Women with Disabilities: Barriers and Facilitators to Accessing ...

WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY,CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College Dublinscreening with the Edinburgh Postnatal Depression Scale (EPDS). Over half ofthe women (21) found screening unacceptable, felt it was an intrusion and werefearful of the consequence for both themselves and the baby. Consequently,they reported deliberately giving false, and positive, responses. Women were ofthe view that, because of lack of time, feedback and privacy, the baby clinic wasan inappropriate place to assess them in any case. The women in this studyalso expressed a clear desire for talking about what they were feeling in anopen, non-judgemental, supportive environment, as opposed to a question andanswer session, which focused on ticking boxes.Robinson (2007) suggests that identifying women at risk may be fine, if thesupportive care that women need follows. However, she is of the view that the‘child protection mania’ which currently exists (to ‘cover people’s backs’), resultsin health care professionals referring women to social services and socialworkers, who may be ignorant about maternity care, postnatal mental illnessand care of the newborn. This raises questions about the appropriateness ofroutine screening for perinatal mental health difficulties, as what could havebeen a positive initiative, in terms of identifying women in need of supportivecare, is in fact becoming a barrier to disclosure.5.6. Barriers to acceptability of services for women with mentalhealth difficulties: Stigma and shame5.6.1. Stigmatisation and discriminationThere is extensive research that suggests that people who experience mentalhealth difficulties are stigmatised and suffer discrimination and rejection inrelation to employment, housing and health insurance. People who fear thestigma of mental illness often forgo treatment, in an attempt to avoid the label.In the context of women who experience mental illness associated withchildbirth the evidence base is sparse. However, what is available suggests thatthe perceived stigma associated with mental illness is a reality, creating andexacerbating problems for women accessing help and support (Shakespeare etal, 2003; Edwards and Timmons, 2005; Jesse et al, 2008). Women in Jesse etal’s study (2008:pg. 9) feared that if they asked for help they would be labelled99