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 Dublina higher prevalence of unrecognised medical problems and developmentaldelay due to inadequate early stimulation in the children of parents withintellectual disabilities (Feldman et al, 1985). Again, it is difficult to relate thisdirectly to the adequacy of the parenting provided, and studies suggest thatthese are, rather, related to lack of support and difficulties in accessing servicesand information (Keltner et al, 1999; McConnell and Llewellyn, 2000; IASSIDSIRG, 2008; Mayes et al, 2008). This view is supported by the fact that manyinterventional studies providing parenting training and support have been foundto improve parenting outcomes (Feldman et al, 1985; Tymchuk, 1985; Fantuzzoet al, 1986; Tymchuk et al, 1988; Llewellyn et al 2003).The immediate response to potential or actual inadequate parenting by parentswith intellectual disabilities has, in the past, involved the almost systematicremoval of children from the parents' custody (McConnell and Llewellyn, 1998;Sheerin, 1998b; Glaun and Brown, 1999); this is evidenced by the findings ofMickelson (1949) and, more recently, those of Accardo and Whitman (1990). Inparticular, it is the fact that over one fifth of families in this latter study, who hadchildren removed from them, had provided satisfactory care, which causesconcern. Feldman (1986:pg. 778) concludes that ‘retarded parents are probablycurrently the only group of citizens whose children are routinely taken away atbirth, before any evidence of child maltreatment can be established to justifyapprehension.’2.7.3.4. Attitudes to the sexuality and reproductive rights of women withintellectual disabilitiesWomen with intellectual disability are often considered either asexual orhypersexual, with little or no ability to control their sexual expression, yet theyhave the same sexual needs and desires as people without intellectualdisabilities (Mitchell et al, 1978; Aunos and Feldman, 2002; Keenan, 2006b).However, through the ages, women with intellectual disabilities were perceivedas ‘the most serious threat to society’ (Trent, 1994:pg. 179), because they wereviewed as abnormally fertile women who gave birth to defective children andspread sexually transmitted diseases (Jones, 1986; Perkins et al, 2002),47
WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY,CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College Dublintherefore making them subjects ‘to be dealt with’ (Mental Deficiency Act, 1913cited in Walmsley, 2000:pg. 65). They were often separated by sex or sterilisedto prevent procreation (Stainton, 1992; Trent, 1994; Cocks et al, 1996;Walmsley, 2000; Black, 2003; Broberg and Roll-Hansen, 2005; McClimens,2005; Keenan, 2006a).Walmsley (2000) has found evidence in Bedfordshire 1916-1918 to indicate thatwomen with intellectual disability were more likely to be institutionalised andtheir sexual conduct was a major factor in this decision. Perkins et al (2002)suggest that the extended families of mothers with an intellectual disability areoften the subject of discrimination, with the disability of their relative perceivedas an individual pathology to be dealt with by medicalising and hospitalisingthem (Oliver, 1990; McClimens, 2005). Such women were also viewed as asocial problem and the focus of rehabilitation (Simmons, 1978; Trent, 1994;McClimens, 2005; Keenan, 2006a).2.8. SummaryAgainst a background of increasing medicalisation of childbirth, where womenwith disabilities may be at risk of being viewed through a medical lens solelybecause of their particular disability, the various aspects of different disabilitieswere examined. The historical development and improvement of national datacollection and statistics is noted and should provide more useful data in thefuture. Within the limits of the published research, the background and contextfor the care of women with all types of disabilities showed a history ofdiscrimination lasting to the present day. Evidence from the literature suggeststhat society has, in many instances, undervalued women with disabilities, hasexerted control over their sexual and reproductive lives and has, at least in thecase of women with mental health difficulties, exacerbated their difficulties.Mothers with intellectual or mental health disabilities, in particular, are oftenseparated from their children, despite a lack of evidence of harm or theexistence of positive benefits to them of performing the mothering role. Societalattitudes such as these may very well lead to barriers for women with disabilities48
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