Perinatal Experiences of Women With Physical Disabilities and Their Recommendations for Clinicians

Abstract

Objective To explore the perinatal experiences of women with physical disabilities (WWPD) and their associated recommendations for maternity care clinicians to improve care. Design A mixed-method study was conducted using a semi-structured interview guide to identify the experiences of WWPD. This qualitative descriptive study is part of a larger study and was conducted to examine the perceptions of WWPD about their interactions with maternity care clinicians and their recommendations for maternity care clinicians to improve care. Participants Twenty-five women with physical disabilities who gave birth within the last 10 years and were 21–55 years of age were recruited and agreed to participate in the study. Methods Participants were asked about their interactions with clinicians during pregnancy and their recommendations for clinicians to improve perinatal care for women with physical disabilities. Transcribed interviews were analyzed using content analysis. Themes that emerged from analysis of the interviews were identified and coded. Kurasaski’s coding was used to establish the reliability of the coding. Results Three themes emerged from analysis of the interview data: clinicians’ lack of knowledge about pregnancy-related needs of WWPD; clinicians’ failure to consider knowledge, experience, and expertise of women about their own disabilities; and clinicians’ lack of awareness of reproductive concerns of WWPD. Women provided recommendations that warrant attention by clinicians who provide perinatal care for women who live with physical disabilities. Conclusion Participants experienced problematic interactions with clinicians related to pregnancy and identified recommendations for maternity care clinicians to address those problems with the goal of improving perinatal health care for WWPD.

Barriers to providing maternity care to women with physical disabilities: Perspectives from health care practitioners

“…Women reported a lack of knowledge on the part of the practitioner about their specific needs related to pregnancy, inaccessible health care settings including health care offices, equipment and birth facilities, and perceived failure of practitioners to consider the woman’s knowledge and expertise related to her own disability. 1, 2 Similar findings have been noted in other studies of maternity care experiences and outcomes of women with various disabilities, including physical disabilities. 3–6 …”

“…1, 2 While many women experienced their provider as supportive, compassionate and helpful, women also perceived negative attitudes and stereotypes about the sexuality and motherhood of women with physical disabilities from providers. Women reported a lack of knowledge on the part of the practitioner about their specific needs related to pregnancy, inaccessible health care settings including health care offices, equipment and birth facilities, and perceived failure of practitioners to consider the woman’s knowledge and expertise related to her own disability.…”

Time trends in births and cesarean deliveries among women with disabilities

“…Subjective indications appear to have contributed substantially to the increase in primary cesarean deliveries, perhaps in response to fears of litigation if adverse outcomes occurred in the absence of intervention [8, 12] One might expect such concerns to be associated with a particularly strong increase in cesarean deliveries among women with disabilities, whose pregnancies may be viewed by clinicians as especially high risk [13]. As yet though, temporal trends in cesarean deliveries among women with disabilities have not been examined.…”

Live birth, miscarriage, and abortion among U.S. women with and without disabilities

“…While various sociodemographic and health characteristics have been associated with each of these outcomes [14, 15], little is known about the relationship between maternal disability and miscarriage or abortion. As interest in childbearing increases among women with disabilities [16, 17] a better understanding is needed of the likelihood of live birth and the risk for miscarriage and abortion.…”