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

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WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY,CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College DublinThere have, however, been a number of generic developments, both nationallyand internationally, which may become vehicles for the development ofappropriate and positive service responses to women with intellectual disability.The United Nations Convention on the Rights of the Person with Disabilities(United Nations (U.N), 2006), which Ireland has signed up to, affirms thatpeople with disabilities have the right to parenthood, fertility, reproduction,family planning (Article 1) and to ‘the same range, quality and standard of freeor affordable health care and programmes…in the area of sexual andreproductive health…’ (U.N., 2006: Article 25). At the time of writing Ireland hasnot yet ratified the Convention.In Ireland, the publication of the Disability Act (Government of Ireland, 2005)provides a statute-based right for people with disabilities to have anindependent assessment carried out in relation to their disability-related healthneeds. The National Standards for Needs Assessment issued by the HealthInformation and Quality Authority (2007) provide protocols for referral toservices such as maternity services within the assessment of needs process.6.4. SummaryAccess to maternity services by women with intellectual disabilities is an underresearchedarea, and their experiences of pregnancy, childbirth and earlymotherhood are not well described. The research that exists in this areadocuments widespread negative attitudes towards the idea of women withintellectual disabilities becoming pregnant and taking on the role of parents.Providing support for women with intellectual disabilities as they experiencepregnancy, childbirth and early motherhood is the main suggestion forimprovement that arises from the literature. Recent legislation may lead toimproved access to maternity services for women with intellectual disabilities inIreland.117
WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY,CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College DublinSection Three: Planning for the futureChapter Seven: Summary and conclusion7.1. Summary7.1.1. OverviewWomen with disabilities represent a diverse group experiencing a variety ofdisabling conditions, all of whom require and have a right to individualised care.The National Disability Survey showed about 20,000 women aged 18 - 34 andabout 18,500 women aged 35 - 44 had a disability in one or more of the 9categories used in the survey (National Disability Survey vol. 1 Table 5B). Themost frequently cited conditions for women of childbearing age were mentalhealth conditions, pain, mobility, intellectual and learning disability, anddifficulties in remembering and concentrating.Evidence from the literature showed that society has tended to undervalue anddiscriminate against women with disabilities, and has, particularly in the past,exerted control over their sexual and reproductive lives (Waxman, 1993;Kallianes and Rubenfeld, 1997; Kaplan, 2006). Accessing information withregard to sexuality, and obtaining quality individualised reproductive care isespecially difficult for women with disabilities as they are often perceived asasexual and not likely recipients of such care (NWCI, 2006; Piotrowski andSnell, 2007).Maternity care across the world has become increasingly medicalised, whichhas led to a diminution of emphasis on the importance of women’s experiencesduring pregnancy and childbirth. Many women, irrespective of their disabilitystatus, are unhappy with aspects of their care during pregnancy or birth inIreland (O’Doherty and Regan, 2006). To have a disability when accessing118
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