Countless healthy, full-term babies are born to deaf and hard of hearing women every day. However, a new study has revealed that some women with hearing loss are at a higher risk of delivering low birth weight or pre-term babies due to related health and societal factors. It is important to note that this increased risk is not a direct side effect of hearing loss itself, but rather a consequence of the way some deaf and hard of hearing women are marginalized, have an elevated risk of poor health, receive less information, and have less successful health outcomes as a result. The study, which was published in the American Journal of Preventative Medicine, is the first of its kind and raises the important question of how the medical community can better serve the needs of hard of hearing expectant mothers.
The Study on Hearing Health and Expectant Mothers
Low birth weight and pre-term birth were the adverse birth outcomes shown to be more common among women with hearing loss, in the study led by Monika Mitra, PhD, of the Lurie Institute for Disability Policy, Brandeis University. Researchers set out to investigate birth outcomes among women with hearing loss by looking at over 18 million births nationwide in the 2008-2011 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project (HCUP). Of those 18 million infants born, 10,500 were born to hard of hearing women. The results of the study were clear: the rates of both pre-term birth and low birth weight were significantly higher among women with hearing loss than in the general population.
A previous study, carried out in 2006 by researchers at the University of Rochester, shed light on a disparity in prenatal care between deaf and hard of hearing women, and their hearing peers. The women with hearing loss reported having fewer prenatal check-ups and less satisfaction with the healthcare they received than hearing women. Hearing women reported having more prenatal visits and receiving more information from their doctors. The researchers also concluded that maximizing communication effectiveness with deaf patients results in better prenatal care and improved patient satisfaction overall.
The aim of the Brandeis study was to follow up the Rochester study and determine whether the reduced access to health care experienced by hard of hearing women results in negative birth outcomes. Although more research is needed, it is clear that a health care gap exists and that not all deaf and hard of hearing women are receiving the quality of health care that they need to deliver healthy, full-term babies.
Factors that could lead to premature or low-birth weight babies
The quality of communication between physician and patient is a major factor in patient satisfaction and adherence to treatment. Deaf patients who use American Sign Language experience significant communication barriers in most medical settings, and hard of hearing patients have communication difficulties that stand in the way of their health as well.
A lack of general health knowledge and negative medical experiences can discourage hard of hearing women to attend prenatal appointments, and lead to negative health outcomes, whereas positive experiences, such as practitioners who have experience communicating with the deaf and hard of hearing results in better outcomes and patients being more actively involved in their own healthcare.
Hard of hearing women have less chances to benefit from mass media, public health messages and other learning opportunities. They are also more likely to be publicly insured as they qualify for Medicare, Medicaid and Social Security benefits. In the study, Medicare and Medicaid were the most common payers for women with hearing loss, while women without hearing loss were more likely to be privately insured.
Healthcare providers do not commonly receive training on how to communicate with deaf and hard of hearing patients, which results in increased patient frustration and poor communication about prenatal care and delivery. Women with hearing loss must often deal with two or more coexisting health issues, and are more likely to be admitted to urban teaching hospitals.
Dr. Mitra noted: “A recent perinatal health framework developed by our team identified a set of individual and mediating factors that may impact maternal and birth outcomes for women with physical disabilities. Mediating factors, for example, include provider knowledge and attitudes toward pregnancy, family support, and psychosocial factors such as stressful life events. Although these factors are not identifiable in the HCUP data, this framework may be also applicable to women with hearing loss. Given the earlier studies on patient-provider communication, potential biological factors, interpersonal violence, and health knowledge and health literacy among people with hearing loss, and the general dissatisfaction of people with hearing loss with their healthcare, these factors could potentially explain the poor birth outcomes found in this study.”
Improved access to health information may be achieved with specialized resource materials, improved prevention and targeted intervention strategies, and self-advocacy skills development. Healthcare providers must also be trained to become more effective communicators with deaf and hard of hearing patients and to use qualified interpreters to assure access to healthcare for these women, if birth outcomes are to be improved.
Your hearing health is important to your overall health and well-being. If you have experienced changes in your hearing abilities, schedule a consultation and hearing exam with us at Hearing Health today.