Mitra Monika, Akobirshoev Ilhom, Moring Nechama Sammet, Long-Bellil Linda, Smeltzer Suzanne C, Smith Lauren D, Iezzoni Lisa I
1 The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University , Waltham, Massachusetts.
2 Center for Health Policy and Research, University of Massachusetts Medical School , Shrewsbury, Massachusetts.
J Womens Health (Larchmt). 2017 Dec;26(12):1356-1363. doi: 10.1089/jwh.2016.6297. Epub 2017 Aug 23.
Previous qualitative studies suggest that women with physical disabilities face disability-specific barriers and challenges related to prenatal care accessibility and quality. This study aims to examine the pregnancy and prenatal care experiences and needs of U.S. mothers with physical disabilities and their perceptions of their interactions with their maternity care clinicians.
We conducted the first survey of maternity care access and experiences of women with physical disabilities from 37 states. The survey was disseminated in partnership with disability community agencies and via social media and targeted U.S. women with a range of physical disabilities who had given birth in the past 10 years. The survey included questions regarding prenatal care quality and childbirth and labor experiences.
A total of 126 women with various physical disability types from 37 states completed the survey. Almost half of the respondents (53.2%) reported that their physical disability was a big factor in their selection of a maternity care provider and 40.3% of women reported that their prenatal care provider knew little or nothing about the impact of their physical disability on their pregnancy. Controlling for maternal demographic characteristics and use of mobility equipment, women who reported that their prenatal care provider lacked knowledge of disability and those who felt they were not given adequate information were more likely to report unmet needs for prenatal care.
The findings from this study suggest the need for training and education for clinicians regarding the prenatal care needs of women with physical disabilities.
先前的定性研究表明，身体残疾的女性在获得产前护理的可及性和质量方面面临与残疾相关的特定障碍和挑战。本研究旨在调查美国身体残疾母亲的怀孕及产前护理经历和需求，以及她们对与产科护理临床医生互动的看法。
我们对来自37个州的身体残疾女性的产科护理可及性和经历进行了首次调查。该调查是与残疾社区机构合作并通过社交媒体进行传播的，目标是过去10年内分娩的患有各种身体残疾的美国女性。调查包括有关产前护理质量以及分娩和产程经历的问题。
来自37个州的126名患有各种身体残疾类型的女性完成了调查。近一半的受访者（53.2%）报告称，她们的身体残疾是选择产科护理提供者的一个重要因素，40.3%的女性报告称，她们的产前护理提供者对其身体残疾对怀孕的影响知之甚少或一无所知。在控制了产妇的人口统计学特征和移动设备的使用情况后，那些报告其产前护理提供者缺乏残疾知识的女性以及那些觉得自己没有得到足够信息的女性更有可能报告有未满足的产前护理需求。
本研究结果表明，需要对临床医生进行关于身体残疾女性产前护理需求的培训和教育。
