"It is challenging to face the judgmental gazes": women with physical disability and perinatal care-seeking in rural Ethiopia: a qualitative case study.

PURPOSE: We explored access to perinatal care for women with physical disability in East Dembia Woreda, Ethiopia, where evidence for inclusive perinatal care and policy is lacking.

MATERIALS AND

METHODS

Instrumental case study was conducted using semi-structured interviews, document reviews, and field notes. Twelve women with physical disability, seven healthcare providers, and five close persons were interviewed. Policies and care guidelines were also reviewed. We analyzed data using reflexive thematic analysis and triangulated across data sources.

RESULTS

We present the theme "Journeys to Motherhood: Reactions, Community Perceptions, and Information Sources Influence Motherhood for Women with Physical Disability." This theme captured how emotional reactions to pregnancy, community perceptions, and information sources shaped motherhood journeys of women with physical disability and ultimately perinatal care-seeking. Some participants were motivated to seek care, desiring disability-free child, while unplanned pregnancies delayed pregnancy acceptance and care-seeking. Support from close persons facilitated care-seeking, whereas stigma and limited engagement from community-based health workers discouraged service use and increased reliance on peers for information.

CONCLUSION

Women with physical disability faced psychosocial, informational, and structural barriers when seeking perinatal care services. Improving access requires disability-responsive services, including preconception and mental health supports, alongside training healthcare providers and community-based stigma-reduction efforts.