For expectant mothers, routine prenatal care is recommended by obstetricians to monitor both mother and baby’s health during pregnancy. Evaluations of blood pressure, weight, uterine size, and fetal heart activity are all standard practices during prenatal visit.
Doctor Lisa Iezzoni and her colleagues published a study titled “Physical Accessibility of Routine Prenatal Care for Women with Mobility Disability” where 22 women with mobility disabilities who had given birth within the prior 10 years were interviewed about their prenatal care experience. The participants were asked specifically about their experiences with getting onto the examination table and being weighed during their exams. Of the participants, 18 out of 22 are wheelchair users.
Getting Onto the Exam Table
Only 8 of the participants said their doctor’s office had adjustable-height exam tables which made transferring onto the table easier. For those facing fixed-height exam tables they report either not being physically examined during the visit or being examined from their wheelchairs.
While some interviewees said that staff members or family members often helped with transfers, one participant with a spinal cord injury said, ‘‘They kept not transferring me for exams because they told me I had to bring somebody to help transfer.”
Another participant, who has cerebral palsy, says she was dropped three separate times by staff members assisting her during transfers:
“I was about four months pregnant the first time I was dropped. I didn’t know that my center of gravity was off, because I’d never been pregnant before. … What happened was the doctor said she could help me, and then she lost her grip on me. …And I hit right on my belly. About a week later, I started bleeding. …And they took me to the hospital. …They did the ultrasound and everything seemed to be okay, … but I was in the hospital for a week.”
None of the participants report having been provided access to any type of lift (such as a Hoyer lift) to assist with transfers.
Of the study’s 22 participants, none of the women report being routinely weighed on an accessible scale during their prenatal exams, and 4 women say that they were never weighted during their checkups.
“There was never a scale that I could use. I have no idea how much weight I gained in my pregnancy, and that’s usually something that they monitor very closely.”
Another participant with a spinal cord injury was told by her obstetrician’s office that she could go to the post office and ask to be weighed on the cargo scale. While this participant says she thought the office staff was trying to be helpful, the comment “rubbed me slightly the wrong way.”
Other participants resorted to the following methods of weight measurement:
“‘My husband got weighed. And then he held me. And then they weighed us together and deducted my weight.’'” (woman with congenital myasthenai)
“While buying a new wheelchair seat cushion in ninth month of pregnancy, was weighed for the first time. This happened at medical supply store, which had an accessible scale.” (woman with spinal cord injury)
“Weighed on accessible scale in cardiology suite every time before coming to OB appointment.” (woman with spina bifida)
After compiling and analyzing the experiences of the study’s 22 participants, Dr. Iezzoni concluded the following:
“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.”
This study appeared in the Journal of Women’s Health, Volume 24, Number 12, 2015. Thank you to Dr. Iezzoni and her colleagues for sharing this information.
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