Suzanne C. Smeltzer, Ed.D., R.N. , Monika Mitra, Ph.D., Linda Long-Bellil, Ph.D., J.D., Lisa I. Iezzoni, M.D., M.Sc., Lauren D. Smith, M.P.H.
Disability and Health Journal, Volume 11, Issue 1, January 2018, Pages 8-13
Women with physical disabilities (WPD) experience major barriers to care during pregnancy. Lack of education about disability in health professionals’ education is a pervasive barrier to quality care. In an effort to explore this issue, this study examined the issue from the perspective of obstetric clinicians who provide care to WPD.
This qualitative descriptive study explored perspectives of obstetric clinicians who provide perinatal care for WPD to inform the educational preparation of clinicians to care for women with disabilities.
We contacted 33 obstetric clinicians who care for pregnant WPD. Thirteen obstetricians and one nurse midwife participated in semi-structured telephone interviews. Interview transcriptions were content analyzed to identify initial themes. Investigators discussed and revised the themes as additional transcripts were reviewed and new themes were identified.
Themes identified from transcript analyses included: lack of education at any level including during postgraduate residency and fellowship on care of pregnant WPD, unplanned career pathway, educating other clinicians, and positive and negative experiences providing obstetrical care to women with physical disability. Several clinicians provided this care because of requests from other clinicians and did not begin their careers with the goal of providing obstetric care to women with physical disabilities. None had received formal education or training including during their residencies or fellowships. The clinicians described very rewarding experiences caring for WPD.
The experiences reported by this study’s participants suggest the need to include disability in undergraduate and postgraduate education and training to improve obstetric care to WPD.