Pregnancy among women with physical disabilities: Unmet needs and recommendations on navigating pregnancy

Abstract

Background Despite concerns raised in the literature on the adverse pregnancy outcomes of women with physical disabilities, there is little information about unmet needs of women with physical disabilities during pregnancy and childbirth. Objective This article provides an in-depth examination of unmet healthcare needs during and around the time of pregnancy among a sample of women with physical disabilities. It also offers recommendations to other women with physical disabilities who are considering pregnancy. Methods Twenty-five phone interviews were conducted with women with physical disabilities from across the United States who had a baby in the past ten years. Individual semi-structured qualitative interviews lasting about two hours were conducted. Interviews were audio-recorded, transcribed, and analyzed using an iterative, interpretive process. Results Women reported a wide range of disabling conditions. Analysis revealed three broad themes related to unmet needs during pregnancy among women with physical disabilities. They included (1) clinician knowledge and attitudes, (2) physical accessibility of health care facilities and equipment, (3) need for information related to pregnancy and postpartum supports. The women also provided recommendations to other women with disabilities who are currently pregnant or thinking of becoming pregnant. Recommendations related to finding a clinician one trusts, seeking peer support, self-advocating, and preparing oneself for the baby. Conclusions This study sheds light on the unmet needs and barriers to care of women with mobility disabilities during pregnancy and childbirth. The study findings highlight the need for policy and practice recommendations for perinatal care of women with mobility disabilities.

Healthcare provider perceptions of accessible exam tables in primary care: Implementation and benefits to patients with and without disabilities

“…[2][3][4][5][6][7][8][9] Additionally, multiple providers noted that elderly patients appreciated how the tables could be adjusted. Similarly, providers noted that the width of the tables was conducive to examining obese patients.…”

“…[2][3][4] Lack of adequate accessible equipment can result in fewer preventive screenings and routine visits, delay care, and worsen health outcomes for PWD compared to persons without disability. [5][6][7][8][9] Story and colleagues found that when PWD access care, difficulties such as lack of physical support to transfer onto tables can negatively impact healthcare encounters. 10 These barriers are often compounded for certain disabled populations, including those with obesity.…”

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

“…Women with physical disabilities (WWPD) reported negative attitudes toward them from acquaintances as well as strangers (Iezzoni, Wint, Smeltzer, & Ecker, 2015a; Nosek, Rintala, Howland, Foley, & Bennett, 1995). They have also reported negative attitudes to their pregnancy on the part of health care clinicians and lack of knowledge about their needs related to pregnancy (Begley et al, 2009; Mitra et al, 2016b; Nosek et al, 1995). Women with disabilities have described inaccessible health care settings, including hospital rooms and clinical offices, and absence of adjustable tables and scales needed to obtain weights if they have limited mobility or are wheelchair users (Iezzoni, Wint, Smeltzer & Ecker, 2015b).…”

“…Women with disabilities have described inaccessible health care settings, including hospital rooms and clinical offices, and absence of adjustable tables and scales needed to obtain weights if they have limited mobility or are wheelchair users (Iezzoni, Wint, Smeltzer & Ecker, 2015b). Additional issues identified by WWPD include their need for information about the interaction of their disability and pregnancy, and for knowledgeable health care clinicians who are sensitive to their needs and respectful of their desire to become parents (Mitra et al, 2016b; Smeltzer, 2007a). …”

“…Negative attitudes, behaviors, and lack of awareness and insensitivity to the needs of women with disabilities during pregnancy (Mitra et al, 2016b; Nosek et al, 1995; Smeltzer, 2007a) have been identified as barriers that are often even more difficult to overcome than the physical barriers (Schopp, Sanford, Hagglund, Gay, & Coatney, 2002). …”