“I feel like I'm not confident enough”: A qualitative study of Cambodian midwives’ experiences in disability-inclusive maternity care

Globally, women with disabilities encounter substantial socio-economic and health disparities, which are further exacerbated by systemic barriers in accessing essential health services. This is particularly evident in maternity care, where women with disabilities often encounter obstacles such as inaccessible facilities, a lack of awareness about disabilities among healthcare providers, discriminatory attitudes, communication barriers, and limited financial resources to access the necessary care. Although healthcare providers have cited providing maternity care services to women with disabilities as a rewarding experience, several barriers hinder their ability to provide maternity care services with disability inclusion. Numerous global studies have identified the challenges faced by healthcare providers in providing maternity services to this population, including insufficient disability training, a lack of evidence-based guidelines, a lack of functional referral systems, and limited essential physical resources. However, there remains a limited understanding of context-specific factors influencing healthcare providers' capability and experiences, which impedes efforts to support healthcare providers, particularly in resource-constrained settings in low- and middle-income countries such as Cambodia. This knowledge gap negatively impacts the capacity of healthcare providers in offering disability-inclusive care and contributes to ongoing disparities in maternity care outcomes for women with disabilities. Therefore, this study aims to explore the experiences of Cambodian midwives regarding the provision of maternity care services for women with disabilities in Cambodia. In so doing, this study seeks to understand the barriers and facilitators that midwives encounter when delivering services to women with disabilities. This study provides empirical evidence about the challenges and facilitators faced by Cambodian midwives in delivering maternity care services to women with disabilities in a resource-constrained setting. The findings contribute to the existing body of knowledge related to maternity care for women with diverse types of disabilities, which could be used to inform policy, planning, practice, and strategies to improve disability-inclusive maternity care in Cambodia and other countries with similar contexts.