LaPierre Tracey A, Zimmerman Mary K, Hall Jean P
Department of Sociology, University of Kansas, 1415 Jayhawk Blvd., Room 716, Lawrence, KS 66045-7540, USA; Department of Health Policy and Management, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
Department of Health Policy and Management, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
Disabil Health J. 2017 Jul;10(3):419-425. doi: 10.1016/j.dhjo.2017.02.011. Epub 2017 Apr 6.
Women with disabilities report fewer pregnancies than those without disabilities.
To explore the range of factors involved in pregnancy decision-making among women with disabilities, and give insight into the decision making process.
Data were obtained from 4 focus groups conducted with 22 women of child-bearing age, who had a chronic physical or mental health condition or disability that influenced their pregnancy decisions. Group transcripts were analyzed using conventional content analysis to identify the types of factors that influence pregnancy decisions and themes related to pregnancy decision-making.
Most had a strong desire for motherhood, although there were varied decisions and some ambivalence over whether or not to attempt pregnancy. Decisions were influenced by an interplay of biomedical, social and personal factors that shaped assessments of three key areas of consideration: importance, feasibility, and costs of pregnancy/motherhood.
It is not just the 'biomedical facts' of health conditions that are relevant, but rather the meaning attributed to these facts and how they are weighed in relation to other significant non-medical factors. By moving beyond the medical model of disability to recognize the importance of social and personal factors, and engaging in patient-centered communication, healthcare providers can facilitate pregnancy decision-making that is consistent with the values and preferences of women with disabilities and improve quality of care and support. In order to make motherhood a more viable option for women with disabilities, societal attitudes and a lack of role models for these women also need to be addressed.
残疾女性报告的怀孕次数少于非残疾女性。
探讨残疾女性怀孕决策中涉及的一系列因素，并深入了解决策过程。
从4个焦点小组收集数据，这些小组由22名育龄女性组成，她们患有慢性身心健康状况或残疾，这些状况影响了她们的怀孕决策。使用常规内容分析法对小组记录进行分析，以确定影响怀孕决策的因素类型以及与怀孕决策相关的主题。
大多数人有强烈的做母亲的愿望，尽管对于是否尝试怀孕有不同的决定和一些矛盾心理。决策受到生物医学、社会和个人因素相互作用的影响，这些因素塑造了对三个关键考虑领域的评估：怀孕/做母亲的重要性、可行性和成本。
相关的不仅仅是健康状况的“生物医学事实”，而是赋予这些事实的意义以及它们如何与其他重要的非医学因素相权衡。通过超越残疾医学模式，认识到社会和个人因素的重要性，并进行以患者为中心的沟通，医疗保健提供者可以促进符合残疾女性价值观和偏好的怀孕决策，并提高护理和支持质量。为了使做母亲对残疾女性来说是一个更可行的选择，还需要解决社会态度以及这些女性缺乏榜样的问题。
