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 DublinThese emotions and prejudicial attitudes heighten women’s sense ofvulnerability, insecurity, isolation and marginalisation and increase the pressureexperienced by women as they embark on, and attempt to negotiate, the manychallenges of pregnancy (McGuinness, 2006). One prominent myth is thatwomen with disabilities are asexual (NWCI, 2006), uninterested in sex or areunable to part take in sexual activity. This assumption is ‘pejorative’ (Kaplan,2006:pg. 450) and may result in health care providers denying access toappropriate services and care. The assumption is also untrue, as women withphysical disabilities are sexual beings who engage in sexual activity. They, too,experience feelings of desire and love, seek sexual gratification and desiremotherhood (Anderson and Kitchin, 2000). Vansteenwegen et al (2003),however, note how some women with a physical disability tend to reject theirsexuality, around which there is a great deal of negativity, prejudice andmisunderstanding (Nisha, 2005).Lee and Oh (2005) highlighted a range of barriers experienced by marriedwomen with a physical disability with regard to obtaining sexual andreproductive health care information. Barriers included lack of knowledgeamong health care professionals and the absence of medical facilities forpeople with disabilities. Many women in this study (n=410) reported not usingsafe sex devices and 25% had insufficient information regarding sexuality andreproductive health.3.5.2.2. Attitudes and behaviours relating to pregnancyBecoming a mother is an aspiration of many women with a physical disability,which, according to Mc Keever et al (2003) represents the ‘capturing of agender or recapturing of a lost gender’ (Mc Keever et al, 2003:pg. 671) andprovides women with a sense of normality. It is an avenue to societalacceptance, as becoming a parent shifts the focus from the disability toparenting and provides women with a platform that emphasises theirindependence and competency (Grue and Tafjord-Laerum, 2002). Pregnancyand parenthood is thus perceived as a triumph over their disability (Goodman,63
WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY,CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College Dublin1994). However, many women with physical disabilities planning to becomepregnant are exposed to prejudicial attitudes of others and experiencetremendous pressure not to do so (Baker et al, 1997; House of CommonsHealth Committee, 2003; Prilleltensky, 2003; McFarlene, 2004; Thierry, 2006).These attitudes are quite often founded upon, and impregnated with, a eugenicphilosophy and ethos and are described as dehumanising (Grabois, 2001).Consequently, women may forgo pregnancy and parenting because they fearthat their disability will be inherited by their child or that the child may bepsychologically deprived or burdened by the fact that one or both parents havea disability (Carty, 1998). Health professionals sometimes label women withdisabilities as having an unwanted, unplanned pregnancy and desiring atermination, which exemplifies their assumption that women with disabilities areincapable of becoming a parent (Welner, 1997; Carty, 1998; Prilleltensky,2003).Women with physical disabilities have described health professionals as aloof,authoritarian and domineering (Westbrook and Chinnery, 1995) or patronising,hostile and unable or unwilling to accommodate diversity (D’Eath et al, 2005).The hypervisibility of the woman’s disability may result in the woman beingshunned or ignored (Zitzelsberger, 2005), although this may be due, in part, tohealth professionals’ nervousness at the different challenges that women withdisabilities (Goodman, 1994) present.3.5.2.3. Attitudes and behaviours postnatallyHaving a physical disability and needing help are in contrast to the normalrepresentation of mothering (McKeever et al, 2003) and health professionalsmay find it difficult to comprehend these women’s ability to mother, nurture andcare for their baby (McFarlene, 2004). Women with physical disabilities describehow they perceive themselves to be constantly judged and scrutinised by healthprofessionals and are fearful that they would be considered a failure(Prilleltensky, 2003; McFarlene, 2004). Many are afraid to ask for assistance asthey fear that such a request would be interpreted as them being incapable and64
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