Introduction: Women with physical disabilities (WPD) face barriers in maternity care, including physical inaccessibility, societal biases, and inadequate healthcare, limiting their engagement in maternal occupations. This study explores the role of Occupational Therapy (OT) in supporting WPD through accessibility improvements, interdisciplinary collaboration, and advocacy. Method: A scoping review of six databases identified 17 relevant studies on systemic maternity care barriers. Findings were validated through focus groups with Estonian occupational therapists (OTs) and midwives. A thematic deductive analysis synthesized data, linking findings to practical OT applications. Findings: Five key themes emerged: provider assumptions, physical accessibility, resource gaps, societal marginalization, and OT’s role in fostering independence and advocacy. Focus groups emphasized OT-led interventions, including provider training, postnatal adaptations, and environmental modifications. Conclusions: OT has transformative potential in improving accessibility, autonomy, and participation for WPD. Findings underscore the need for interdisciplinary collaboration, disability-inclusive policies, and OT-led postnatal interventions. Significance: Integrating OT into maternity care can advance equitable healthcare, support maternal independence, and promote inclusive, client-centered practices for WPD.