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 Dublinexamination (Bar-Hava et al, 1999). Accessible bathroom facilities that facilitateease of movement for people with mobility disabilities, with an emergency cordthat extends to the floor should be situated on each unit and clearly signposted(McKay-Moffat, 2007). A designated unit/ward specifically adapted for womenwith disabilities may alleviate any issues in relation to accessibility when awoman with disability needs is admitted to the health care environment. Othermodifications that will help to ensure access to health care include theprocurement of suitable equipment and technical aids, for example, hoists,height adjustable hydraulic examination tables, and accessible baby cots.3.6.5. Facilitators to improve service provisionEnhancing maternity care for disadvantaged groups, including women withdisabilities, requires better planning and coordination of services utilising amultidisciplinary approach (Clancy and Andresen, 2002; D’Souza and Garcia,2004; Kelsall, 1992; Carty et al, 1993; Goodman, 1994; Thomas and Curtis,1997; Lipson and Rogers, 2000; Clark, 2002; Comhairle na nOspidéal, 2003;WWDA, 2004; D’Eath et al, 2005; Institute of Obstetricians and GynaecologistsSubgroup, 2006; McKay-Moffat and Cunningham, 2006). Establishing links anda mechanism of referral to the various support services will facilitate the sharingof knowledge amongst disciplines (Campion, 1997; Thomas and Curtis, 1997),thus enhancing standards of care and women’s experiences, which shouldresult in a higher level of satisfaction (McKay-Moffat and Cunningham, 2006).A key Irish study commissioned by the National Disability Authority in 2005captured the experience of people with disabilities, including persons withintellectual, physical and sensory disabilities, of the health services (D’Eath etal, 2005). Unlike respondents in other work (Piotrowski and Snell, 2007),women who participated in this study reported some positive experiences withthe health services. The value of acceptance and reciprocity was demonstratedin the participants’ experience of General Practitioners, with some exemplifyingpartnership approaches and inclusive practices (D’Eath et al, 2005).71
WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY,CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College Dublin3.7. Facilitators to improve accommodation of women withphysical disabilities3.7.1. Facilitators to overcome communicational and informationalchallengesWomen with physical disabilities should have access to all information(Thomas, 1998) and education about their condition (Mitton et al, 2007) in anappropriate language and format that is easily understandable. Healthprofessionals must recognise that they are a conduit for information (Thomas,1998; Harkin, 2001). Canadian research has indicated that culturally sensitiveantenatal education classes should be provided specifically for women withphysical disabilities (Conine et al, 1986; Carty et al, 1993). Pendergrass et al(2001) recommends that health service providers should use the internet toprovide information and, in particular, to establish health information sites forwomen with disabilities.3.8. Facilitators to improve acceptability of services for womenwith physical disabilities3.8.1. Facilitators to overcome attitudinal challengesDisability awareness and training should be an integral part of all healthprofessionals’ education and induction to services, supplemented with regularseminars (Carty et al, 1993; Goodman, 1994; Baker et al, 1997; Campion,1997; Royal College of Midwives (RCM), 2000; Veltman et al, 2001; Schopp etal, 2002; Ubido et al, 2002; Scheer et al, 2003; Nzegwu, 2004; Underwood,2004; Valios, 2004; WHC, 2004; WWDA, 2004; D’Eath et al, 2005; Harris, 2006;McGuinness, 2006; RCN, 2007; Smeltzer et al, 2007). In particular, healthprofessionals could learn from women with disabilities (Smeltzer, 2007). Healthprofessionals should embrace diversity (Crow, 2003) and recognise theimportance of seeing beyond the disability (McGuinness, 2006).72
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