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 DublinMcKay-Moffat &Cunningham (2006)McKeeveret al (2003)Mitton et al(2007)NationalDisabilityAuthority(NDA)(2002)U.K.CanadaU.K.Irelandbirth and thepostpartum period.To investigatechildbirthexperiences ofwomen with aphysical disabilityand to examine theexperiences ofmidwives providingcare to women witha physical disabilityduring childbirth.To investigate themotheringexperiences ofmothers with aphysical disabilityTo explore healthand lifeexperiences ofmothers withrheumatoid arthritis.To explore thegeneralpopulation’sperceptions ofdisability andQualitativedescriptive,exploratory.Semistructuredinterviews.Qualitativedescriptive,exploratory.Unstructuredinterviews.Qualitative.Semistructuredinterviews.Quantitative.Social surveyinterviews.8 midwives, and5 mothers with aphysicaldisability.11 mothers witha physicaldisability usingwheelchairs andscooters7 women withrheumatoidarthritis agedbetween 21-41yrs.1,000 adultsfrom the generalpopulation.inappropriate and referral mechanismsnonexistent.Five themes emerged from mothers – theirquest for normality, the disability takingprecedence over pregnancy, midwives’ lack ofawareness and knowledge about the women’sdisability, importance of disability awarenessand positive attitudes for midwives, the needfor effective communication. Three themesemerged from the midwives’ perspective –midwives’ varied knowledge and experience,positive attitudes and positive communication.Mothering experience influenced by ability toaccess the physical environment and homecare services. Assistance was rarely givendespite an identified need. Impaired mobilityimpacts on the mothering role.Five themes emerged from women’sexperiences: inner strength gained from theirillness, their illness was an antecedent todepression, women were labelled despite theirdesire to feel normal, felt like a failure as wifeand mother. Women expressed the need foreducation about their illness and its effect onpregnancy and associated complications.Positive and negative public attitudes inrelation to a variety of topics including definingdisability, treatment of people, education &employment and difficulties encountered bypeople with disabilities, who is responsible for165
WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY, CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College DublinNationalDisabilityAuthority(NDA)(2007)Nosek(1995)Nosek(2001)Pierce(2003)IrelandU.S.A.U.S.A.Irelandpeople withdisabilities.To explore thegeneralpopulation’sperceptions ofdisability andpeople withdisabilitiesTo examinebarriers toreproductive healthmaintenanceamong women withphysical disabilities.To examine thebroad range ofissues that womenwith a physicaldisability encounterin relation to sexualfunctioning, andsexual andreproductive healthcareTo investigate howpeople with multipleQuantitative.Social surveyinterviews.Qualitativedescriptive,exploratory.Unstructuredinterviews.Triangulation– Qualitativeandquantitative.Unstructuredinterviews andquestionnaire.Qualitativeinterviews.1,004 adultsfrom the generalpopulation.31 women witha physicaldisability.Qualitative – 31with a physicaldisabilityQuantitative –1,150 women,of whom 946completed thequestionnaire(504 with and442 withoutdisability). 45%response rate9 minority ethnicpeople withcaring for them, the rights of people withdisabilities to have relationships and be sexual.Public attitudes were more positive than in the2002 survey. Attitudes were determined inrelation to the same topics as in the 2002survey (above)Physical and attitudinal challenges wereencountered by women when accessingreproductive health care. Health professionalswere insensitive to women and care wasinfluenced by medical systems. An analyticmodel towards disability is suggested toinfluence a person’s behaviour andreproductive health.Women with disabilities have difficultyestablishing relationships, social andenvironmental factors impact on women’s selfesteem, abuse was prevalent among women,women had sexual desires but limitedopportunity to participate in sexual activity,women with physical disabilities encounterchallenges when accessing reproductive healthcare including difficulty locating a physician toadminister care.Minority ethnic people are invisible in Irishsociety. This population encounters difficulties166
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University of DublinTrinity College
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