Linda Long-Bellil1, Monika Mitra2, Lisa I Iezzoni3, Suzanne C Smeltzer4, Lauren D Smith5. 1. Center for Health Policy and Research, University of Massachusetts Medical School, 333 South Street, Shrewsbury, MA, 01545, United States. Electronic address: linda.long@umassmed.edu. 2. Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, 02453, United States. Electronic address: mmitra@brandeis.edu. 3. Harvard Medical School, The Mongan Institute for Health Policy, Massachusetts General Hospital, 50 Staniford Street, Room 901B, Boston, MA, 02114, United States. Electronic address: liezzoni@partners.org. 4. Center for Nursing Research, Villanova University College of Nursing, 800 Lancaster Avenue, Villanova, PA, 190895, United States. Electronic address: Suzanne.smeltzer@villanova.edu. 5. The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, 02453, United States. Electronic address: smithL@brandeis.edu.
Abstract
BACKGROUND: Childbirth is widely acknowledged as one of the most painful experiences most women will undergo in their lifetimes. Alleviating labor and delivery pain for women with physical disabilities can involve an additional level of complexity beyond that experienced by most women, but little research has explored their experiences. OBJECTIVE: The purpose of this study was to explore the experiences of women with physical disabilities with respect to pain relief during labor and delivery with the goal of informing their care. METHODS: Data were collected using semi-structured interviews with twenty-five women with physical disabilities from across the United States. RESULTS: Women expressed specific preferences for the method of pain relief. Some confronted systemic barriers in exploring their options for pain relief, while others were given a choice. At times, anesthesiologists lacked knowledge and experience in caring for women with disabilities. Conversely, some women described how the administration of anesthesia was meticulously planned and attributed their positive labor and delivery experiences to this careful planning. CONCLUSIONS: Advanced, individualized planning and evaluation of their options for pain relief was most satisfying to women and enabled them to make an informed choice. This approach is consistent with the recommendations of clinicians who have successfully provided pain relief during labor to women with complex physical disabilities. Clinicians who have successfully delivered babies of women with these and similar disabilities emphasize the importance of a team approach where the anesthesiologist and other specialists are involved early on in a woman's care.
BACKGROUND: Childbirth is widely acknowledged as one of the most painful experiences most women will undergo in their lifetimes. Alleviating labor and delivery pain for women with physical disabilities can involve an additional level of complexity beyond that experienced by most women, but little research has explored their experiences. OBJECTIVE: The purpose of this study was to explore the experiences of women with physical disabilities with respect to pain relief during labor and delivery with the goal of informing their care. METHODS: Data were collected using semi-structured interviews with twenty-five women with physical disabilities from across the United States. RESULTS:Women expressed specific preferences for the method of pain relief. Some confronted systemic barriers in exploring their options for pain relief, while others were given a choice. At times, anesthesiologists lacked knowledge and experience in caring for women with disabilities. Conversely, some women described how the administration of anesthesia was meticulously planned and attributed their positive labor and delivery experiences to this careful planning. CONCLUSIONS: Advanced, individualized planning and evaluation of their options for pain relief was most satisfying to women and enabled them to make an informed choice. This approach is consistent with the recommendations of clinicians who have successfully provided pain relief during labor to women with complex physical disabilities. Clinicians who have successfully delivered babies of women with these and similar disabilities emphasize the importance of a team approach where the anesthesiologist and other specialists are involved early on in a woman's care.
Authors: Claire Z Kalpakjian; Heidi J Haapala; Susan D Ernst; Brittany R Orians; Melissa L Barber; Ashley L Wiseman; Lukonde Mulenga; Shannen Bolde; Sara Rosenblum; Gina M Jay Journal: Disabil Health J Date: 2020-12-24 Impact factor: 4.615