Perceptions of motherhood in mothers of children with disabilities in Turkey: a qualitative study

OBJECTIVES

This study aimed to explore how mothers of children with disabilities perceive mothering through metaphor.

SUBJECTS AND METHODS

The study was conducted in March 2023 with 28 women who had experienced motherhood. The data were collected using the Descriptive Information Form and the Metaphorical Perceptions Form developed by the researchers who reviewed the literature. The women's metaphorical perceptions were obtained by filling in the following sentence: 'Being a mother of a child with disabilities is like/similar to … … … . because … … '.. The interviews were conducted individually using the in-depth interview method and analysed using the descriptive analysis technique.

RESULTS

The metaphors created by mothers of children with disabilities were grouped under two main themes: interpretation and challenges. Each major theme contains sub-themes. The main theme of interpretation includes cleansing from sins and divine reward, empowerment, being privileged, and acceptance/change in outlook on life, while the sub-theme of challenges includes constant struggle, stigmatisation, imprisonment/isolation, and uncertainty.

CONCLUSION

The women involved in the study produced the most metaphors for their perceptions of being a mother of a child with a disability for the sub-theme of imprisonment/isolation in the main theme of challenges. On the other hand, the least number of metaphors were produced in the sub-theme of acceptance/change in the outlook on life in the main theme of interpretation. According to the results, the perception of motherhood of women with children with disabilities will especially guide midwives who are responsible for the care of children with disabilities aged 0-6 years, and mental health workers.

Parental and Pandemic Burnout, Internalizing Symptoms, and Parent-Adolescent Relationships: A Network Analysis

The COVID-19 pandemic and preventive measures undertaken by many governments have had a significant impact on family relationships, which could result in worsened parenting. In our study, we used network analysis to examine the dynamic system of parental and pandemic burnout, depression, anxiety, and three dimensions of relationship with an adolescent: connectedness, shared activities, and hostility. Parents (N = 374; M_age = 42.9) of at least one child at the age of adolescence completed an online survey. The central symptoms in the network were parental emotional exhaustion and parental anxiety. Parental emotional exhaustion correlated negatively with activities shared with the adolescent, but positively with hostility. Anxiety correlated positively with parental emotional exhaustion. Emotional exhaustion and anxiety were the strongest bridge symptoms between parental burnout, internalizing symptoms, and parenting. Our results suggest that psychological interventions supporting parent-adolescent relationships should address primarily parental emotional exhaustion and anxiety.

Maternal healthcare for women with physical disabilities in Northern Vietnam: perspectives of healthcare providers

BACKGROUND

Pregnancy among women with physical disabilities is common around the world; however, there are limited qualitative studies that explore the perspectives of healthcare providers toward pregnant women with disabilities outside of the Global North.

OBJECTIVE

This article explores perspectives and experiences of maternal healthcare providers in the delivery of services to women with physical disabilities in Northern Vietnam.

METHODS

Semi-structured interviews were conducted with 14 healthcare providers who worked in public and/or private healthcare North Vietnamese facilities where maternal services were provided. Data were thematically analyzed.

RESULTS

The participants included six males and eight females. Ten were obstetricians/gynecologists, one was a doctor specializing in obstetric imaging diagnosis, three were midwives, and one was a midwife/assistant doctor. Four themes were identified. In the first theme, providers attached provisos to the right to motherhood including the view that the women were limited to one child and should undergo prenatal screenings for fetal abnormalities. In the second theme, the providers reported that disability was not incorporated into their education; this led to half of them lacking confidence in providing appropriate maternal healthcare services for women with physical disabilities. The third theme found that although women with physical disabilities were considered as a priority group, decisions around who was seen before others or provided with fee discount/exemption were left in the hands of staff. The fourth theme identified that some providers overlooked their needs for physical accessibility and independence.

CONCLUSION

This study shows that maternal healthcare providers in Vietnam discounted the needs of women with physical disabilities. The needs of women with disabilities should be included in the training of maternal healthcare providers in Vietnam.

Parenting with a physical disability: A scoping review of assessment methods

INTRODUCTION

Daily childcare can be challenging for parents with a physical disability who have young children. Occupational therapists are valuable facilitators to family participation. However, occupational therapists have reported significant gaps in knowledge when documenting the parenting role of parents with a physical disability in occupational therapy practice. This study explored and described the parenting assessment methods used with parents with a physical disability in the scientific literature.

METHODS

A scoping review was conducted, and search results were reviewed by two separate reviewers. The search strategy was applied to five databases (Embase, CINAHL, MEDLINE, HaPI, PsycInfo). Numerical and thematic analyses were conducted.

RESULTS

Four thousand one hundred fifty articles were screened, and 73 relevant scientific articles were included. Seventy-six assessment methods were identified, including 20 assessment instruments with few reported population-specific psychometric studies. Most assessments were conducted via interviews (n = 45), followed by questionnaires (n = 27), and only six were performance based. Parenting practices and experience were the two dimensions most assessed, with little attention given to parenting responsibility. Mothers with multiple sclerosis, spinal cord injury, rheumatoid arthritis, and cerebral palsy were the most assessed.

CONCLUSION

Further research is needed to develop specific, multidimensional, and validated parenting assessments for all parents with a physical disability, including performance-based assessments. Formal assessments should be conducted by professionals, including occupational therapists, who have the necessary training.

The vicious circle of stereotypes: Teachers’ awareness of and responses to students’ gender-stereotypical behaviour

The study was conducted using a mixed methods approach combining lesson observations and interviews with teachers. A total of 204 hours of observation in 34 classes of 7th and 8th graders (aged 13–14 in the Polish primary school system) were conducted to investigate teachers’ behaviour that may exacerbate gender stereotypes and gender bias in the classroom. Moreover, the 25 female teachers conducting the observed lessons were interviewed to identify: (i) teachers’ awareness of stereotypical behaviours of girls and boys during classes; (ii) teachers’ awareness of possible causes of these behaviours; (iii) teachers’ responses to these behaviours, including actions that could deepen gender stereotypes; and (iv) teachers’ sensitivity to the gender polarised content of school textbooks. The results of the study show that teachers, although they are aware of the existence of gender stereotypes and declare their willingness to counteract them, tend to strengthen rather than eliminate these stereotypes with the strategies and actions undertaken. They have difficulty recognising possible reasons for the occurrence of stereotypical student behaviour and have little awareness of the gender-polarised content of school textbooks. The results of the study are discussed, inter alia, in light of the concept of the vicious circle of stereotypes and self-fulfilling prophecies in education.

Motherhood Experiences of Visually Impaired and Normally Sighted Women

The present study explores the characteristics of visually impaired mothers’ personal identities as reflected in their individual representations of motherhood taking account of the impact of the specific social context on these representations. The sample included 20 visually impaired (VI) and 21 normally sighted (NS) mothers. In line with the narrative psychological approach to motherhood, each participant gave a narrative account of her related experiences in a semi-structured interview. The transcribed responses were subjected to a thematic analysis aimed at comparing the narratives of visually impaired and normally sighted mothers’ for thematic composition in order to identify shared and impairment specific themes of motherhood experiences. The motherhood experiences were sorted into eight thematic categories: Emotions; Continuity; Personal Development; Connectedness; Challenges; Partner; Roles and Principles; and Calling/Career. While in some categories VI and NS mothers showed similar patterns of experience, such as finding a new purpose in life and developing a new role in the family with the advent of pregnancy (Personal Development), in other categories motherhood experiences were thematized differently, such as VI mothers focused on challenges posed by day-to-day situations, NS mothers were rather concerned with their children’s future (Challenges). The study presents the shared and non-shared aspects of disabled and non-disabled women’s motherhood experiences with the primary aim of demonstrating the potential impact of the prevailing sociocultural norms, and attitudes considering visually impaired mothers on their motherhood experiences.

"Under great anxiety": Pregnancy experiences of Vietnamese women with physical disabilities seen through an intersectional lens

BACKGROUND

There is scant research on pregnancy experiences of women with physical disabilities in low and middle-income countries. This qualitative study used an intersectional lens to explore pregnancy experiences of women with physical disabilities in northern Vietnam. Specifically, socio-cultural, economic, and environmental influences were analysed, drawing upon their lived experiences.

METHODS

Two in-depth interviews were conducted at different time-points in 2018 with women with physical disabilities who had given birth in the previous three years. Twenty-nine women participated in the first interview and 27 in the follow-up interview. The interviews were thematically analysed.

RESULTS

The women were happy and excited when discovering their pregnancy but they also experienced anxiety, fear, and distress. Their ambivalence related to concerns around having a child with disabilities, their capability to carry a pregnancy, and their mothering abilities. Negative community views of disability were internalised by the women. These socio-culturally constructed beliefs led to lack of confidence in their pregnancy journey. This was exacerbated by inaccessible environments that contributed to increased risk of falls, and women who used wheelchairs experienced particular difficulties. Other powerful influences included poverty, lost income, and costs associated with pregnancy. Single mothers with disabilities experienced additional stigma and discrimination as Vietnamese society judged their pregnancies as socially unacceptable.

CONCLUSION

This study contributes to knowledge and understanding about women with physical disabilities, specifically how the intersection of gender, disability, socio-economic, and marital status shaped their pregnancy experiences in Vietnam. Multiple challenges were encountered by the women in their pregnancy journey, including negative community views, inaccessible environments, and poverty. The findings highlight the necessity for Vietnamese women with physical disabilities to be actively engaged in talking about their experiences to ensure maternal and child health providers become more sensitive to their pregnancy and motherhood needs.

Parenting with a physical disability and cognitive impairments: a scoping review of the needs expressed by parents

PURPOSE

Parents, whose daily activities are limited by a disability, account for 6.2% of the American population with minor children. Considering the prevailing knowledge gaps concerning parents with a physical disability and cognitive impairments, there is an urgency to instigate an investigation of their unmet needs. In this study, we will examine the scope of literature relating to the specific needs of parents with a physical disability and cognitive impairments in early child rearing occupations.

METHODS

A scoping review of peer-reviewed literature was conducted by two independent raters in four databases (CINAHL, EMBASE, Medline, PsycINFO). Data were extracted and analyzed numerically and thematically using the International Classification of Functioning, Disability and Health (ICF).

RESULTS

Twenty-nine studies were included for review representing the needs of 113 parents. Emerging needs related to 15 ICF categories and three corresponding themes: parents' (1) needs when engaging with their young children, (2) personal needs in and outside the home, and (3) needs navigating the health system.

CONCLUSIONS

The unmet needs of parents with a physical disability and cognitive impairments legitimize the development of clinical services for this population. Future research should focus on developing assessments and interventions specific to parental needs in child rearing occupations.IMPLICATIONS FOR REHABILITATIONAdults with a physical disability and cognitive impairments who parent young children have unmet needs with regards to engaging in child rearing, meeting their personal needs, and navigating the health system.Studies reporting on the impact of impairments on parenting mostly focus on elucidating physical impairments and less so cognitive impairments.Developing a more comprehensive understanding of parental needs will inform further development of targeted assessments and interventions for parents with a physical disability and cognitive impairments.

“Never Say Never?” Heterosexual, Bisexual, and Lesbian Women’s Accounts of Being Childfree

Feminist scholars have identified a “motherhood imperative” in Western cultures, when heterosexual women are understood to both want and to have children. However, social shifts have resulted in a decrease in pronatalism as well as an increase in social recognition of the parenting desires of same-sex parents. Despite a resurgence of interest in childfree identities, research to date has predominantly focused on heterosexual women’s explanations for being childfree and their experiences of marginalization. Our aim in the current study was to explore how childfree heterosexual, lesbian, bisexual, and queer women negotiate their childfree lives and identities in the context of their personal and social relationships within changing cultural contexts. Data from 23 interviews with women in the United Kingdom, who responded to a call for childfree participants, were thematically analyzed. We constructed two themes: (1) Never say never? Negotiating being childfree as ever precarious, which shows how women constructed being childfree as requiring constant revisiting and renegotiating to maintain and (2) An ordinary life: Constructing being childfree as rational and reasonable, in which we identify the rhetorical efforts of participants to establish their being childfree as an ordinary, reasonable, and rational position. We conclude that for these women, childfreedom was constantly in flux and that maintaining a positive childfree identity required considerable identity work in order to manage intimate personal relationships and wider friendships. Online slides for instructors who want to use this article for teaching are available on PWQ's website at http://journals.sagepub.com/page/pwq/suppl/index

Maternal and newborn health needs for women with walking disabilities; "the twists and turns": a case study in Kibuku District Uganda

Background

In Uganda 13% of persons have at least one form of disability. The United Nations’ Convention on the Rights of Persons with Disabilities guarantees persons with disabilities the same level of right to access quality and affordable healthcare as persons without disability. Understanding the needs of women with walking disabilities is key in formulating flexible, acceptable and responsive health systems to their needs and hence to improve their access to care. This study therefore explores the maternal and newborn health (MNH)-related needs of women with walking disabilities in Kibuku District Uganda.

Methods

We carried out a qualitative study in September 2017 in three sub-counties of Kibuku district. Four In-depth Interviews (IDIs) among purposively selected women who had walking disabilities and who had given birth within two years from the study date were conducted. Trained research assistants used a pretested IDI guide translated into the local language to collect data. All IDIs were audio recorded and transcribed verbatim before analysis. The thematic areas explored during analysis included psychosocial, mobility, health facility and personal needs of women with walking disabilities. Data was analyzed manually using framework analysis.

Results

We found that women with walking disabilities had psychosocial, mobility, special services and personal needs.

Psychosocial needs included; partners’, communities’, families’ and health workers’ acceptance. Mobility needs were associated with transport unsuitability, difficulty in finding transport and high cost of transport. Health facility needs included; infrastructure, and responsive health services needs while personal MNH needs were; personal protective wear, basic needs and birth preparedness items.

Conclusions

Women with walking disabilities have needs addressable by their communities and the health system. Communities, and health workers need to be sensitized on these needs and policies to meet and implement health system-related needs of women with disability.

The experience of adult children of mothers with intellectual disability: A qualitative retrospective study from Poland

BACKGROUND

Little is known about the experience of growing up with a mother with intellectual disability. The aim of this study was to explore this experience from the perspective of adult children.

METHOD

In-depth interviews with 23 adult children brought up by mothers with moderate-to-severe intellectual disability. The interview data were analysed using grounded theory methods.

RESULTS

The childhood experiences of the interviewees and the role their mothers played in their upbringing varied, depending in part on the involvement of extended family. It was the stigma of maternal intellectual disability, rather than their mother's functional limitations, that posed the greatest challenge.

CONCLUSION

Interviewees characterized their mothers and childhoods as different, yet ordinary. Understanding the social context, including but not limited to the availability of informal support, is critical to understanding the experience of children growing up with mothers with intellectual disability.