Healthcare providers' perspectives and experiences caring for individuals with lower limb absence during the perinatal period: a qualitative study

Cheryl Chow; Natalie McKellar; Alyssa Hodgson; Esther Chiang; Natasha Lad; Vyshnavi Jeevananthan; Janet Campbell; Donna Cumming; Brittany Pousett; Crystal MacKay

doi:10.1080/09638288.2025.2541046

Healthcare providers' perspectives and experiences caring for individuals with lower limb absence during the perinatal period: a qualitative study

Disabil Rehabil. 2025 Aug 8:1-10. doi: 10.1080/09638288.2025.2541046. Online ahead of print.

Authors

Cheryl Chow¹, Natalie McKellar¹, Alyssa Hodgson¹, Esther Chiang¹, Natasha Lad¹, Vyshnavi Jeevananthan¹, Janet Campbell^{1

2}, Donna Cumming³, Brittany Pousett^{3

4}, Crystal MacKay^{1

2

5}

Affiliations

¹ Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
² West Park Healthcare Centre, University Health Network, Toronto, ON, Canada.
³ Barber Prosthetics Clinic, Vancouver, BC, Canada.
⁴ Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
⁵ Queen's University, Kingston, ON, Canada.

PMID: 40778564
DOI: 10.1080/09638288.2025.2541046

Abstract

Purpose: This study explored healthcare providers' (HCPs') experiences providing care for individuals with lower limb amputation (LLA) during the perinatal period, the perceived impact of pregnancy on individuals with LLA, and strategies to improve perinatal support for individuals with LLA.

Methods: This is a qualitative descriptive study. Semi-structured interviews were conducted with HCPs with experience caring for individuals with LLA during the perinatal period. A thematic analysis was conducted, informed by the DEPICT model.

Results: Eleven HCPs (prosthetists, n = 6; physiatrists, n = 5) participated. Three themes were identified that describe HCPs' perspectives on the impact of pregnancy on LLA and their approach to providing care during the perinatal period: (1) Clinical Approach: Problem Solving and Preparation, (2) Managing the Physical Impacts of Pregnancy by Maintaining Mobility, and (3) Tailoring Care to Individual Needs. Participants described using clinical expertise and trial and error to support individuals during pregnancy with limited education and resources. They reported variability in patients' physical (e.g. swelling, fatigue) and psychosocial needs necessitating tailored management.

Conclusion: There is a lack of resources and education for clinicians regarding pregnancy and LLA. While clinicians managed this by using clinical reasoning and planning ahead, more resources for HCPs who provide care are needed.

Keywords: Pregnancy; amputation; interviews; lower limb absence; qualitative; rehabilitation.

Plain language summary

Participants described a wide range of symptoms during pregnancy that were managed using trial and error, clinical reasoning and planning ahead.Participants lacked resources and training on pregnancy in individuals with lower limb amputation (LLA) suggesting that more resources and training to support healthcare providers (HCPs) who provide care to this population are needed.HCPs can support people with LLA during pregnancy by planning ahead for mobility and prosthesis management and providing resources on LLA and pregnancy to their patients (e.g., educational materials, connection to peers who have experienced pregnancy).