THE EXPERIENCE OF DEAF AND HARD-OF-HEARING WOMEN REGARDING ACCESS TO AND QUALITY OF PERINATAL CARE: A SYSTEMATIC REVIEW

Objective: Deaf and hard-of-hearing (DHH) women face significant barriers to accessing and receiving quality perinatal care, including communication challenges, inadequate healthcare provider training, and systemic discrimination. This systematic review synthesizes evidence on the perinatal experiences of DHH women and identifies key obstacles and potential solutions to improve maternal healthcare accessibility. Methods: A comprehensive literature search was conducted across PubMed, Google Scholar, and Elsevier Midwifery Journal, yielding 19 studies that met the inclusion criteria. Results: The findings indicate that communication barriers, such as the lack of sign language interpreters and limited cultural competence among healthcare providers, result in lower satisfaction, delayed care, and increased risk of adverse maternal outcomes. The absence of structured continuity-of-care models further exacerbates the exclusion of DHH women from critical medical decision-making. Racial disparities also contribute to higher instances of medical neglect, particularly among Black DHH women. Postpartum challenges include difficulties with breastfeeding support and limited access to accessible maternal health education. Advocacy and self-empowerment strategies, such as the use of doulas and assistive technologies, have been shown to improve patient experience. Conclusions: This review underscores the need for mandatory healthcare provider training in deaf culture and communication strategies, the implementation of inclusive healthcare policies, and the integration of assistive technologies to enhance perinatal care. Future research should focus on the long-term health outcomes of DHH mothers and the effectiveness of inclusive perinatal care models. Précis statement: Deaf and hard-of-hearing women face significant barriers in perinatal care due to communication challenges, healthcare provider training gaps, and systemic discrimination, necessitating inclusive policies and assistive communication strategies to improve maternal outcomes.