“Nothing suitable for us”: experiences of women with physical disabilities in accessing maternal healthcare services in Northern Vietnam

Abstract

PURPOSE: This article explores how maternal healthcare access was experienced by women with physical disabilities in Northern Vietnam. METHODS: A qualitative methodology with an interpretive phenomenological design was used. In-depth interviews were conducted with women with physical disabilities who had given birth in the previous three years. Twenty-nine women participated in a first in-depth interview, and 27 women completed follow-up interviews. Physical access audits were also conducted at 14 facilities providing maternal healthcare services. Data were thematically analyzed. RESULTS: The women said they highly valued antenatal care but rarely attended postnatal check-ups. Their decisions around service uptake were influenced by attitudinal barriers from staff, particularly failure to recognize that women with physical disabilities had a right to motherhood and quality maternal healthcare. Specialized information on pregnancy and childbirth for women with physical disabilities was limited. Long waiting times, confusing referral systems, and financial hardship were also significant problems in accessing maternal healthcare. Many healthcare facilities were not disability friendly. CONCLUSIONS: Women with physical disabilities in Northern Vietnam encountered multiple challenges when accessing maternal healthcare services. Many Vietnamese healthcare services are ill-equipped to provide disability-inclusive and responsive maternal healthcare because of inadequate structural design, attitudinal barriers, limited appropriate information, and financial burden. There should be increased attention paid to mainstreaming the needs of women with physical disabilities into maternal healthcare services in Vietnam.Implications for rehabilitationThere is a need for strong and sustained advocacy from all related staff, including rehabilitation workers, to improve the quality of healthcare for pregnant women with physical disabilities in Vietnam.Disability training should be integrated into mainstream in-service courses for maternal healthcare providers and curricula for medical, midwifery and nursing students.A resource package that provides women with physical disabilities with reliable and comprehensive information on disability and pregnancy, childbirth and maternal healthcare should be developed and disseminated.Professional protocols and infrastructure for maternal healthcare for women with physical disabilities should be more sensitive and responsive to their needs and rights.

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