‘They are my future’: childbearing desires and motivations among women with disabilities in Ghana - implications for reproductive healthcare

Abstract

Background Previous research has highlighted widespread public mis/perceptions that portray women with disabilities (WWDs) as asexual, less likely to marry, and often not interested in childbearing. However, evidence from high-income settings shows that many WWDs are sexually active and do have or want to have children. Notwithstanding this, very few studies have focused on understanding childbearing desires and motivations among WWDs in low-income settings. This qualitative research explored childbearing desires and motivations among WWDs in Ghana. Methods A cross-sectional qualitative study was conducted with WWDs aged 18–49 years in Northern Ghana. The distribution of participants by disability types were as follows: physical disability/impairment (n = 37); visual impairment (n = 11); speech and hearing impairment (n = 14); epilepsy (n = ten); and albinism (n = five). A pre-tested open-ended thematic topic guide was designed and used to conduct in-depth interviews. Interviews were tape-recorded and later transcribed for analysis. Transcripts were coded using QSR NVivo 11 software. Thematic content analysis techniques were used to analyse and present the data. Results Nearly all the WWDs interviewed were sexually active, desiring to have children, and intended to have as many children as they could support. Strong desire to experience the joy of motherhood; fear of social insecurity; fear of old age economic insecurity; desire to challenge stigma and negative stereotypes about disability, sexuality and motherhood; and desire for self-actualisation, were key motivations for childbearing. Conclusion Our findings challenge existing negative public perceptions about the status of WWDs in relation to sexuality, childbearing and motherhood. More importantly, our findings suggest that if the Sustainable Development Goals related to universal access to sexual and reproductive healthcare are to be attained, WWDs must be targeted with quality sexual and reproductive healthcare information and services.

Testing The Effect of an Integrated-Intervention To Promote Access to Sexual and Reproductive Healthcare and Rights Among Women With Disabilities In Ghana: A Quasi-Experimental Study Protocol

“…One-on-one regular SRHRs education, information provision, and referral Support for WWDs at the health facility level is essential but not su cient to guarantee full access to needed SRHRs information and services. As in many low-income settings, disability still carries social stigma in Ghana [22,24]. This often results in limited social support for WWDs, including support to receive healthcare [5,24].…”

“…As in many low-income settings, disability still carries social stigma in Ghana [22,24]. This often results in limited social support for WWDs, including support to receive healthcare [5,24]. We propose to implement a one-on-one regular SRHRs education and information provision, and referral system to help create a supportive system to help WWDs access and use SRH services.…”

“…We propose to implement a one-on-one regular SRHRs education and information provision, and referral system to help create a supportive system to help WWDs access and use SRH services. While a community-wide approach is appealing, evidence from previous research in Ghana show that most decision-making around SRH among WWDs revolves around individual disabled women and their families [22,24]. The idea, therefore, is to match all WWDs enrolled either into the rst arm of the experiment or the third arm to trained community health volunteers (CHVs).…”

“…Meanwhile, recent data shows that rates of sexual activity, need for family planning (FP), and childbirth services among WWDs are comparable to those of non-disabled women [19][20][21]. This challenge is compounded by the fact that research on disability and reproductive health is even far more limited in many low-income contexts, including Africa [5,[22][23][24]. A recent study puts this issue quite bluntly: 'There is a complete lack of published literature in peer reviewed journals on the reproductive health status of women with disabilities' [25].…”

“…One group that has particularly been disadvantaged but has nevertheless received little attention in Ghana is PWDs [22,24]. Approximately 3% of Ghana's population has some disability [27].…”