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

WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY,CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College Dublintaken away was seen as the main functions of statutory agencies ( Diaz-Canjelaand Johnson, 2004; Kessler and Ackerson, 2004; Montgomery et al, 2006).Findings from studies that examined the social and clinical characteristics ofmothers whose babies are supervised or removed, suggest that single womenwith a diagnosis of schizophrenia or other illness involving psychosis, living onlow income or below the poverty line, and with low social supports are atparticularly high risk of having their baby supervised by social services and/orraised by someone else (Miller and Finnerty, 1996; Howard et al, 2003;Hollingsworth, 2004). In one study, 50% of women with a diagnosis ofschizophrenia and 10% of women with bipolar disorder in a South Londonmother and baby unit were discharged without their children, or dischargedunder formal supervision from child protection services (Kumar, 1995). In Dippleet al’s (2002) study of women attending rehabilitation psychiatric services inLeicestershire (U.K.), 68% (37) of the mothers had at least 1 child they werepermanently separated from before the child was 18 years old, and in 11 casesthe separation occurred at birth. Only 3 of the 20 women with enduring mentalhealth difficulties in Sands et al’s (2004) study, in the United States, had fullcustody of all their children. The predominant pattern was for the children to bedispersed between a variety of settings – some with mother, father,grandparents, and other relatives, some in foster care, residential care andsome adopted. Not surprisingly, a number of the mothers appeared genuinelybewildered about the custodial arrangements of their children and were unsurewhether children in long term foster care had been adopted or if they were in aposition to do anything to get reunited with their children. In all of the researchthe recurring theme was of women who felt controlled by a legal and psychiatricsystem that was insensitive to them as mothers and human beings.Years after the separation, these women still spoke of their enduring sadness,pain and anger about their loss and were struggling to process and integratetheir experience of being judged as an unfit mother (Miller and Finnerty, 1996;Joseph et al, 1999; Chernomas et al, 2000; Dipple et al, 2002). It is noteworthy38