There is limited existing research on the experiences of women with physical disabilities (PD) during pregnancy,1, 2, 3, 4, 5, 6 and less specific to women with lower limb absence (LLA).7,8 Women with LLA have unique needs and challenges related to their prostheses which are exacerbated during pregnancy. As the body changes throughout pregnancy, the fit and comfort of the prosthetic socket is likely to change, which can affect mobility and create safety concerns for the mother and baby. The impact on the individual can include limited physical activity and increased risk of falls as balance can be affected by changing body weight, joint laxity, and ill-fitting prostheses.7,9,10

The relationship between pregnancy and other common mental and physical health challenges for individuals with LLA have yet to be examined. For example, it is well known that the metabolic costs of walking and other activities of daily living are greater among individuals with LLA.11 Equally, individuals with LLA have been found to experience high rates of anxiety and depression, particularly in the years following an acquired limb absence.12,13 However, limited existing research explores these physical and mental health impacts in relation to symptoms associated with the perinatal period. As a result, the potential physical consequences combined with the lack of information available related to pregnancy and LLA can negatively impact the physical and mental health of pregnant women with LLA.7

While prosthetic users of childbearing years have many questions about pregnancy and postpartum10, health care providers can be poorly equipped to meet the needs of pregnant women with PD, both in their limited medical knowledge and their attitudes towards patients.1, 2, 3, 4, 5, 6 Advanced planning and collaboration between pregnant women and health care providers (HCPs) have led to more positive perinatal experiences.6,14, 15, 16 However, the needs of women with LLA during pregnancy are not well understood, creating barriers to planning and preparation for the perinatal period. Existing research on PD and pregnancy focuses on the physical impacts,7,9 relationships between patients and HCPs,6,14,15 and HCP education.3,5,14

There is a gap in research on women with LLA's psychosocial experiences, as well as the postpartum period. The only published research exploring the psychosocial experiences of pregnancy among women with LLA is Hanna and Donetto's analysis of online blogs. Their research found a lack of information for pregnant individuals with LLA and concern surrounding risk of falls due to mobility challenges. However, they also found that individuals downplayed their symptoms and shared uplifting messages and encouragement for others with LLA who may wish to get pregnant. The authors recommend future research involve collaboration with mothers with LLA to obtain an in-depth understanding and to leave space to share their most challenging experiences.2

To our knowledge, no existing research addresses the postpartum needs or experiences of women with LLA. Studies acknowledge the need for more information and resources related to physical and psychological postpartum supports for women with PD,6,14,17 but these do not address the specific needs of women with LLA. In previous research focused on pregnancy and LLA, the impact of postpartum mobility challenges and physical changes, and the risk of postpartum depression, are overlooked. Due to the safety concerns, as well as potential mental and physical health consequences noted previously, it is crucial to better understand the experiences of women with LLA during the perinatal period to provide better care and resources for this population. Our study fills this gap by exploring women's experiences during pregnancy and postpartum.

The purpose of this paper is to explore the psychosocial experiences of individuals with LLA as they journey through the pregnancy and postpartum periods. This research will outline common psychosocial experiences that pregnant women with LLA may find useful in navigating their own unique journeys. A subsequent paper will outline the perceived physical impacts of pregnancy among women with LLA.