A Wise Wife and Good Mother: Reproductive Health and Maternity among Women with Disability in South Korea

Societal attitude and behaviours towards women with disabilities in rural Nepal: pregnancy, childbirth and motherhood

BACKGROUND

This study reviews the attitudes and behaviours in rural Nepalese society towards women with disabilities, their pregnancy, childbirth and motherhood. Society often perceives people with disabilities as different from the norm, and women with disabilities are frequently considered to be doubly discriminated against. Studies show that negative perceptions held in many societies undervalue women with disabilities and that there is discomfort with questions of their control over pregnancy, childbirth and motherhood, thus limiting their sexual and reproductive rights. Public attitudes towards women with disabilities have a significant impact on their life experiences, opportunities and help-seeking behaviours. Numerous studies in the global literature concentrate on attitudes towards persons with disabilities, however there have been few studies in Nepal and fewer still specifically on women.

METHODS

A qualitative approach, with six focus group discussions among Dalit and non-Dalit women without disabilities and female community health volunteers on their views and understandings about sexual and reproductive health among women with disabilities, and 17 face-to-face semi-structured interviews with women with physical and sensory disabilities who have had the experience of pregnancy and childbirth was conducted in Rupandehi district in 2015. Interviews were audio-recorded, transcribed, and translated into English before being analysed thematically.

RESULTS

The study found negative societal attitudes with misconceptions about disability based on negative stereotyping and a prejudiced social environment. Issues around the marriage of women with disabilities, their ability to conceive, give birth and safely raise a child were prime concerns identified by the non-disabled study participants. Moreover, many participants with and without disabilities reported anxieties and fears that a disabled woman's impairment, no matter what type of impairment, would be transmitted to her baby, Participants - both disabled and non-disabled, reported that pregnancy and childbirth of women with disabilities were often viewed as an additional burden for the family and society. Insufficient public knowledge about disability leading to inaccurate blanket assumptions resulted in discrimination, rejection, exclusion and violence against women with disabilities inside and outside their homes. Stigma, stereotyping and prejudice among non-disabled people resulted to exclusion, discrimination and rejection of women with disabilities. Myths, folklore and misconceptions in culture, tradition and religion about disability were found to be deeply rooted and often cited as the basis for individual beliefs and attitudes.

CONCLUSION

Women with disabilities face significant challenges from family and society in every sphere of their reproductive lives including pregnancy, childbirth and motherhood. There is a need for social policy to raise public awareness and for improved advocacy to mitigate misconception about disability and promote disabled women's sexual and reproductive rights.

Access and quality of maternity care for disabled women during pregnancy, birth and the postnatal period in England: data from a national survey

OBJECTIVES

More disabled women are becoming mothers, and yet, their care is rarely the focus of quantitative research. This study aimed to investigate access and quality of maternity care for women with differing disabilities.

DESIGN

Secondary analysis was conducted on data from a 2015 national survey of women's experience of maternity care. Descriptive and adjusted analyses were undertaken for five disability groups: physical disability, sensory impairment, mental health disability, learning disability and multiple disability, and comparisons were made with the responses of non-disabled women.

SETTING

Survey data were collected on women's experience of primary and secondary care in all trusts providing maternity care in England.

PARTICIPANTS

Women who had given birth 3 months previously, among whom were groups self-identifying with different types of disability. Exclusions were limited to women whose baby had died and those who were younger than 16 years at the time of the recent birth.

RESULTS

Overall, 20 094 women completed and returned the survey; 1958 women (9.5%) self-identified as having a disability. The findings indicate some gaps in maternity care provision for these women relating to interpersonal aspects of care: communication, feeling listened to and supported, involvement in decision making, having a trusted and respected relationship with clinical staff. Women from all disability groups wanted more postnatal contacts and help with infant feeding.

CONCLUSION

While access to care was generally satisfactory for disabled women, women's emotional well-being and support during pregnancy and beyond is an area that is in need of improvement. Specific areas identified included disseminating information effectively, ensuring appropriate communication and understanding, and supporting women's sense of control to build trusting relationships with healthcare providers.

Nurses' Experiences of Caring for Disabled Women during Pregnancy and Childbirth

PURPOSE

This phenomenological study was to describe and to understand nurses' experiences of caring for woman with disability during pregnancy and childbirth.

METHODS

Participants were 13 nurses from 3 hospitals and 2 local clinics in J city, and were selected through snow-balling method. Data were collected two face to face, semi-structured interviews. The researcher used MP3 player and smart phone for recording as well as transcription process. As for the data analysis, Colaizzi's method was applied.

RESULTS

Nurses' experiences were structured as four theme clusters: 'Communicating between/among nurses', 'Recognizing pregnancy and childbirth of woman with disability', 'Taking care of woman with disability based on their differences' and 'Reflecting on nursing care for woman with disability'.

CONCLUSION

It seemed that nurses' recognition to woman with disability and her pregnancy and childbirth was related their nursing care for woman with disability.

[Pregnancy in women with spinal cord injuries: State of knowledge]

OBJECTIVES

Updating knowledge of health professionals about pregnant women with spinal cord injuries. Development of maternity hospitals to make them accessible to spinal cord injured pregnant women to improve their care in pre-, per- and post-partum.

METHODS

Cross-sectional declarative study based on a questionnaire distributed to health professionals in the maternity hospital of the University Hospital of Nantes and liberal midwives of Nantes conurbation, based on their knowledge, their difficulties and their expectations for obstetrical care for spinal cord injured women. An inventory was carried out in parallel at the maternity hospital of the University Hospital of Nantes.

RESULTS

Seventy-two percent of health professionals surveyed rated their level of knowledge on spinal cord injuries insufficient or even non-existent. Among the professionals, 84.8% said they encountered difficulties to take care of spinal cord injured women. The main cited difficulty relates to unsuitable equipment or premises, obstacle indeed found during the inventory made on the maternity hospital.

CONCLUSION

Several proposals are being considered, including specific trainings, the execution of a management protocol for spinal cord injured women, the establishment of a situation's form of handicap, the layout of the maternity hospitals premises, and finally, the creation of reference's centers in the region to optimize the follow-up of these patients.

THE SUPPORT NETWORK IN PREGNANCY AND CHILDBIRTH: THE CONCEPTIONS OF WOMEN WITH PHYSICAL DISABILITY

This study aimed to investigate the conception of women with physical disability regarding the support network for the exercising of motherhood. It is descriptive-exploratory research, with qualitative approach, whose data were collected through semistructured interviews with 12 women with physical disability, undertaken between April and June 2014. The technique of thematic analysis was used for the treatment of the information, and Symbolic Interactionism was used as the theoretical framework. The interviewees reported the importance of the support of the partner, of family members, and of health professionals, during pregnancy and the postpartum, for them to be able to exercise the maternal role. The absence of this support influenced their conceptions regarding their capacity in this function. One can observe the need to promote the reproductive health of the person with a disability, so as to mitigate the stigmas and thus provide them with appropriate support. In addition to this, the health professionals must be trained to understand holistically their needs and rights.

Social Context of Disabled Parenting

The article discusses parenting of individuals with disability. It was based on the perspective of barriers, which (next to the perspective of risk and the functional perspective) marks the nature of discourse this theme takes in the literature on the subject and in practice. The perspective of barriers, related to the social model of disability, emphasizes the social factors important for the quality of parenting of individuals with disability. These factors were analyzed on the basis of available research results with mothers and fathers with disability, and able-bodied individuals who are part of their professional and non-professional environment. The article draws attention to the specificity of socialization of individuals with disability and its significance for preparations for family roles, social attitudes towards disabled individuals’ parenting, and their determinants. It also presents disabled parents’ experiences and the importance of realizing their role of a mother or father.

Women with disability: the experience of maternity care during pregnancy, labour and birth and the postnatal period

BACKGROUND

It has been estimated that 9.4% of women giving birth in the United Kingdom have one or more limiting longstanding illness which may cause disability, affecting pregnancy, birth and early parenting. No large scale studies on a nationally representative population have been carried out on the maternity experiences of disabled women to our knowledge.

METHOD

Secondary analysis of data from a survey of women in 2010 by English National Health Service Trusts on behalf of the Care Quality Commission was undertaken. 144 trusts in England took part in the postal survey.Women self-identified with disability and were excluded if less than 16 years of age or if their baby had died. The 12 page structured questionnaire with sections on antenatal, labour and birth and postnatal care covered access, information, communication and choice. Descriptive and adjusted analyses compared disabled and non-disabled groups. Comparisons were made separately for five disability subgroups: physical disability, sensory impairment, mental health conditions, learning disability and women with more than one type of disability.

RESULTS

Disabled women comprised 6.14% (1,482) of the total sample (24,155) and appeared to use maternity services more than non-disabled women. Most were positive about their care and reported sufficient access and involvement, but were less likely to breastfeed. The experience of women with different types of disability varied: physically disabled women used antenatal and postnatal services more, but had less choice about labour and birth; the experience of those with a sensory impairment differed little from the non-disabled women, but they were more likely to have met staff before labour; women with mental health disabilities also used services more, but were more critical of communication and support; women with a learning disability and those with multiple disabilities were least likely to report a positive experience of maternity care.

CONCLUSION

This national study describes disabled women's experiences of pregnancy, child birth and postnatal care in comparison with non-disabled women. While in many areas there were no differences, there was evidence of specific groups appropriately receiving more care. Areas for improvement included infant feeding and better communication in the context of individualised care.