women with intellectual and developmental disabilities have higher rates of poverty and mental illness, but even after adjusting for these factors, their rates of emergency department visits and hospitalizations were still higher.

The Journal of Women’s Health editorial calls for Medicaid to cover more postpartum care and the American College of Obstetricians and Gynecologists to recommend more postpartum medical visits for this group of women. In the U.S., up to 80 per cent of mothers with intellectual and developmental disabilities are on Medicaid.

“Our research is part of a growing body of evidence demonstrating a real need to provide better support to women with intellectual and developmental disabilities during and after pregnancy. We hope that this call to action results in tangible changes in obstetric care guidelines in the near future,” Brown says.

Jump to top page

More News & Media »

Media inquiries

Please contact Media Relations

Email: media@wchospital.ca

Phone: 416-323-6400 ext. 4054


Media Kit

Please visit our Media Kit page for resources such as images, B-roll video and backgrounders on Women's College Hospital.

  • Fully affiliated with:
  • University of Toronto
  • A member of:
  • Council of Academic Hospitals of Ontario (CAHO)