Background
Although many women with physical disabilities report poor quality
reproductive health care, little research has addressed labor, delivery, and
anesthesia experiences of these women. This study was conducted to explore
these experiences in women with significant mobility disabilities.
Methods
A qualitative descriptive study was conducted with 22 U.S. women who
had delivered newborns within the prior 10 years. All had significant
mobility disabilities. Two-hour, in-depth telephone interviews were
conducted using a semi-structured, open-ended interview protocol, which
addressed many topics, including labor, delivery and anesthesia experiences.
We recruited most participants through social networks, interviewing women
from 17 states. Conventional content analysis, facilitated by NVivo
software, was used to identify major themes.
Results
The women’s mean age was 34.8 ± 5.3 years. Most women
were white, college-educated, and used wheeled mobility aids. Four key
themes emerged from participants’ narratives of laboring and giving
birth with a disability. These included women’s preferences for type
of delivery; clinicians and some women expected no labor pain; fears
prompting active advocacy, and positive experiences. As participants
discussed their experiences with anesthesia, four additional themes were
identified: importance of consultation with the anesthesia team; decisions
regarding epidural/spinal vs. general anesthesia; failed epidural with
repeated efforts; and fear of injury related to anesthesia.
Conclusions
The responses of women in this study suggest that there is need to
make intrapartum care better for women with physical disabilities and to
improve their experiences with labor, birth and obstetric anesthesia care.