Deaf women and pregnancy and perinatal health: Creating systems for communication access
Compared with the general population, deaf and hard of hearing (DHH) women are at increased risk for adverse pregnancy conditions (e.g. eclampsia) and perinatal outcomes (e.g. preterm labour), as found in a retrospective cohort study. As a component of that study, Panko et al. conducted 45 interviews with deaf women who communicate in American Sign Language (ASL); they discovered themes centring around communication and advocacy, including consistent access to qualified interpreters, patient support from healthcare teams, communication quality between patients and clinicians, and self-advocacy strategies. The authors present important arguments addressing imbalanced reliance on social networks, inadequate interpreter presence and training, and incorporation of deaf awareness during healthcare professional education. As deaf physicians (representing maternal and fetal medicine and internal medicine) with personal and professional perspectives on healthcare and perinatal experiences, authors believe that communication access and equity must be woven throughout the fabric of healthcare systems and education institutions.
Typical strategies to engage interpreters depend on individual providers to identify communication needs and activate interpreters, risking marked cognitive overload and subsequent process inconsistencies. To achieve communication equity, healthcare systems must develop and implement processes for identifying and documenting every patient's communication preferences, making such information quickly available to every provider at each patient encounter. For example, labour and delivery units represent the uncertainty of perinatal timing and potential emergencies. They should have contingency plans for prompt access to interpretation and for ensuring that the patient's communication preferences are handed off among nurses and clinicians throughout the patient's stay, including to those caring for the newborns.
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