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 DublinCHAPTER FIVE: WOMEN WITH MENTAL HEALTH DIFFICULTIES:BARRIERS AND FACILITATORS TO ACCESSING SERVICES ANDPROFESSIONAL HELP DURING PREGNANCY, CHILDBIRTH AND EARLYMOTHERHOOD ............................................................................................... 895.1. Introduction ............................................................................................. 895.2. Barriers to availability of services for women with mental healthdifficulties ....................................................................................................... 905.2.1. Links between maternity and mental health services.......................... 905.2.2. In-patient and community services ..................................................... 915.2.3. Provision of services appropriate to needs ......................................... 925.3. Barriers to accessibility of services for women with mental healthdifficulties: Impact of symptoms on ability to take action.......................... 935.3.1. Inadequate recognition or denial of pregnancy ................................... 935.3.2. Women’s motivation to access services ............................................. 945.4. Barriers preventing accommodation of women with mental healthdifficulties: Access to health information .................................................... 945.4.1. Women’s knowledge about antenatal mental health difficulties .......... 945.4.2. Information provision about antenatal mental health difficulties .......... 955.4.3. Women’s knowledge about services and help available ..................... 955.4.4. Lack of fluency in English leading to lack of knowledge of services ... 965.5. Barriers preventing accommodation of women with mental healthdifficulties: Assessment and screening practices ...................................... 965.5.1. Assessment practices ......................................................................... 965.5.2. Lack of knowledge, time and awareness in maternity care professionals..................................................................................................................... 975.5.3. Screening practices ............................................................................ 985.6. Barriers to acceptability of services for women with mental healthdifficulties: Stigma and shame ..................................................................... 995.6.1. Stigmatisation and discrimination ....................................................... 995.6.2. Labelling and shame in a multi-cultural population ........................... 1005.7. Barriers to acceptability of services for women with mental healthdifficulties: Fear of being judged a ‘bad’ mother ...................................... 1015.7.1. Society’s views of mothers with mental health difficulties ................. 1015.7.2. Family’s views of mothers with mental health difficulties .................. 1025.7.3. Women’s reluctance to admit to mental health difficulties ................ 1035.7.4. Women’s fears of being judged ‘an incompetent mother’ ................. 1045.8. Barriers to acceptability of services for women with mental healthdifficulties: Fear of loss of custody ............................................................ 1055.8.1. Feeling the need to prove themselves .............................................. 1055.8.2. Fear of services ................................................................................ 1055.8.3. Trust in health professionals ............................................................. 106v
WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY,CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College Dublin5.9. Barriers to acceptability of services for women with mental healthdifficulties: Conflict and fears over taking medication ............................. 1075.9.1. Fear of addiction ............................................................................... 1075.9.2. Fear of effect of medications on the fetus or baby ............................ 1075.9.3. Fears of impaired ability to care for their children ............................. 1085.10. Barriers to affordability of services for women with mental healthdifficulties ..................................................................................................... 1095.11. Facilitators to overcome availability challenges for women withmental health difficulties ............................................................................. 1095.12. Facilitators to overcome accessibility challenges for women withmental health difficulties ............................................................................. 1105.13. Facilitators to improve accommodation of women with mental healthdifficulties ..................................................................................................... 1105.14. Facilitators to improve acceptability of services for women withmental health difficulties ............................................................................. 1115.15. Facilitators to improve affordability of services for women withmental health difficulties ............................................................................. 1125.16. Summary .............................................................................................. 112CHAPTER SIX: WOMEN WITH INTELLECTUAL DISABILITY: BARRIERS TOACCESSING SERVICES AND PROFESSIONAL HELP DURINGPREGNANCY, CHILDBIRTH AND EARLY MOTHERHOOD ....................... 1146.1. Introduction ........................................................................................... 1146.2. Barriers to acceptability of services for women with intellectualdisabilities..................................................................................................... 1146.2.1. Society’s attitudes to women with intellectual disabilities becomingpregnant ..................................................................................................... 1146.2.2. Society’s attitudes to women with intellectual disabilities caring for theirchildren: the presumption of parental inadequacy ...................................... 1156.3. Facilitators to improve access to services for women with intellectualdisabilities..................................................................................................... 1166.4. Summary ................................................................................................ 117SECTION THREE: PLANNING FOR THE FUTURE ..................................... 118CHAPTER SEVEN: SUMMARY AND CONCLUSION .................................. 1187.1. Summary ................................................................................................ 118vi
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