Maternity care experiences of women with physical disabilities: A systematic review

Mariëlle Heideveld-Gerritsen,Maartje Van Vulpen,Martine Hollander,Sabine Oude Maatman,Henrietta Ockhuijsen,Agnes Van Den Hoogen

doi:10.1016/j.midw.2021.102938

Abstract

ObjectiveFifteen percent of the world's population has some form of disability, the most common form being a physical disability. Ten percent of women with disabilities are of childbearing age; however, because women with disabilities are often deemed less likely to have children, accessibility to maternity care is limited. Women with disabilities experience problems during pregnancy and childbirth due to physical barriers and barriers to information, problems with communication and the attitude of providers. A recent World Health Organization statement calls for more action, dialogue, research and advocacy on disrespectful treatment during childbirth. To give substance to this, an overview of the experiences of women with a physical disability is essential. Therefore, the aim of this systematic review is to identify and provide an overview of reported maternity care experiences of women with physical disabilities, including sensory disabilities. DesignThis systematic review was conducted using a meta-aggregation approach for synthesis and the steps of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The search strategy focused on qualitative studies in the databases PubMed, Embase and CINAHL. The Critical Appraisal Skills Programme checklist was used to evaluate methodological quality, and a best-evidence synthesis was performed. FindingsOf the 4,486 studies screened, ten were included. The methodological quality of the studies ranged from high to moderate. The results indicated that women experience barriers related to accessibility of facilities, adapted equipment, lack of knowledge, and healthcare providers' dismissals of their concerns and unwillingness to assist. In contrast, support has a positive influence on women's experiences. Key conclusions and implications for practiceThere is evidence that women with physical disabilities continue to encounter barriers in accessing maternity care related to inaccessible care settings, lack of knowledge and the attitude of healthcare providers. Healthcare providers should be trained to be aware of women's special needs and to improve clinical practice.

Highlights

Worldwide, more than one billion people, or fifteen percent of the world’s population, have some type of disability (World Health Organization, 2011a; World Health Organization and World Bank, 2011)
This review describes commonly reported experiences to address these barriers in clinical practice
Eleven articles focused on pregnancy or childbirth and not on maternity care

Summary

Introduction

More than one billion people, or fifteen percent of the world’s population, have some type of disability (World Health Organization, 2011a; World Health Organization and World Bank, 2011). Disabled people belong to the largest minority group (World Health Organization, 2018). According to the World Health Organization (WHO), disabilities are ‘an umbrella term, covering impairments, activity limitations and participation restrictions’. The main categories of disabilities are intellectual, cognitive, neurological, psychiatric, physical and sensory. Physical disabilities are the most common (Government of Western Australia Department of communities Disability Services, 2015). A physical disability can be defined as ‘a longterm loss or impairment of a person’s body function, resulting in limited mobility, endurance, dexterity or physical function’ (GPII DeveloperSpace, 2019). Physical disabilities are known as sensory disabilities if they affect sight, speech, hearing or language (DomusVi, 2019)

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