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Pregnancy in Women with Physical Disability

The WORLD HEALTH ORGANIZATION defines the term DISABILITY as a consequence of impairments, activity

limitations, participation restrictions, and environmental factors.

In relation to the article Pregnancy in Women with Physical Disability (Smeltzer, 2007), I would rather focus my concern sharing my ideas on women with physical disabilities as to their needs, problems and concerns not only during pregnancy but also during labor and delivery and also after childbirth or during puerperium/postpartum.

In general, women with physical disabilities are stereotyped, forgetting that the reproductive stage that they too are endowed with the capacity to be impregnated, able to carry the products of conception for the whole duration to full term, can go through the process of childbirth and can accept and perform the new roles and responsibilities of a mother beginning at puerperium/postpartum.

Health Care Providers who are not familiar with the health care needs of this group of women should take into consideration the important issues and experiences of these women.

Health care for women with disabilities related to pregnancy, childbearing and puerperium should start with effective and appropriate communication.  Communication addressed and care rendered to women with disabilities should be empowering, strengthens their abilities and should boost their morale for emotional stability.

As mentioned by Misra, Grasen, and Weisman (2000) “women with disabilities should receive preconception counseling to make sure that they are in the healthiest condition giving emphasis on nutritional status, weight control, cessation of smoking and alcohol use, and treatment of any active symptoms or secondary conditions related to disability.”

During the period of Pregnancy Cycle, Santiago (2002); and Nasek et. al., (1977) had identified some barriers which prevent women with disabilities from obtaining prenatal care suitable and appropriate for their condition.  Health Care Providers should take the efforts to improve rendered prenatal care amidst their disabilities so that these pregnant women with disabilities can receive care in a comfortable and dignified manner.  Negative attitudes of Health Care Providers and lack of physical access to equipment of the facility and environments ranked number one among the barriers; hence this serves as an awakening on the part of the Health Care Providers.

Like other women, those with disabilities are often anxious and concerned about the labor and delivery process they are about to experience.  Assessment and care rendered to these patients should not warrant the safety and well-being of a woman and her baby and evaluation and decisions of type of care based on the assessment obtained should be based on sound obstetric indications rather than the mere presence of a disability.

Necessary care during the puerperium/postpartum period rendered to women with disabilities may require longer period of stay in the hospital.  Easy access to her infant should be made possible as suggested by Carty (1998) and Madorsky (1995) for the purpose of establishing feelings of fulfillment on the part of the mother.  Other new roles and responsibilities should be well explained and words of encouragement should be given especially so with breastfeeding providing all the necessary assistance and guidance for these women with disabilities to gain independence in caring for their infants.

Smeltzer’s (2007) concludes that nurses aim to be holistic in their approach to the patients in their care.  Thus, women with disabilities who are pregnant or considering pregnancy should expect that the holistic approach be extended to them, and that clinicians will welcome their legitimate claim to be parents and provide them care and support through their pregnancies, during the labor and delivery processes and the postpartum period.#

By Mrs. Phoebe Bacayana

Director, Reproductive Health Care Center

Aldersgate College