title: Effects of disability on pregnancy experiences among women with impaired mobility.
abstract: OBJECTIVE
  Little is known about how functional impairments might affect the pregnancies of women with mobility disability. We aimed to explore complications that arise during pregnancy that are specifically related to physical functional impairments of women with significant mobility disabilities.
  
  
  METHODS
  Qualitative descriptive analysis.
  
  
  METHODS
  Telephone interviews with women from 17 USA states.
  
  
  METHODS
  22 women with significant mobility difficulties who had delivered babies within the prior 10 years; most participants were recruited through social networks.
  
  
  METHODS
  We conducted 2-h, in-depth telephone interviews using a semi-structured, open-ended interview protocol. We used NVIVO software to sort interview transcript texts for conventional content analyses.
  
  
  METHODS
  Functional impairment-related complications during pregnancy.
  
  
  RESULTS
  The women's mean (standard deviation) age was 34.8 (5.3) years. Most were white, well-educated, and higher income; eight women had spinal cord injuries, four cerebral palsy, and 10 had other conditions; 18 used wheeled mobility aids; and 14 had cesarean deliveries (eight elective). Impairment-related complications during pregnancy included: falls; urinary tract and bladder problems; wheelchair fit and stability problems that reduced mobility and compromised safety; significant shortness of breath, sometimes requiring respiratory support; increased spasticity; bowel management difficulties; and skin integrity problems (this was rare, but many women greatly increased skin monitoring during pregnancy to prevent pressure ulcers).
  
  
  CONCLUSIONS
  In addition to other pregnancy-associated health risks, women with mobility disabilities appear to experience problems relating to their functional impairments. Pre-conception planning and in-depth discussions during early pregnancy could potentially assist women with mobility disabilities to anticipate and address these difficulties.
authors.affiliation: Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
authors.forename: Lisa I
authors.initials: LI
authors.lastname: Iezzoni
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Wint
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Smeltzer
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Ecker
mesh_terms: D000328:Adult; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008875:Middle Aged; D051346:Mobility Limitation; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D013119:Spinal Cord Injuries; D013904:Thoracic Vertebrae / Q000293:injuries; D014552:Urinary Tract Infections
keywords: Pregnancy; disability; falls; functional impairment; pressure ulcers; respiratory support; spasticity; wheelchair