BMC Pregnancy and Childbirth | |
Women with disability: the experience of maternity care during pregnancy, labour and birth and the postnatal period | |
Ron Gray1  Haiyan Gao1  Reem Malouf1  Maggie Redshaw1  | |
[1] Policy Research Unit for maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Old Road, Oxford OX3 7LF, UK | |
关键词: Maternity survey; Birth; Pregnancy; Maternity care; Disability; | |
Others : 1137877 DOI : 10.1186/1471-2393-13-174 |
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received in 2013-05-13, accepted in 2013-09-10, 发布年份 2013 | |
【 摘 要 】
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.
【 授权许可】
2013 Redshaw et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20150318045716329.pdf | 259KB | download |
【 参考文献 】
- [1]World Health Organization (WHO): Disability, including prevention, management and rehabilitation. 2011. Available at: http://www.who.int/nmh/a5817/en/ webcite. Accessed 09-11-2012
- [2]World Health Survey: Disability- a global picture. 2002. (Chapter 2):31. Available at: http://www.who.int/disabilities/world_report/2011/chapter2.pdf webcite. Accessed 09-11-2012
- [3]Steinmetz E: American with disabilities: Report No.P70-107. Washington (DC): US Census Bureau 2006; 2002.
- [4]Smeltzer CS: Pregnancy in women with physical disabilities. J Obstet Gynecol Neonatal Nurs 2007, 36:88-96.
- [5]Lipson JG, Rogers JG: Pregnancy, birth, and disability: women’s health care experiences. Health Care Women Int 2000, 21:11-26.
- [6]Blackford K, Richardson H, Grieve S: Prenatal education for mothers with disabilities. J Adv Nurs 2000, 32:898-904.
- [7]Sumilo D, Kurinczuk JJ, Redshaw ME, Gray R: Prevalence and impact of disability in women who had recently given birth in the UK. BMC Pregnancy Childbirth 2012, 12:31-37. BioMed Central Full Text
- [8]Kirshbaum M: Serving families with disability issues: through the looking glass. Marriage Fam Rev 1995, 21(1/2):9-28.
- [9]Coyle CP, Santiago MC: Healthcare utilization among women with physical disabilities. Medscape Women Health 2002, 7(4):2.
- [10]Lee LO, Heykyung OH: A wise wife and good mother: reproductive health and maternity among women with disability In South Korea. Sex Disabil 2005, 23(3):121-144.
- [11]Lin HC, Chen YH, Lee HC: Prenatal care and adverse pregnancy outcomes among women with schizophrenia; a national population-based study in Taiwan. J Clin Psychiatry 2009, 70(9):1297-1303.
- [12]Lin HC, Lee HC: The relation between maternal schizophrenia and low birth weight is modified by parental age. Can J Psychiatry 2010, 55(6):377-385.
- [13]Prilleltensky O: A ramp to motherhood: the experiences of mothers with physical disabilities. Sex Disabil 2003, 21(1):21-47.
- [14]Gill C, Kerotoski MA, Turk NMA: Becoming visible: Personal health experiences of women with disabilities. In D. M. Women with physical disabilities: Achieving and maintaining health and wellbeing. Baltmore: Pall H. Brookes; 1996:5-15.
- [15]Signore C, Spong CY, Krotoski D, Shinowara NL, Blackwell SC: Pregnancy in women with physical disabilities. Obstet Gynecol 2011, 117:935-947.
- [16]Hanson KW, Neuman P, Dutwin D, Kasper JD: Uncovering the health challenges facing people with disabilities: The role of health insurance. Health Affairs—Web Exclusive; 552-565. Available at: http://content.healthaffairs.org/content/early/2003/11/19/hlthaff.w3.552.full.pdf+html webcite
- [17]Thierry JM: Promoting the health and wellness of women with disabilities. J Womens Health 1998, 7:505-507.
- [18]Healthcare Commission 2007: Women’s experiences of maternity care in the NHS in England. 2007. Available at http://www.nhssurveys.org/Filestore/CQC/2007_Maternity_services_survey_report.pdf webcite Accessed 12-08-13
- [19]Healthcare Commission Maternity Review 2008: Towards better births, a review of maternity services in England. 2008. Available at: http://archive.cqc.org.uk/_db/_documents/Towards_better_births_200807221338.pdf webcite. Accessed 11-01-13
- [20]Heeringa S, West T, Patricia AB: Applied survey data analysis. Boca Raton: Taylor & Francis; 2010.
- [21]Office for National Statistics (ONS): Births in England and Wales by characteristics of birth 2. 2011. Available at: http://www.ons.gov.uk/ons/taxonomy/index.html?nscl=Maternities webcite. Accessed 12-01-13
- [22]Jomeen J, Glover LF, Davis S: Midwives’ illness perceptions of antenatal depression. Br J Midwifery 2009, 17(5):296-303.
- [23]Jomeen J, Glover L, Jones C, Garg D, Marshall C: Identifying and assessing women’s perinatal psychological health: exploring the experiences of health visitors. J Reprod Infant Psychol 2013., 31Accepted for publication
- [24]Mir G, Ahmad W, Jones L: Learning difficulties and ethnicity. London: Department of Health; 2001.
- [25]Walsh PN, Heller T: Health of Women with Intellectual Disabilities. Oxford: Blackwell Science; 2002.
- [26]Grue L, Tafjord-Laerum KT: Doing motherhood: some experiences of mothers with physical disabilities. Disabil Soc 2002, 17(6):671-683.
- [27]Chen YH, Lin HL, Lin HC: Does multiple sclerosis increase risk of adverse pregnancy outcomes? A population-based study. Mult Scler 2009, 15:606-612.
- [28]Canti V, Castiglioni MT, Rosa S, Franchini S, Sabbadini MG, Manfredi AA, Rovere-Querini P: Pregnancy outcomes in patients with systemic autoimmunity. Autoimmunity 2012, 45:169-175.
- [29]Becker H, Stuifbergen A, Tinkle M: Reproductive health care experience of women with physical disabilities: a qualitative study. Arch Phys Med Rehabil 1997, 78:s26-s32.
- [30]O’Cathain A, Thoms K: Any other comments? Open questions on questionnaires – a bane or a bonus to research? BMC Med Res Methodol 2004, 5:25.
- [31]Gavin N, Benedict M, Adams M: Health service use and outcomes among disabled Medicaid pregnant women. Womens Health Issues 2006, 16:313-322.
- [32]Redshaw M, Rowe R: Recorded delivery: a national survey of women’s experience of maternity care. 2006. Available at: https://www.npeu.ox.ac.uk/recorded-delivery webcite
- [33]Department of Public Health: Maternity matters: Choice, access and continuity of care in a safe service. 2007. Available at: http://www.northwest.nhs.uk/document_uploads/Maternity_Matters/DH_074199%5B1%5D.pdf webcite
- [34]Redshaw MM, Heikkila KK: Ethnic differences in women’s worries about labour and birth. Ethn Health 2011, 16:1-11.