Maternal Healthcare Experiences of and Challenges for Women with Physical Disabilities in Low and Middle-Income Countries: A Review of Qualitative Evidence

Abstract

This article reports on the outcomes of a comprehensive review of qualitative research using the Joanna Briggs Institute (JBI) guidelines to guide a systematic approach addressing women with physical disabilities (WWPD)’s access to and utilization of maternal health care services in low and middle-income countries. The article specifically examines existing literature on the experiences and challenges facing WWPD in accessing and utilization of these services during pregnancy, childbirth and the post-natal period. Fifteen studies that met inclusion criteria were identified. Findings from the review highlight that pregnancy and motherhood are meaningful for WWPD in both individual and socio-cultural ways. Multiple challenges facing WWPD were identified, including low self-esteem and confidence, negative responses and lack of family support, problematic experiences of transport, health and other social systems for maternal healthcare of WWPD, and social unacceptance and discrimination from the community. Addressing barriers in accessing healthcare services was perceived as an individual responsibility of WWPD and their families, rather than perceptions that society had a responsibility to act. The reproductive rights of WWPD, particularly expression of sexuality and the right to motherhood needs to be conceptualized beyond individual responsibility. Society needs to eliminate attitudinal and environmental barriers to ensure WWPD can choose to be mothers without threat of discrimination or negative social consequences.

Appendix 1: Example of Searching in CINAHL

	Syntax	Result
S1	Disabled OR disability OR disabilities OR impaired OR impairment OR handicapped OR handicap OR wheelchair	139,804
S2	pregnancy OR pregnant OR “birth delivery” OR birthing OR childbearing OR childbirth OR “maternal care” OR “maternal healthcare” OR “maternal health” OR “maternal services” OR maternity OR “reproductive health” OR “reproductive care” OR “reproductive healthcare” OR “reproductive services” OR motherhood OR parenting OR mothering OR mothers OR parents OR perinatal OR antenatal OR prenatal OR intranatal OR “delivery care” OR “obstetric care” OR postnatal OR postpartum	254,990
S3	Africa OR Asia OR Caribbean OR “West Indies” OR “South America” OR “Latin America” OR “Central America”	34,186
S4	“developing country” OR “developing countries” OR “developing nation” OR “developing nations” OR “developing population” OR “developing populations” OR “developing world” OR “less developed country” OR “less developed countries” OR “less developed nation” OR “less developed nations” OR “less developed population” OR “less developed populations” OR “less developed world” OR “lesser developed country” OR “lesser developed countries” OR “lesser developed nation” OR “lesser developed nations” OR “lesser developed population” OR “lesser developed populations” OR “lesser developed world” OR “Global South” OR “under developed country” OR “under developed countries” OR “under developed nation” OR “under developed nations” OR “under developed population” OR “under developed populations” OR “under developed world” OR “underdeveloped country” OR “underdeveloped countries” OR “underdeveloped nation” OR “underdeveloped nations” OR “underdeveloped population” OR “underdeveloped populations” OR “underdeveloped world” OR “middle income country” OR “middle income countries” OR “middle income nation” OR “middle income nations” OR “middle income population” OR “middle income populations” OR “low income country” OR “low income countries” OR “low income nation” OR “low income nations” OR “low income population” OR “low income populations” OR “lower income country” OR “lower income countries” OR “lower income nation” OR “lower income nations” OR “lower income population” OR “lower income populations” OR “underserved country” OR “underserved countries” OR “underserved nation” OR “underserved nations” OR “underserved population” OR “underserved populations” OR “underserved world” OR “under served country” OR “under served countries” OR “under served nation” OR “under served nations” OR “under served population” OR “under served populations” OR “under served world” OR “deprived country” OR “deprived countries” OR “deprived nation” OR “deprived nations” OR “deprived population” OR “deprived populations” OR “deprived world” OR “poor country” OR “poor countries” OR “poor nation” OR “poor nations” OR “poor population” OR “poor populations” OR “poor world” OR “poorer country” OR “poorer countries” OR “poorer nation” OR “poorer nations” OR “poorer population” OR “poorer populations” OR “poorer world” OR “developing economy” OR “developing economies” OR “less developed economy” OR “less developed economies” OR “lesser developed economy” OR “lesser developed economies” OR “under developed economy” OR “under developed economies” OR “underdeveloped economy” OR “underdeveloped economies” OR “middle income economy” OR “middle income economies” OR “low income economy” OR “low income economies” OR “lower income economy” OR “lower income economies” OR “low gdp” OR “low gnp” OR “low gross domestic” OR “low gross national” OR “lower gdp” OR “lower gnp” OR “lower gross domestic” OR “lower gross national” OR lmic OR lmics OR “third world” OR “lami country” OR “lami countries” OR “transitional country” OR “transitional countries”	19,139
S5	Afghanistan OR Albania OR Algeria OR “American Samoa” OR Angola OR Argentina OR Armenia OR Azerbaijan OR Bangladesh OR Belarus OR Belize OR Benin OR Bhutan OR Bolivia OR Bosnia OR Herzegovina OR Hercegovina OR Botswana OR Brazil OR Brasil OR Bulgaria OR “Burkina Faso” OR “Burkina Fasso” OR Burundi OR Urundi OR “Cabo Verde” OR Cambodia OR Cameroon OR “Central African Republic” OR Chad OR China OR Colombia OR Comoros OR Congo OR “Costa Rica” OR “Côte d’Ivoire” OR Croatia OR Cuba OR Djibouti OR Dominica OR “Dominican Republic” OR Ecuador OR “East Timor” OR Egypt OR “Arab Republic” OR “El Salvador” OR “Equatorial Guinea” OR Eritrea OR Ethiopia OR Fiji OR Gabon OR Gambia OR Georgia OR Ghana OR Grenada OR Guatemala OR Guinea OR Guinea-Bissau OR Guyana OR Haiti OR Honduras OR India OR Indonesia OR Iran OR Iraq OR Jamaica OR Jordan OR Kazakhstan OR Kenya OR Kiribati OR “North Korea” OR Kosovo OR “Kyrgyz Republic” OR Laos OR “Lao PDR” OR Lebanon OR Lesotho OR Liberia OR Libya OR Macedonia OR Madagascar OR Malawi OR Malaysia OR Maldives OR Mali OR “Marshall Islands” OR Mauritania OR Mauritius OR Mexico OR Micronesia OR Moldova OR Mongolia OR Montenegro OR Morocco OR Mozambique OR Myanmar OR Burma OR Namibia OR Nauru OR Nepal OR Nicaragua OR Niger OR Nigeria OR Pakistan OR Panama OR “Papua New Guinea” OR Paraguay OR Peru OR Philippines OR Romania OR Russia OR Russian OR Rwanda OR Samoa OR “São Tomé and Principe” OR Senegal OR Serbia OR “Sierra Leone” OR “Solomon Islands” OR Somalia OR “South Africa” OR Sudan OR “Sri Lanka” OR “St. Lucia” OR “St. Vincent and the Grenadines” OR “Saint Vincent” OR Suriname OR Surinam OR Swaziland OR Syria OR Tajikistan OR Tanzania OR Thailand OR Timor-Leste OR Togo OR Tonga OR Tunisia OR Turkey OR Turkmenistan OR Turkmen OR Tuvalu OR Uganda OR Ukraine OR Uzbekistan OR Uzbek OR Vanuatu OR Venezuela OR Vietnam OR “Viet Nam” OR “West Bank” OR Gaza OR Yemen OR Zambia OR Zimbabwe	177,168
S6	MW in subject heading: developing countries	9796
S7	MW in subject heading: low and middle income countries	155
S8	S3 OR S4 OR S5 OR S6 OR S7	203,033
S9	S1 AND S2 AND S8	917