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 Dublindisability are not identified in these papers, it is likely, from the descriptions, thatthe participants had mild intellectual disabilities. Others, notably Tymchuk(1985), Budd and Greenspan (1985) and Tymchuk et al (1988) have exploredthe ability of parents with mild levels of intellectual disability to learn how toparent adequately, through decision-making training. Perkins et al (2002) andDitchfield and Burns (2004) argue that society continues to focus on the risk toand the outcomes for the children of parents with intellectual disabilities, with noclear concern for the risks to the health and wellbeing of the parents, and, moreparticularly, to the mothers.A number of authors (Kroese et al, 2002; Llewellyn and McConnell, 2002;McConnell et al, 2003; Aunos et al, 2008) have explored the issue of supportnetworks for pregnant women and mothers with intellectual disability, notingthat, in the absence of such supports, such women are more likely toexperience stress and poor health. The only study located that was focussed onthe outcomes of pregnancy in women with intellectual disability found increasedrates of pre-eclampsia, low birthweights and increased admission of resultingbabies to neonatal intensive care (McConnell et al, 2003). This important studycalls for further research to explore the reasons for such adverse outcomes.6.3. Facilitators to improve access to services for women withintellectual disabilitiesThe recent study of 152 trusts providing obstetric or midwifery-led maternityservices in England showed that 58% of trusts in England have antenatal andpostnatal information available in a specific form for women with learningdifficulties (Commission for Healthcare Audit and Inspection, 2008). In makingthe case for improved sexual health and maternity services for women withintellectual disabilities Tarleton and Ward (2007), in their study into parentingwith support, recommend that such services to be provided in a ‘joined-up’approach. Apart from Tarleton and Ward's study, the literature yielded little, ifany, evidence for structures or processes that could facilitate health or maternitycare for women with intellectual disabilities. It is generally acknowledged thatthis is an under-addressed and under-researched field.116