If you are able bodied, it can be hard to realize how difficult everyday situations can be for someone with a disability. As doulas, we all believe everyone deserves to give birth with dignity. Accessibility in birth is an important part of ensuring that.
We have seen people from all demographics give birth both with and without care they should deserve. Some facilities and providers do not ensure everyone gives birth with dignity. This is something which can impact anyone.
However, people with disabilities are disproportionately impacted by poor support and lack of accommodations. At IDI, we want to ensure our doulas are prepared to support all people. That is why we offer our Diversity, Equity, and Inclusion for Birth Workers course.
Accessibility in Birth – Why It Matters
Maternal infant morbidity and mortality measure the overall wellness of a community, country, group, etc. When we see disparities in those numbers among certain groups, we know we are not doing something well.
Parents with disabilities often report issues with practical accessibility which directly impacts care. One study found:
“Only 17.2%, however, received any information or training on the provision of healthcare to women with disabilities. Eighty-one percent agreed somewhat or strongly that women with disabilities are less likely to receive comprehensive reproductive healthcare.”
With the data the study determined:
“Women with disabilities require reproductive healthcare no less than women without disabilities; however, the evidence consistently identifies disparities.”
When creating of DEI course, we spoke with several individuals who had experience being pregnant and parenting with a disability. One wheelchair user stated her OB/GYN provider was never able to weigh her properly. She was left wondering if weight had any impact on her gestational diabetes diagnosis.
When it comes to birth, we know that mobility can be helpful both for labor progress and comfort. Yet patients with mobility aids are not necessarily guaranteed a room with space to use their aids. This can lead to having limited options during birth.
If less than 18% of providers have any training in supporting women with disabilities while providing OB/GYN care, they may not even realize the lack of accessibility in birth their patients are facing.
Listen to People With Disabilities
Providing accessible birth care is a vital part of public health. In fact, it is a global concern. The World Health Organization recently published an article, A quest for dignified health care for women with disabilities, highlighting the birth experience of a woman with disabilities.
‘“No, no, no! We don’t want to take care of her!” These were the words that Coumba Ndiaye, from Dakar, Senegal, heard repeatedly when she sought care to deliver her baby. She approached four health centres, but all refused her, saying her disability (related to polio as a child) would make the delivery “too complicated.”’
She was eventually referred to a hospital, where she was met with immediate insistence that she have a c-section birth. One respectful health worker stepped in to assist her in having a vaginal birth. However, just an hour after birth, no one aided her in moving, and when she fell, she hemorrhaged. She would not wake up for two days and was directed to not have more children.
While she was eventually able to find some care, she was turned away several times first. She went on to have complications that may have been preventable with a bit of support and accommodations.
Be sure to read her entire story, on the WHO site.
To understand how to best support our clients with disabilities, we need to listen to their experiences.
How Can We Support Accessibility in Birth?
As doulas, we can listen to our clients. We can also guide them to ask their provider questions about the birthing facilities.
There is a great likelihood that your client is used to having to advocate for themselves. However, in this instance you can bring your birth experience to help them know what to ask about. You can also remind and encourage them they have the right to a dignified birth experience.
You can also be an ally and support disability and accessibility advocates within your community.
Looking for more tools to support clients? Be sure to register for our Diversity, Equity, and Inclusion for Birth Workers course.
Author: Aliza Juliette Bancoff
Aliza Juliette Bancoff is a well-known doula and doula trainer who has been providing doula services to families for over a decade. She is the founder of Main Line Doulas, a doula group providing doula support in the great Philadelphia area for the last decade, the International Doula Institute, which provides online doula training and lactation training and certification programs and the International Breastfeeding Institute which provides lactation training and certification. She is the co-founder of United Birth, a company devoted to increasing access to doulas across the country to make the perinatal time safer both physically and emotionally. “Every birthing person deserves access to quality doula support. And we are working to make that a reality across the country. The work we are doing to get doulas to every birthing person will decrease the black infant and maternal mortality rate significantly by 2030.” Says Bancoff. Aliza is known for her compassionate and empowering approach to doula work, and she has been featured in numerous media outlets, including United Nations Maternal Health Report, Parent Magazine, CafeMom, theBump and many more. Aliza's journey into doula work began when she gave birth to her first child and felt a strong calling...