Access to, and experiences of, maternity care for women with physical disabilities: A scoping review

Objective: Women with physical disabilities face multiple barriers in accessing safe, respectful and acceptable healthcare. As the number of women with physical disabilities becoming pregnant rises, ensuring their access to acceptable and high-quality maternity care becomes increasingly important. This review aimed to explore the most recent evidence regarding access to, and experiences of, maternity care for women with physical disabilities in high-income countries.

Design: A scoping review was undertaken as guided by the Preferred Reporting Items for Systematic Reviews extension for scoping reviews (PRISMA-ScR). A systematic search of five online databases identified relevant articles published in English from 2000 to 2020. Reference lists of included studies were also screened, and quality was appraised using the Joanna Briggs Institute Checklists. A thematic synthesis was undertaken to develop descriptive and analytical themes.

Findings: After screening, 27 articles from eight high-income countries were included. All articles were identified as having moderate or high methodological rigour in the quality appraisal. Women with physical disabilities reported numerous barriers in accessing maternity care and described predominantly mixed and negative experiences of care. These findings were grouped under three major themes: women with physical disabilities want a "normal" pregnancy experience; the need to strengthen maternity provider's disability knowledge and skills; and promoting enabling environments for improved access to, and experiences of, maternity care.

Key conclusions and implications for practice: This review found that for women with physical disabilities access to, and experiences of, maternity care is suboptimal. Improving maternity providers disability knowledge and awareness, increasing the availability of support services for women, and increasing person-centred care through organisational policies and provider training may help to address the inequities women with disabilities face in accessing high-quality maternity care.