A lack of evidence for disability-inclusive maternal health interventions and promising progress: an updated systematic review.

Background: Pregnant women with disabilities experience significantly higher rates of adverse pregnancy outcomes compared to those without disabilities. Evidence-based interventions that address disability-related barriers during pregnancy are essential to reducing health disparities. Objective: We aimed to update a 2014 systematic review to identify interventions designed for pregnant women with disabilities. Methods: We conducted a systematic review of studies published between 2012 and 2025 to identify interventions addressing disability-related barriers during pregnancy and birth. Results: We found a striking absence of evidence with no eligible studies identified from 22,719 publications. While we found multiple studies that evaluated the safety and efficacy of medications to manage disability-associated conditions during pregnancy, none of these studies focused on the potential disabling impact of the health conditions for pregnant women with disabilities, our intended focus. However, in our discussion, we describe three recent pilots, including co-produced resources for pregnant patients with disabilities, educational interventions for midwives, and an innovative patient empowerment tool, that suggest the field may be at a turning point. Conclusions: Our systematic review did not find evidence of disability inclusive maternal health interventions to improve pregnancy and childbirth experiences. However, we point to limited but promising studies for their use of co-production and patient engagement principles underscoring the potential for accelerating progress when research is conducted with, rather than on, disabled communities. While the pilots serve as proof of concept that disability-inclusive reproductive health research is both necessary and achievable, investments in disability inclusive maternal healthcare could yield significant returns for those with disabilities.