Women with disabilities' experiences with respectful maternity care in Nepal: a phenomenological study.

BACKGROUND: Respectful maternity care (RMC) is essential to safe, dignified childbirth, yet women with disabilities in Nepal face unique barriers in accessing such care. Limited evidence exists on their experiences in relation to the White Ribbon Alliance's RMC Charter. OBJECTIVE: To explore the lived experiences of women with disabilities regarding respectful maternity care in the semi-urban outskirts of Kathmandu, Nepal, and to identify priorities for improving maternity care. METHODS: A phenomenological study design was employed between April and May 2023. Data collection included 12 in-depth interviews with women with disabilities, 7 with healthcare providers, and 2 focus group discussions with 11 Female Community Health Volunteers. Interviews were audio-recorded, transcribed, translated into English, and thematically analyzed, guided by the RMC Charter. RESULTS: Women's experiences varied widely. Negative accounts included disrespect, poor communication, compromised privacy, and structural barriers such as overcrowded facilities and lack of disability-friendly infrastructure. Economic constraints and transport challenges further limited timely access to care. Some providers perceived women with disabilities as having limited autonomy, though most women reported making their own healthcare decisions. Positive experiences included respectful communication, practical support, and personal assistance from providers. CONCLUSION: Women with disabilities in the Kathmandu outskirts encounter disability-specific barriers to respectful maternity care, including provider attitudes, inadequate communication, and inaccessible facilities. We recommend integrating disability-focused RMC training into health professional curricula, investing in disability-friendly infrastructure, and adopting policies that safeguard privacy, dignity, and autonomy.