We don't know. We've never had anybody like you before: Barriers to perinatal care for women with physical disabilities

Background: While more women with physical disabilities are becoming mothers, many encounter barriers to perinatal care and experience poor outcomes. Little is known about the perinatal care experiences and outcomes of women with physical disabilities in Canada. Objective: This qualitative study sought to understand the perinatal care experiences and outcomes of women with physical disabilities in one Canadian province, with an emphasis on identifying barriers to care. Methods: In-depth interviews were conducted with 13 women with physical disabilities who had given birth in the last 5 years. Follow-up interviews were conducted with 10 of the 13 participants. All interviews were audio-recorded and transcribed verbatim. Data analysis was informed by a constructivist grounded theory approach. Results: Based on analysis of participants' interviews, five themes regarding barriers to care were identified: (1) Inaccessible care settings, (2) Negative attitudes, (3) Lack of knowledge and experience, (4) Lack of communication and collaboration among providers, and (5) Misunderstandings of disability and disability-related needs. Conclusions: Study findings reveal that the perinatal care system is not set up with women with physical disabilities in mind and that barriers to perinatal care may contribute to poor outcomes. More research and training are needed to address barriers to perinatal care for women with physical disabilities. Collaboration among perinatal and disability-related providers and meaningful inclusion of women with physical disabilities in educational initiatives and care plans are vital to improve care experiences and outcomes. (C) 2017 Elsevier Inc. All rights reserved.