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 DublinEdhborget al(2005)EdwardsandTimmons(2005)Ugarriza(2004)SwedenU.K.U.S.A.To explore anddescribeSwedish womenwith depressivesymptoms’experience inthe first 4monthsTo consider ifwomen withpostnatal illnessexperiencestigmaTo explore thefeasibility ofusing grouptherapy forwomen withPPD andbarriers toattendingtherapy sessionInterviewsSemistructuredinterviewsPre and posttest usingBecksDepressionInventory 11.Ongoing notes22 women with PPDrecruited throughlarge maternity unit.Babies were agedbetween 65 and 125daysSix women admittedto a mother andbaby unit with postnatal illness34 women withpostpartumdepression wereasked to participate.8 women (Hispanic-American and Anglo-American) agreed.Only 6 attendedLiving up to the image of good mother.Shame and guilt at not being happy.The stigma of mental illness results inwomen not wanting to disclose distress.Fear of loss of custody. Five women had adelay in receiving appropriate help ashealth care professionals (midwives, GP,health visitor) were slow in recognising thewomen’s distress, discounting it as a‘normal’ part of post birth experience.Diagnosis was a relief; however, womenwere concerned about stigma fromorganisations if they had to disclose illnessin the future, such as emigration, lifeassurance.No woman completed all 10 sessions.Sense of shame and failure at having PPD.Feelings of embarrassment and failure as awoman and mother. Difficulty in adjustinghome and family schedule to fit in therapysessions. Family events clashing withtherapy times. Mothers reluctant to attendtherapy without child, so if child was ill themothers stayed at home.183
WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY, CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College DublinHeneghanet al(2004)Diaz-CanejaandJohnson(2004)Hollingsworth(2004)U.S.A.U.K.U.S.A.To exploremothers’ beliefsaboutdiscussingparenting stressand depressionsymptoms withtheir child’spaediatricianExplore theexperience ofmothers with‘severe mentalillness’To testhypothesis thatindividualenvironmentalfactors combinewith mentalillness to predicta history of childcustody lossSeven focusgroupinterviewsSemistructuredinterviewsQuantitativemeasures ofdemographicenvironmentaland supportvariables, andinterviews44 women, with amean age of 27years, from a varietyof socio-economicgroups, recruitedfrom 5 communitypaediatric practicesand 1 hospitalpractice20 mothers with amedical diagnosis ofschizophrenia,bipolar disorder andsevere depressionrecruited fromcommunity mentalhealth teamsChildren < 16 years322 women withsevere mentalillness, involved inquantitative phase,and 82 in interviews.Mothers in all socioeconomic groupsexpressed fear of judgment as a ‘badmother’ and were fearful of a referral to achild protection agency if they requestedhelp. Mothers in low socioeconomic groupsparticularly fearful of social workintervention.Children central to women’s recoveryMedication and symptoms of illness impairability to mother. Concern over geneticinheritance. Stigma of illness preventedthem accessing service and being open.Professional assumptions of ‘poor mother’acts as a barrier to being open. Fear of lossof custody. Services withdrawn as soon ascrisis is overWomen with persistent mental illness,indicated by hospitalisation, unmarried,household income at or below poverty line,large number of children, lacking parentalknowledge, and few social supports are atincreased risk of child custody loss.Interview data suggested that substanceabuse history and ‘troublesome’neighbourhood conditions were present.184
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University of DublinTrinity College
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