Have you cared for a woman with a disability having babies? Did you know if she had a disability or not? Did you ask her what were her worries about having a baby?
As a health professional, you may or may not have cared for a woman with a disability having a baby. Some health professionals find this difficult, as they may not have interacted with a person with a disability in their own social life. You may be uncomfortable to talk to the woman about her disability. This is not unusual. Many health professionals find asking about disability, and particularly intellectual disability challenging. Physical disability, visual and hearing impairment are usually more obvious than asking about intellectual or learning disability.
How do I ask about her disability?
People with disabilities in general experience stigma and discrimination in their lives. Especially those with intellectual disability (ID). If you think she might have an ID and you’re not sure how to ask, use these tips-
- Lead in with general questions first to help her feel comfortable.
- Start with a question about schooling, as this is less confronting. “How was school for you?” or “Did you have any difficulties at school?” is a good way to start. This opens up the conversation, which you can then explore in more detail.
- Be non-judgemental – people with a disability already experience prejudice in their lives
Sometimes it may take several visits with this mother-to-be for her to open up and disclose her disability. She will need to build up her trust in you – that you are not judging her but are there to support her. Many women with disability feel other people, including family and friends may not believe they can be mothers. Sometimes they may fear that they will have their baby taken away, and this might be the reason they are not disclosing their disability.
Supporting her confidence in becoming a mother.
Reassure them that you are there to support them, as well as your clinical role. Your role is helping her develop her confidence in becoming a mother. Parenting is a learned skill for everyone, whether they have a disability or not.
Starting your health provider-mother relationship early in pregnancy means you have more time to help her develop these skills.
Providing information to women with disability in pregnancy
The type and way of providing information about pregnancy, birth and parenting will depend on the mother’s disability. When the mother has communication difficulties, establishing how best to provide information is crucial right from the start. Her partner, family or carer will be integral in finding the best way to do this. However, during conversations with the mother, you need to focus on her, and talk to her, not her carers. This is similar to the principles when using interpreters for women from culturally and linguistically diverse communities.
Women with intellectual disability need information provided in small amounts at the level of their understanding. Using pictures and models is a helpful adjunct to your explanation. Written information needs to be reworded. If you are developing written materials, check the readability level of the document first. There are also guidelines on developing these materials for people with ID.
Women with other disabilities will often have a good understanding of their disability but will be unsure of how it affects their pregnancy. If you are not sure about this, ‘Disability in Pregnancy and Childbirth’ book contains lots of useful information for health providers.
Does she need NDIS support?
If the mother has existing National Insurance Disability Scheme (NDIS) funding, you may need to assist her to apply for further funding to support her new role as a parent. If she has been relatively independent in caring for herself prior to becoming pregnant and did not need NDIS funding she may need to apply for assistance now. Having a baby requires new skills and adds further challenges. To support her develop as a mother, additional funded services may be needed.
For other information:
Women with Disabilities Australia – a national organisation to support women with disabilities. Although not specific for maternity services, there is a section on motherhood and parenting.
Family Planning NSW – provides factsheets and training in the area of sexuality and disability.
New South Wales Council for Intellectual Disability – this site provides information about and for people with intellectual disability.
Parenting Research Centre – The ‘Healthy Start’ section has specific pregnancy and parenting resources for parents with intellectual disability
Change – a UK based website that provided information and services for people with intellectual disability. A picture gallery for developing written materials and specific resources for pregnancy and parenting are available.
National Disability Insurance Scheme – information on this scheme and funding for support if your client has a disability