Radboud University Medical Center, Post Office Box 9101, 6500 HB Nijmegen, the Netherlands; Utrecht University, Post Office Box 80125, 3508 TC Utrecht, the Netherlands.
Radboud University Medical Center, Post Office Box 9101, 6500 HB Nijmegen, the Netherlands.
Midwifery. 2021 May;96:102938. doi: 10.1016/j.midw.2021.102938. Epub 2021 Feb 10.
Fifteen percent of the world's population has some form of disability, the most common form being a physical disability. Ten percent of women with disabilities are of childbearing age; however, because women with disabilities are often deemed less likely to have children, accessibility to maternity care is limited. Women with disabilities experience problems during pregnancy and childbirth due to physical barriers and barriers to information, problems with communication and the attitude of providers. A recent World Health Organization statement calls for more action, dialogue, research and advocacy on disrespectful treatment during childbirth. To give substance to this, an overview of the experiences of women with a physical disability is essential. Therefore, the aim of this systematic review is to identify and provide an overview of reported maternity care experiences of women with physical disabilities, including sensory disabilities.
This systematic review was conducted using a meta-aggregation approach for synthesis and the steps of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The search strategy focused on qualitative studies in the databases PubMed, Embase and CINAHL. The Critical Appraisal Skills Programme checklist was used to evaluate methodological quality, and a best-evidence synthesis was performed.
Of the 4,486 studies screened, ten were included. The methodological quality of the studies ranged from high to moderate. The results indicated that women experience barriers related to accessibility of facilities, adapted equipment, lack of knowledge, and healthcare providers' dismissals of their concerns and unwillingness to assist. In contrast, support has a positive influence on women's experiences.
There is evidence that women with physical disabilities continue to encounter barriers in accessing maternity care related to inaccessible care settings, lack of knowledge and the attitude of healthcare providers. Healthcare providers should be trained to be aware of women's special needs and to improve clinical practice.
世界上 15%的人口有某种形式的残疾，最常见的形式是身体残疾。10%的残疾女性处于生育年龄；然而，由于残疾女性被认为不太可能生育，因此获得产妇保健的机会有限。残疾妇女在怀孕和分娩期间会遇到身体障碍和信息障碍、沟通问题以及提供者的态度等问题。世界卫生组织最近的一份声明呼吁在分娩过程中对不尊重行为采取更多行动、对话、研究和宣传。为此，必须概述残疾妇女的生育经历。因此，本系统评价的目的是确定并概述身体残疾妇女（包括感官残疾妇女）报告的产妇保健经历。
本系统评价采用元聚合方法进行综合，并遵循系统评价和荟萃分析的首选报告项目（PRISMA）声明的步骤。检索策略侧重于在 PubMed、Embase 和 CINAHL 数据库中进行定性研究。使用批判性评估技能计划清单评估方法学质量，并进行最佳证据综合。
在筛选出的 4486 项研究中，有 10 项研究被纳入。研究的方法学质量从高到中不等。结果表明，妇女在获得设施、适应性设备、知识缺乏以及医疗保健提供者对其关注和协助意愿的不屑等方面面临障碍。相比之下，支持对妇女的经历有积极影响。
有证据表明，身体残疾妇女在获得与无障碍护理环境、缺乏知识和医疗保健提供者态度相关的产妇保健方面仍然面临障碍。应培训医疗保健提供者，使其意识到妇女的特殊需求，并改善临床实践。
