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 DublinAppendices 3 - 6. The main findings from papers in each category werecombined and are presented in Chapters 3 to 6.1.7. Format of the reviewChapter 1 introduces the review, sets out the aims and purpose, describes themethodology and gives an overview of the content. Chapter 2 provides thebackground and context for the main sections, including a brief introduction tochildbirth and motherhood in Ireland. Definitions of disability and a historicalbackground of the different disabilities and their relationship to pregnancy,childbirth and motherhood are also reported. Chapter 3 outlines the barriers andfacilitators for women with physical disabilities in accessing services duringpregnancy, childbirth and early motherhood. Chapter 4 describes how womenwith vision or hearing impairment experience barriers and facilitators inaccessing these services. Chapter 5 examines the barriers and facilitators forwomen with mental health difficulties in accessing services and professionalhelp during pregnancy, childbirth and early motherhood. Chapter 6 exploreshow women with intellectual disabilities encounter barriers and facilitators toaccessing these services. A summary of key findings, with identification of themajor research gaps, concludes each of these chapters. Chapter 7 provides asummary overview and Chapter 8 lists key research findings and identifiesresearch gaps.7
WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY,CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College DublinChapter Two: Background and context2.1. IntroductionThis chapter provides, firstly, a brief introduction to childbirth and motherhood inIreland. An outline is then provided of the difficulties in ascertaining informationfrom official statistics on the number of women in Ireland with disabilities in eachcategory of interest. Definitions are included where necessary and the historicalbackground and context of pregnancy, childbirth and motherhood for womenwith physical, sensory, mental health and intellectual disabilities is given.Finally, societal attitudes to all women with disabilities are described, which maylead to barriers for women with disabilities in accessing suitable services inpregnancy, childbirth or motherhood. This chapter sets the scene for thepresentation of a detailed exploration of facilitators and barriers to access ofservices in succeeding chapters.2.2. Childbirth and motherhood in IrelandThe provision of maternity care, presently supplied through 20 maternityhospitals/units (19 of which are publicly-funded), catered for 64,237 births in2006 (Central Statistics Office (CSO), 2008a). Over the past 4 decades,maternity care has become increasingly medicalised due to 3 main factors:- A widespread provision of privatised health care for women above thepoverty line, centred on consultant obstetricians as principal providers ofcare- A progressive move to close down the provision of midwifery care in thecommunity from the 1960s onwards- A move to build centralised maternity units in large hospitals under thedirection of obstetric consultants while smaller units have been closed down.The dominant model now in use is that of consultant-led, hospitalised birth(Wagner, 2001; Devane et al, 2007), although there are in existence 2 pilot8
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