Speaker: Ponsiano Kabakyenga Nuwagaba
Facilitator: Hayat Gommaa
In low- and middle-income countries, several barriers impede utilisation of antenatal care (ANC) services by women with disabilities, yet ANC is a critical entry point for pregnant women to receive quality maternity care services. We investigated the experiences of pregnant women with physical disabilities in utilising ANC services to suggest strategies for improving the services.
Methods: A qualitative study using a multiple case study design was conducted. Twelve women with physical disabilities and six midwives from three health facilities in Sheema District in rural south-western Uganda, were selected as study participants. Women were sampled using snowball sampling. Midwives and health facilities were sampled using purposive sampling. Data was gathered through face-to-face interviews and a focus group discussion between November 2020 to January 2021. Data was transcribed, translated and thematically analysed. Ethical approval was obtained from University of Cape Town and Uganda National Council for Science and Technology. No competing interests declared.
Results: Women had mixed experiences of midwives and other health workers, noting that sometimes midwives would be supportive and other times, they would be unapproachable. Participants felt that midwives had limited knowledge on disability and were emotionally unprepared to attend to pregnant women with disabilities. There were suggestions for disability inclusion, including a dedicated ANC clinic and making connections with stakeholders, for fit-for-purpose ANC services.
Conclusion: Midwives have limited understanding of the implications of physical disability on women’s utilisation of ANC services. Respect for women with disabilities’ dignity and needs should be emphasized in midwifery education and training.
Recording: youtube.com/watch?v=ihQOrbHdI2M
Speaker: Amy Goh, Dia Kapoor, and Anna Nguyen
Facilitator: Olajumoke Ojeleye
Asians and Asian Americans (Asians) have the second highest rate of caesarean birth in the U.S. Asians have the lowest rate of out-of-hospital birth and are low utilizers of midwifery care. This presentation examines cesarean birth amongst Asians who have birthed at U.S. institutions participating in the AABC’s Perinatal Data Registry (PDR).
Methods: Data from the PDR from 2007-2020 was utilized. Logistical regression was completed to determine the odds of cesarean birth for nulliparous and multiparous Asians in medically low-risk and elective hospitals categories.
Results: 2,983 Asian birthing people were sampled. Multiparous birthing people had 1.5 greater odds of caesarean birth compared to nulliparous birthing people (OR = 1.54; 95% CI, 1.19 – 2.03; p .01). The elective hospitalization group had higher adjusted odds of caesarean births compared to the low-risk and total population (OR = 1.54; 95% CI, 1.23 -1.93; p; .01). Nulliparous people in the elective hospitalization category had a rate of caesarean birth 1.5 times higher than the total (OR = 1.26; 95% CI, 1.09 -1.46; p .01) and 1.36 times higher than the low-risk sample (OR = 1.36; 95% CI, 1.13 -1.63; p .01).
Conclusion: This study highlights inequities in multiparous and nulliparous cesarean birth among medically low-risk Asians. Further research is needed in disaggregation of perinatal outcomes and on reasons for low utilization of midwifery care and out-of-hospital births amongst U.S. Asians.
Recording: https://youtu.be/jc1ZxhkUvrc
