Advertisement

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

  • Thi Vinh NguyenEmail author
  • Julie King
  • Niki Edwards
  • Cong Tuan Pham
  • Michael Dunne
Original Paper

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.

Keywords

Women with physical disabilities Pregnancy Childbirth Maternal healthcare Low and middle-income countries Multi-country review 

Notes

Acknowledgements

The first author was supported by a Ph.D. scholarship from Queensland University of Technology.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

This review used qualitative data from published articles and research reports. Among 15 included studies, 11 studies mentioned that the studies got ethical approval, and four studies did not mention ethical approval.

References

  1. 1.
    UNFPA: A Situational Analysis of the Sexual and Reproductive Health of Women with Disabilities (2009). http://wwda.org.au/wp-content/uploads/2013/12/UNFPA_Repro_wwd1.pdf. Accessed 15 Mar 2018
  2. 2.
    Frohmader, C., Ortoleva, S.: Issues Paper The Sexual and Reproductive Rights of Women and Girls with Disabilities ICPD 2014: International Conference on Human Rights (2013)Google Scholar
  3. 3.
    Do, T.T., Nguyen, H.H.: Opportunities to love and sexuality from women with disabilities perspective (Cơ hộ i để có tình yêu, tình dục từ góc nhìn của những phụ nữ khuyết tật). Monogr. Sex. Gend. Health 22 (2011)Google Scholar
  4. 4.
    UNFPA: Emerging issues: sexual and reproductive health of persons with disabilities. New York, UNFPA (2007). ISBN# 978-0-89714-868-9Google Scholar
  5. 5.
    Shakespeare, T., Gillespie-Sells, K., Davies, D.: The Sexual Politics of Disability: Untold Desires, pp. 206–209. Burns and Oates, London (1996)Google Scholar
  6. 6.
    Iezzoni, L.I., et al.: Prevalence of current pregnancy among US women with and without chronic physical disabilities. Med. Care 51(6), 555–562 (2013)CrossRefGoogle Scholar
  7. 7.
    Iezzoni, L.I., et al.: Effects of disability on pregnancy experiences among women with impaired mobility. Acta Obstet. Gynecol. Scand. 94(2), 133–140 (2015)CrossRefGoogle Scholar
  8. 8.
    Morton, C., et al.: Pregnancy outcomes of women with physical disabilities: a matched cohort study. PM&R 5(2), 90–98 (2013)CrossRefGoogle Scholar
  9. 9.
    Smeltzer, S.C.: Pregnancy in women with physical disabilities. J. Obstet. Gynecol. Neonatal Nurs. 36(1), 88–96 (2007)CrossRefGoogle Scholar
  10. 10.
    Horner-Johnson, W., et al.: Pregnancy among US women: differences by presence, type, and complexity of disability. Am. J. Obstet. Gynecol. 214(4), 529. e1–529. e9 (2016)CrossRefGoogle Scholar
  11. 11.
    Lee, E.-K.O., Oh, H.: A wise wife and good mother: reproductive health and maternity among women with disability in South Korea. Sex. Disabil. 23(3), 121–144 (2005)CrossRefGoogle Scholar
  12. 12.
    Iezzoni, L.I., et al.: Conditions causing disability and current pregnancy among US women with chronic physical disabilities. Med. Care 52(1), 20–25 (2014)CrossRefGoogle Scholar
  13. 13.
    Tarasoff, L.A.: “We don’t know. We’ve never had anybody like you before”: barriers to perinatal care for women with physical disabilities. Disabil. Health J. 10(3), 426–433 (2017)CrossRefGoogle Scholar
  14. 14.
    Smeltzer, S.C., et al.: Perinatal experiences of women with physical disabilities and their recommendations for clinicians. J. Obstet. Gynecol. Neonatal Nurs. 45(6), 781–789 (2016)CrossRefGoogle Scholar
  15. 15.
    Smith, E., et al.: Barriers to accessing safe motherhood and reproductive health services: the situation of women with disabilities in Lusaka, Zambia. Disabil. Rehabil. 26(2), 121–127 (2004)CrossRefGoogle Scholar
  16. 16.
    Gavin, N.I., Benedict, M.B., Adams, E.K.: Health service use and outcomes among disabled Medicaid pregnant women. Women’s Health Issues 16(6), 313–322 (2006)CrossRefGoogle Scholar
  17. 17.
    Mitra, M., et al.: Maternal characteristics, pregnancy complications, and adverse birth outcomes among women with disabilities. Med. Care 53(12), 1027–1032 (2015)CrossRefGoogle Scholar
  18. 18.
    Šumilo, D., et al.: Prevalence and impact of disability in women who had recently given birth in the UK. BMC Pregnancy Childbirth 12(1), 31 (2012)CrossRefGoogle Scholar
  19. 19.
    Malouf, R., Henderson, J., Redshaw, M.: Access and quality of maternity care for disabled women during pregnancy, birth and the postnatal period in England: data from a national survey. BMJ Open 7(7), e016757 (2017)CrossRefGoogle Scholar
  20. 20.
    Lim, N.G., et al.: Pregnancy, prenatal care, and delivery of mothers with disabilities in Korea. J. Korean Med. Sci. 30(2), 127–132 (2015)CrossRefGoogle Scholar
  21. 21.
    UN: Convention on the Rights of Persons with disabilities, g. Assembly, Editor. (2006) UNGoogle Scholar
  22. 22.
    UN: Convention on the Elimination of All Forms of Discrimination Against Women (1979)Google Scholar
  23. 23.
    WHO and World Bank: World Report on Disability. http://www.who.int/disabilities/world_report/2011/en/ (2011). Accessed 26 Feb 2018
  24. 24.
    Lawler, D., Lalor, J., Begley, C.: Access to maternity services for women with a physical disability: a systematic review of the literature. Int. J. Childbirth 3(4), 203–217 (2013)CrossRefGoogle Scholar
  25. 25.
    Tarasoff, L.A.: Experiences of women with physical disabilities during the perinatal period: a review of the literature and recommendations to improve care. Health Care Women Int. 36(1), 88–107 (2015)CrossRefGoogle Scholar
  26. 26.
    Joanna Briggs Institute: Reviewers’ Manual, 2014th edn. JBI, Adelaide (2014)Google Scholar
  27. 27.
    World Bank: World Bank Country and Lending Groups. https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups (2018). Accessed 8 Mar 2018
  28. 28.
    Ahumuza, S.E., et al.: Challenges in accessing sexual and reproductive health services by people with physical disabilities in Kampala, Uganda. Reprod. Health 11(1), 59 (2014)CrossRefGoogle Scholar
  29. 29.
    Boonpiam, N.: Experience of Motherhood Among Women with Physical Disability in Thailand, in Faculty of Graduate Studies. Mahidol University, Thailand (2006)Google Scholar
  30. 30.
    Bremer, K., Cockburn, L., Ruth, A.: Reproductive health experiences among women with physical disabilities in the Northwest Region of Cameroon. Int. J. Gynaecol. Obstet. 108(3), 211–213 (2010)CrossRefGoogle Scholar
  31. 31.
    Dean, L., et al.: ‘You’re disabled, why did you have sex in the first place?’ An intersectional analysis of experiences of disabled women with regard to their sexual and reproductive health and rights in Gujarat State, India. Glob. Health Action 10, 1290316 (2017)CrossRefGoogle Scholar
  32. 32.
    da Silva, Fernandes, Carvalho, C., de Santana, R., Brito, R.S.D.: The support network in pregnancy and childbirth: the conceptions of women with physical disability. Texto & Contexto Enfermagem 25(2), 1–8 (2016)Google Scholar
  33. 33.
    Ganle, J.K., et al.: Challenges women with disability face in accessing and using maternal healthcare services in Ghana: a qualitative study. PLoS ONE 11(6), e0158361 (2016)CrossRefGoogle Scholar
  34. 34.
    Ledger, L., et al.: Access to maternal and newborn health services for women with disabilities in Timor-Leste. 2016, CBM Australia; Nossal Institute for Global Health, University of Melbourne; Ra’es Hadomi Timor Oan: AustraliaGoogle Scholar
  35. 35.
    Mavuso, S.S., Maharaj, P.: Access to sexual and reproductive health services: experiences and perspectives of persons with disabilities in Durban, South Africa. Agenda Empower. Women Gend. Equity 29(2), 79–88 (2015)Google Scholar
  36. 36.
    Morrison, J., et al.: Disabled women׳s maternal and newborn health care in rural Nepal: a qualitative study. Midwifery 30(11), 1132–1139 (2014)CrossRefGoogle Scholar
  37. 37.
    An, N.T.T.: Sexual and reproductive health of people living with physical disabilities in Ho Chi Minh City, Vietnam. Masters dissertation. La Trobe University, Australia (2016)Google Scholar
  38. 38.
    Peta, C.: Disability is not asexuality: the childbearing experiences and aspirations of women with disability in Zimbabwe. Reprod. Health Matters 25(50), 10–19 (2017)CrossRefGoogle Scholar
  39. 39.
    Rugoho, T., Maphosa, F.: Challenges faced by women with disabilities in accessing sexual and reproductive health in Zimbabwe: the case of Chitungwiza town. Afr. J. Disabil. 6, 252 (2017)CrossRefGoogle Scholar
  40. 40.
    Tanabe, M., et al.: Intersecting sexual and reproductive health and disability in humanitarian settings: risks, needs, and capacities of refugees with disabilities in Kenya, Nepal, and Uganda. Sex. Disabil. 33(4), 411–427 (2015)CrossRefGoogle Scholar
  41. 41.
    Tefera, B., et al.: The grace of motherhood: disabled women contending with societal denial of intimacy, pregnancy, and motherhood in Ethiopia. Disabil. Soc. 32(10), 1510–1533 (2017)CrossRefGoogle Scholar
  42. 42.
    Hemingway, L.: Disabled People and Housing: Choices, Opportunities and Barriers. Policy Press, Bristol (2011)CrossRefGoogle Scholar
  43. 43.
    Rioux, M., Valentine, F.: Does theory matter? Exploring the nexus between disability, human rights, and public policy. In: Pothier, D., Devlin, R. (eds) Critical Disability Theory: Essays in Philosophy, Politics, Policy, and Law, pp. 47–69 (2006)Google Scholar
  44. 44.
    Oliver, M.: Understanding Disability: From Theory to Practice. St Martin’s Press, New York (1996)CrossRefGoogle Scholar
  45. 45.
    Shakespeare, T.: The social model of disability. Disabil. Stud. Read. 2, 197–204 (2006)Google Scholar
  46. 46.
    Darney, B.G., et al.: Primary Cesarean delivery patterns among women with physical, sensory, or intellectual disabilities. Womens Health Issues 27(3), 336–344 (2017)CrossRefGoogle Scholar
  47. 47.
    Grue, L., Lærum, K.T.: ‘Doing motherhood’: some experiences of mothers with physical disabilities. Disabil. Soc. 17(6), 671–683 (2002)CrossRefGoogle Scholar
  48. 48.
    Walsh-Gallagher, D., Sinclair, M., Mc Conkey, R.: The ambiguity of disabled women’s experiences of pregnancy, childbirth and motherhood: a phenomenological understanding. Midwifery 28(2), 156–162 (2012)CrossRefGoogle Scholar
  49. 49.
    Prilleltensky, O.: A ramp to motherhood: the experiences of mothers with physical disabilities. Sex. Disabil. 21(1), 21–47 (2003)CrossRefGoogle Scholar
  50. 50.
    Schildberger, B., Zenzmaier, C., König-Bachmann, M.: Experiences of Austrian mothers with mobility or sensory impairments during pregnancy, childbirth and the puerperium: a qualitative study. BMC Pregnancy Childbirth 17(1), 201 (2017)CrossRefGoogle Scholar
  51. 51.
    McKay-Moffat, S., Cunningham, C.: Service for women with disabilities: mothers’ and midwives’ experiences. Br. J. Midwifery 14(8), 472–477 (2006)CrossRefGoogle Scholar
  52. 52.
    Powell, R.M., et al.: Family attitudes and reactions toward pregnancy among women with physical disabilities. Women’s Health Issues 27(3), 345–350 (2017)CrossRefGoogle Scholar
  53. 53.
    Rosenthal, E.: The Rights of Children with Disabilities in Viet Nam. In Bringing Viet Nam’s Laws into compliance with the UN Convention on the Rights of Persons with Disabilities. Report prepared for UNICEF by Eric Rosenthal and Mental Disability Rights International. 2009Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of Public Health and Social Work, Faculty of HealthQueensland University of TechnologyBrisbaneAustralia
  2. 2.Centre for Environment and Population HealthGriffith UniversityBrisbaneAustralia
  3. 3.Institute for Community Health ResearchHue UniversityHueViet Nam

Personalised recommendations