Women with Disabilities: Barriers and Facilitators to Accessing ...

WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY,CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College Dublinappointments over the telephone is difficult for women so many have to go intothe clinic in person or ask somebody else to make the appointment. This can bea cumbersome task if women are reliant on public transport. Kelsall (1992)found that alternative methods of communication are rarely explored. In additionto the challenges encountered in making appointments, the majority of womenwho are deaf have difficulty gaining access to health care facilities that operatean intercom system (House of Commons Health Committee, 2003). Waiting forappointments is, for many, a source of frustration and embarrassment (Ubido etal, 2002). The lack of a visual call system in waiting areas means that thosewith hearing impairment may not be aware of when their name has been called,so they either miss their cue or rely on others to tell them when it is their turn,which relegates them to a dependent role. If women lip read they may not seeor recognise their name being verbalised because health professionals may‘over-mouth’ and shout and, especially when verbalised with impatience, itbecomes difficult for women who are deaf to understand what is being said.This may lead to frustration and anxiety which further impedes the woman’sability to lip-read or sign effectively (Kelsall, 1992; Iezzoni et al, 2004). As aresult women are more inclined to avoid health services and not attend forappointments, rather than deal with the embarrassment and frustration thatdevelop from such challenges (Iezzoni et al, 2004; O’Hearn, 2006; Steinberg,2006).4.6 Barriers preventing accommodation of women with ahearing impairment4.6.1. Access to health information and antenatal education classesThere is a severe deficit in the provision of formal health information for womenwho are deaf (Josiah, 2004). Antenatal classes may be sources of frustrationand confusion for these women. Signed antenatal classes are uncommon, sothis excludes a large majority of women who use sign language as their primarymode of communication. For women who lip-read, class facilitators may posechallenges by not positioning themselves in good light, words may be unclearand rushed, slide presentations may be difficult to read and if used in a78