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加拿大安大略省残疾生育者的产前保健体验。

Prenatal Care Experiences of Childbearing People With Disabilities in Ontario, Canada.

出版信息

J Obstet Gynecol Neonatal Nurs. 2023 May;52(3):235-247. doi: 10.1016/j.jogn.2023.02.001. Epub 2023 Mar 17.

DOI:10.1016/j.jogn.2023.02.001
PMID:36940781
Abstract

OBJECTIVE

To explore the care experiences of childbearing people with physical, sensory, and/or intellectual/developmental disabilities during pregnancy.

DESIGN

Descriptive qualitative.

SETTING

Ontario, Canada, where physician and midwifery care during pregnancy are provided at no direct cost to residents.

PARTICIPANTS

Thirty-one people with physical, sensory, and/or intellectual/developmental disabilities (who self-identified as cisgender women [n = 29] and trans or nonbinary persons [n = 2]) who gave birth in the last 5 years.

METHODS

We recruited childbearing people with disabilities through disability and parenting organizations, social media, and our team's networks. Using a semistructured guide, we conducted in-person and virtual (e.g., telephone or Zoom) interviews with childbearing people with disabilities in 2019 to 2020. We asked participants about the services they accessed during pregnancy and if services met their needs. We used a reflexive thematic analysis approach to analyze interview data.

RESULTS

Across disability groups, we identified four common themes: Unmet Accommodation Needs, Lack of Coordinated Care, Ableism, and Advocacy as a Critical Resource. We found that these experiences manifested in unique ways based on disability type.

CONCLUSION

Our findings suggest the need for accessible, coordinated, and respectful prenatal care for people with disabilities, with the requirements of such care depending on the needs of the individual person with a disability. Nurses can play a key role in identifying the needs and supporting people with disabilities during pregnancy. Education and training for nurses, midwives, obstetricians, and other prenatal care providers should focus on disability-related knowledge and respectful prenatal care.

摘要

目的

探索妊娠期间身体、感官和/或智力/发育障碍的生育者的护理体验。

设计

描述性定性研究。

地点

加拿大安大略省,该省向居民提供免费的医生和助产士孕期护理。

参与者

31 名身体、感官和/或智力/发育障碍的生育者(自我认同为顺性别女性[29 人]和跨性别或非二元性别者[2 人]),他们在过去 5 年内分娩。

方法

我们通过残疾和育儿组织、社交媒体以及我们团队的网络招募残疾生育者。在 2019 年至 2020 年期间,我们使用半结构化指南对残疾生育者进行了面对面和虚拟(如电话或 Zoom)访谈。我们询问了参与者在怀孕期间所获得的服务,以及这些服务是否满足他们的需求。我们使用反思性主题分析方法对访谈数据进行分析。

结果

在不同的残疾群体中,我们确定了四个共同的主题:未满足的适应需求、缺乏协调的护理、残疾歧视以及倡导是一个关键资源。我们发现,这些体验根据残疾类型以独特的方式表现出来。

结论

我们的研究结果表明,残疾人生育者需要获得可及、协调和尊重的产前护理,而这种护理的要求取决于个人残疾者的需求。护士可以在识别需求和在怀孕期间为残疾人生育者提供支持方面发挥关键作用。护士、助产士、产科医生和其他产前护理提供者的教育和培训应侧重于与残疾相关的知识和尊重性的产前护理。

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