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 DublinBrandon, 1957a, 1957b). This realisation did not, however, bring about asignificantly changed attitude towards women with intellectual disability(Abramson et al, 1988), but rather refocused the attention on efforts andstrategies to deny their parenting capability. Thus, Espe-Sherwindt and Crable(1993) argue that several myths developed around the reality:• That the children of intellectually disabled parents will be themselvesintellectually disabled;• That intellectually disabled parents will have more children than, onaverage, the norm;• That intellectually disabled parents provide inadequate parenting;• That parents with intellectual difficulties cannot learn adequate parentingskills.It is likely that these issues served to re-instil the fear that was inherent ineugenic thought (as is clear from the first 2 statements), whilst introducing afurther concern regarding the security of children born to persons withintellectual disability. Whereas the first and second issues were quicklydisproved (Brandon, 1957a; Reed and Reed, 1965; Gillberg and Geijer-Karlsson, 1983; Koller et al, 1988), fears regarding the adequacy of parents withintellectual disabilities remained, and probably still remain, in question(Fantuzzo et al, 1986).It is clear from the literature that many such people are striving to provide fortheir children, often in very difficult situations, and a significant number of theseparents are mothers, parenting alone following either abandonment or sexualassault. A critical review of the literature found that the effects of sexualviolence against women with intellectual disability appeared to be comparableto those experienced by similarly traumatised women in the general population.Aggression and self-injury were sometimes exhibited and psychiatric symptomsincluded depression, anxiety and indicators of traumatic stress reaction(Sequeira and Hollins, 2003). Struggling with the after-effects of such trauma45
WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY,CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College Dublincould, understandably, prevent women with intellectual disability from displayingadequate parenting. It is recognised that amongst women with intellectualdisability who are parenting alone, there is a tendency towards poorer health(IASSID SIRG, 2008), which could also hinder the quality of their parentingactivities.Keltner et al (1995) suggest that not only is there a lack of support, but barriersexist to these women accessing public service supports, including the fear oftheir children being taken into care, and lack of accessible information. Keltneret al (1999) however, in a study of child outcomes, which attempted to removepoverty as a confounding factor, suggest that poverty is not the main factor inthis regard. Further research is needed in this area but, whatever the causes,what emerges from the literature is that mothers with intellectual disabilitiesoften struggle against numerous disadvantages to provide adequate parenting,yet many succeed. An explorative study found that around 1.5% of persons withintellectual disability in the Netherlands were parents, mostly those with milddisabilities. In the eyes of their professional care-givers, 33% were definitely“good enough” parents, 51% were “not-good-enough” parents and in theremaining 16% there was no clear decision. The authors identified that a highquality social network, acceptance of the parents in the community and theirability to follow advice were key elements to success in parenting (Willems et al,2007).The impact on children of parental inadequacy among parents with intellectualdisabilities has been widely studied (Brandon, 1957a and 1957b; Borgman,1969; Gath, 1988; Pixa-Kettner, 1999; May and Simpson, 2003). Amongst theeffects identified are neglect (Crain and Millor, 1978; Katz, 1992), abuse (Helferand Kempe, 1974; Schilling et al, 1982), and inadequate or inappropriatenutrition (McConnell and Llewellyn, 2000). It is not clear, however, whetherthese child outcomes are related solely to parental inadequacy or to thesituational poverty and lack of support that is frequently the backdrop to suchparenting (McConnell and Llewellyn, 2000). It has also been shown that there is46
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