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

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. 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. 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. 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. Negative community attitudes and limited access to information call for community awareness programs and disability-competency training for perinatal care providers to enable equitable perinatal care access in rural Ethiopia.Reproductive rights of women with physical disability, including choosing and planning pregnancy, should be upheld through accessible counseling and advocacy that promotes informed decision-making and challenges attitudes discouraging childbearing.Perinatal policies and guidelines need to include disability-specific strategies, including preconception support and mental health screening.A resource package that provides women with physical disability with reliable and comprehensive information about disability and perinatal care should be developed and disseminated to support informed access to perinatal care services. Negative community attitudes and limited access to information call for community awareness programs and disability-competency training for perinatal care providers to enable equitable perinatal care access in rural Ethiopia. Reproductive rights of women with physical disability, including choosing and planning pregnancy, should be upheld through accessible counseling and advocacy that promotes informed decision-making and challenges attitudes discouraging childbearing. Perinatal policies and guidelines need to include disability-specific strategies, including preconception support and mental health screening. A resource package that provides women with physical disability with reliable and comprehensive information about disability and perinatal care should be developed and disseminated to support informed access to perinatal care services.