Aims and objectives Due to the scarcity of the evidence based literature for women with physical disabilities, we did case reviews of this group of women in our unit during the last ten years to provide preliminary basis for highlighting the challenges involved in their management.
Methodology/discussion We have had total 46 pregnancies in women with physical disabilities. Total 9 women were wheelchair bound. Eleven were delivered by caesarean section and seven of these women had caesarean section due to their disability. Twenty six had normal vaginal deliveries, two had forceps delivery and seven had miscarriages. Apart from the miscarriages, all the deliveries had reassuringly normal outcome.
Apart from the Obstetric consultant, the multidisciplinary team caring for these women included anaesthetist, haematologist, manual handling team, support workers, ward managers, theatre team and general practitioners. Their carers were also actively involved in their care.
The challenges we encountered were difficulty in scanning due to posture, anaesthetic challenges for both airways/spines, positioning at delivery, bladder care, difficulty in looking after baby and also psychological adaptation for some women but due to the care plans from the multidisciplinary team, we could manage these women well.
Conclusion As a result of recent advances in improved quality of life and life expectancy in patients with physical disabilities, we often see these women attending pre pregnancy and antenatal clinics.
A multidisciplinary care plan, as well as clear and effective communication among different health care providers, will help ensure safe and optimal outcome of these women.
References Pregnancy and disability – Royal College of Nursing guidance for midwives and nurses
Cerebral Palsy – Disability Charity – Scope UK
Pregnancy in Women With Physical Disabilities, JOGNN, 36,88–96;2007
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