Comparative perspectives: a cross-sectional survey of key stakeholders regarding OB/GYN accessibility for women with...

An estimated 1.3 billion people and over one-fifth of women globally live with a disability (1). Women with disabilities face lower rates of preventative care and higher rates of morbidity and premature mortality compared to persons without a disability. Obstetrics and gynecology care providers (OB/GYN providers) deliver longitudinal care to women across the lifecycle and serve as important stakeholders for bringing clarity and context to conversations about health care accessibility for patients with disabilities (patients), while patients and their advocates are critical contributors, to ensure that information obtained reflects lived experiences. The aim of this study was to compare the experiences and perceptions of patients, OB/GYN providers, and advocates regarding accessibility of OB/GYN care.

A quantitative, descriptive, cross-sectional study was conducted using an online survey distributed to patients, OB/GYN providers, and advocates through professional networks, advocacy groups, and social media from August 2024-April 2025. Surveys gathered demographic data as well as perceptions of barriers and facilitators to care and related outcomes. Thematic analysis of open-ended questions was also conducted.

A total of 369 participants completed surveys. Most patients had physical (74.4%) or cognitive disabilities (48.2%). Compared to patients, OB/GYN providers and advocates were more likely to report care delays (23.5 vs. 50.7 vs. 30.8%) and rescheduled appointments (18.0 vs. 22.1 vs. 19.4%) and less likely to report appointment cancellations (15.7 vs. 10.2 vs. 12.9%), due to unmet accommodation needs (all p < 0.001). Patients reported wait times of 1 month to 1 year to have a canceled appointment rescheduled; many OB/GYN providers (62.5%) reported rescheduling wait times of < 2 weeks. Most patients (86.7%) reported not receiving needed care when their appointments were canceled without rescheduling, while 14.3% of OB/GYN providers and 50.0% of advocates reported that patients never received care (p < 0.001). Nearly all care providers (94.2%) believed that OB/GYN teams make the effort to prioritize comfort and safety for disabled patients. One-third of providers were unaware of what accommodations their offices provided. Patients identified physical barriers (51.9%) and social barriers (29.2%) as primary factors negatively impacting care in both questionnaire and open-ended responses.

Discordant perceptions exist between patients, OB/GYN providers and advocates regarding the prevalence and impact of disruptions in OBGYN care for patients with disabilities and OB/GYN provider sensitivity and care quality provided to affected patients. Engaging key stakeholders with different and valuable perspectives in conversations helps establish a critical framework from which to develop harmonious solutions that can reduce care gaps and improve OBGYN care for patients with disabilities.