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 DublinThe review did not consider in detail access of women with disabilities togeneral health services, personal assistance and care issues, the effects ofpoverty and social exclusion, or women and disability in general as the NDAhas previously commissioned reviews in these areas.1.3. MethodologyA systematic review of the literature, published in English, from 1950 to 2009was undertaken, with reference to earlier seminal texts or texts providing ahistorical background, to identify the challenges that women with disabilitiesencounter when accessing health services during pregnancy, childbirth andearly motherhood. Searches were undertaken in the major electronicbibliographic databases and a number of methods were used to identify therelevant literature:• database searches using CINAHL, PubMed (1950-2009), Midirs,PsychoInfo, PsychoArticle, Embase, ERIC (1966-2009), ScienceDirect, Web of Science, Wiley inter science, Applied Social ScienceIndex and Abstracts (1983-2009), Social Science Citation Index andSocial Sciences Index (1983–2009);• the library of Trinity College Dublin (TCD) and the National DisabilityAuthority were hand searched for relevant books, reports and generalarticles e.g. The Commission on the Status of People withDisabilities;• web-based searches on disability and health services, includingwebsites for The Irish Government, The European Commission, TheWorld Health Organisation (WHO), The United Nations (U.N.), andthe Department of Health (DOH) websites of the Netherlands and theUnited Kingdom;• a general Internet search using Google and Google Scholar searchengine;3
WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY,CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College Dublin• grey literature e.g. Index to Theses of Great Britain and Ireland,unpublished reports and policy documents.Major organisations and experts in the field were also contacted (Appendix 2).Citation searches were conducted on key papers and the reference lists ofincluded studies were checked for additional references.A combined free-text and thesaurus approach was adopted for key-wordselection. ‘Population’ search terms included disabil*, disability, physicaldisability, decreased mobility, immobility, disabled person, visually impairedperson, vision disorders, blind, deaf, hearing impaired, hard of hearing,intellectual disability, learning disability, developmental disability; mentalretardation, mental health, mental illness, enduring mental health difficulties,severe mental illness, pre/postnatal mental illness, pre/postnatal depression,anxiety, schizophrenia, psychosis, mother and baby units, and child custody.Other key words used included: health services, maternity services, healthprofessional, inequality, equity, barriers, access, challenges, attitudes,pregnancy, childbirth, maternity; motherhood, parenting, parents, socialconstruct, explanation, and definition. No date, study-type or publication-typerestrictions were used, apart from non English studies and those imposed bythe databases searched.1.4. Types of literature sourcedThe review identified that there was a paucity of literature in relation to thechallenges that women with disabilities encounter when accessing health careservices during pregnancy, childbirth and early motherhood. A substantivevolume of literature was sourced in relation to the debate surrounding womenwith disabilities, their right to reproductive technologies, and their effort to berecognised as women who can fulfil the traditional roles society affords towomen. This literature, details of which are given in section 1.6 and Appendices3-6, can be categorised into 2 distinctive types; the first is the existential lived4
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