Abstract
Women with disabilities face significant barriers in accessing perinatal healthcare, often leading to poor maternal and neonatal outcomes. This narrative review, conducted using a PRISMA-informed systematic search strategy, aims to identify and synthesize the global literature on barriers to perinatal healthcare among women with disabilities, with a contextual sub-analysis of studies relevant to the Kashmir region. A total of 61 studies, published between 1967 and 2024, were identified through a PRISMA-informed systematic search process across four academic databases: Psycinfo, Jstor, Medline, and Google Scholar. Studies were appraised using the Mixed Methods Appraisal Tool (MMAT). Given substantial heterogeneity in study designs, disability types, outcomes, and regional contexts, findings were synthesized using an interpretive narrative thematic approach rather than statistical aggregation. The review synthesized findings from both qualitative (n = 36) and quantitative (n = 25) studies, including 10 studies focused on Kashmir, highlighting a significant regional research gap. Thematic synthesis identified three major themes: (1) barriers related to perinatal healthcare, (2) support systems during the perinatal period, and (3) healthcare system policy response and gaps. Barriers comprised physical inaccessibility, attitudinal stigma, knowledge and information barriers and socio-cultural barriers. Among the 61 studies reviewed, physical and attitudinal barriers were the most frequently reported (in 42 studies), followed by knowledge and information barriers, (in 28 studies) and socio-cultural barriers (in 25 studies). Support systems particularly emotional, familial and peer networks, were identified as important facilitators of perinatal healthcare access. In the Kashmir context, these barriers are intensified due to political instability, under-resourced health infrastructure, and sociocultural stigma. These findings underscore the importance of disability-inclusive perinatal healthcare strategies and context-sensitive policy approaches.