Physical Accessibility of Routine Prenatal Care for Women with Mobility Disability.
BACKGROUND
Routine prenatal care includes physical examinations and weight measurement. Little is known about whether access barriers to medical diagnostic equipment, such as examination tables and weight scales, affect prenatal care among pregnant women with physical disabilities.


METHODS
We conducted 2-hour, in-depth telephone interviews with 22 women using a semistructured, open-ended interview protocol. All women had significant mobility difficulties before pregnancy and had delivered babies within the prior 10 years. We recruited most participants through social networks. We sorted interview transcript texts using used NVivo software and conducted conventional content analyses to identify major themes.


RESULTS
Interviewee's mean (standard deviation) age was 34.8 (5.3) years. Most were white, well-educated, and higher income; 8 women had spinal cord injuries, 4 cerebral palsy, and 10 had other conditions; 18 used wheeled mobility aids. Some women's obstetricians had height adjustable examination tables, which facilitated transfers for physical examinations. Other women had difficulty transferring onto fixed height examination tables and were examined while sitting in their wheelchairs. Family members and/or clinical staff sometimes assisted with transfers; some women reported concerns about transfer safety. No women reported being routinely weighed on an accessible weight scale by their prenatal care clinicians. A few were never weighed during their pregnancies.


CONCLUSIONS
Inaccessible examination tables and weight scales impede some pregnant women with physical disabilities from getting routine prenatal physical examinations and weight measurement. This represents substandard care. Adjustable height examination tables and wheelchair accessible weight scales could significantly improve care and comfort for pregnant women with physical disabilities.
1 Mongan Institute for Health Policy, Massachusetts General Hospital , Boston, Massachusetts.|3 Department of Medicine, Harvard Medical School , Boston, Massachusetts.
Lisa I
LI
Iezzoni
1 Mongan Institute for Health Policy, Massachusetts General Hospital , Boston, Massachusetts.
Amy J
AJ
Wint
5 Center for Nursing Research, Villanova University College of Nursing , Villanova, Pennsylvania.
Suzanne C
SC
Smeltzer
2 Department of Obstetrics and Gynecology, Massachusetts General Hospital , Boston, Massachusetts.|4 Department of Obstetrics and Gynecology, Harvard Medical School , Boston, Massachusetts.
Jeffrey L
JL
Ecker
D000328:Adult; D006233:Persons with Disabilities; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D051346:Mobility Limitation; D011247:Pregnancy; D037841:Pregnant People; D011295:Prenatal Care; D012959:Socioeconomic Factors; D014910:Wheelchairs