Our objective was to assess patient and provider perspectives regarding barriers to appropriate reproductive healthcare for women with physical disabilities.METHODS:
We recruited women with physical disabilities and obstetrics and gynecology (ob/gyn) providers who care for this population at two teaching hospitals. Participants completed 30-minute in-depth, semi-structured interviews using qualitative methodology. Domains of communication, accessibility, ob/gyn care, and provider training were explored. Interviews were professionally transcribed and independently coded by 3 investigators. Investigators independently read through coded interviews to identify themes. Analysis was supported with qualitative data analysis software (NVivo 10.0). We expected that recruitment of 25 patient participants and 20 provider participants would allow saturation of thematic content.RESULTS:
We interviewed 28 women with physical disabilities and 20 providers. Providers' knowledge with regard to this population was based primarily on personal experience. Many patients had instructed their providers in transfer technique and alternative positions for examinations. Physicians worried about time constraints in caring for this population. However, patients did not describe feeling rushed at appointments, and appreciated detailed counseling relevant to their care. Both patients and providers discussed the difficulty in maneuvering within small exam rooms, and difficulty with transfers on and off gynecologic exam tables.CONCLUSION:
Formal training for ob/gyn providers in the care of women with physical disabilities may be warranted. Providers and patients felt that medical facilities should be better equipped to accommodate women with physical disabilities. This research will inform future quantitative observational research as well as interventions to improve the reproductive health experience for women with disabilities.