Obstetrics and Gynecology Resident Comfort in Caring for Pregnant People with Physical Disabilities

Abstract

Objective

Pregnant people with disabilities face higher complication rates, yet few guidelines exist on caring for this population. This study evaluates obstetrics and gynecology (OBGYN) residents' comfort in caring for pregnant people with physical disabilities.

Study Design

A 19-question e-survey was developed and piloted for content and face validation. Likert scale was used to assess comfort in caring for pregnant patients with physical disabilities. The e-survey was sent to U.S. OBGYN residents via CREOG-coordinator listserv, a listserv to all U.S. OBGYN residency coordinators, in February 2024, with three reminder emails. Descriptive statistics were used to analyze the data, and variables with clinical and statistical significance were considered for adjustment in regression models.

Results

Eighty-eight residents completed the survey. The mean age was 29 years; 88% identified as female. All ACOG regions were represented. Eight and 44% reported formal education on disability care in residency and medical school, respectively. Seventy-three percent felt uncomfortable positioning disabled patients for a pelvic examination, 59% felt uncomfortable discussing sexual health practices, and 89% felt uncomfortable making recommendations regarding the mode of delivery. Those without education in residency were 91% less likely to be comfortable making recommendations regarding the mode of delivery (absolute risk reduction [aRR]: 0.09; 95% confidence interval [CI]: 0.01 and 0.59). Only 30% were comfortable discussing lactation/breastfeeding with patients with physical disabilities; residents without personal experience including caring for family members or friends or other caretaking experiences were 66% less likely to be comfortable (aRR: 0.34; 95% CI: 0.12 and 0.99). A total of 92.5% of residents wanted more education in this space. Of those 83, 71, and 82% desired didactics, patient panels, and simulations, respectively.

Conclusion

Among responding residents, comfort in caring for pregnant people with physical disabilities is low. Additional training is necessary to adequately care for this population.

Key Points

• OBGYN resident comfort with disability care is low.

• Few residents receive formal disability training.

• Formal education improves disability care comfort.

Keywords

resident education - obstetrics - disability - pregnant people with disabilities

Publication History

Received: 14 February 2025

Accepted: 10 April 2025

Accepted Manuscript online:
16 April 2025

Article published online:
08 May 2025

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