There are about 1.7 million disabled parents in the UK, mostly with physical and sensory impairments.
Health and social services have a legal duty under the Disability Discrimination Act 2005 to make reasonable adjustments to ensure their services and any information are accessible to disabled people.
Issues in pregnancy
- Some disabled parents face negative attitudes to their decision to have a child.
- Physical access to buildings, and familiarisation with the layout for people with a visual impairment.
- Accessible equipment such as examination tables, beds and maternity cribs.
- Use of side room if extra equipment e.g. wheelchair too large for postnatal ward.
- Flexible appointment times (for people with chronic fatigue or pain).
- Communication difficulties - people with sensory impairments may need an advocate or interpreter.
- Questions about safety of medication.
- Being classified automatically high risk, with the assumption that a caesarean will be necessary or that home birth will be impossible.
- Pregnancy exacerbating (or sometimes alleviating) symptoms.
- Finding suitable birth positions.
- Advance consultation with anaesthetist on epidural positioning.
- Accessibility of antenatal classes.
- May need occupational therapist support to plan adaptive strategies or support.
- May need a social care needs assessment for support needs.
Issues in parenting
- A social care needs assessment can identify support required in the new parenting role.
- Where a disabled parent receives support from a personal assistant, s/he has to adjust to having an outside person involved in family life and to cope with his/her feelings about not being able to care for his/her child without help.
- There is a lot of information available from specialist organisations and other disabled parents on how to meet the challenges of parenting with a physical disability for example www.dppi.org.uk
- May be able to access volunteer support e.g. Home Start.
Key points for health professionals
- Understand the social model of disability (that impairment is the functional limitation of the body but disability is caused by the barriers to participation created by society).
- Ask the individual what words are acceptable to him/her to describe the condition.
- Work with the individual, who is the expert on his/her condition, to identify his/her abilities and needs.
- Liaise with the disability specialist.
- Address complex needs by networking with the multi-disciplinary team.
- Develop a maternity care plan with the pregnant woman, without imposing stereotyped assumptions e.g. that a caesarean section is automatically necessary
- Identify appropriate sources of equipment, aids and parent-to-parent support.
Key organisations and publications
DPPI and National Centre for Disabled Parents
Many useful publications including guides for disabled parents on practical issues.
Information service: 0800 018 4730
Deaf Parenting UK
http://www.deafparent.org.uk/
Disabled Parents Network
http://www.disabledparentsnetwork.org.uk/
Epilepsy Action UK: Mothers in mind project
Information for mothers and professionals
http://www.epilepsy.org.uk/mothersinmind
Arthritis Research Campaign
http://www.arthritisresearchuk.org/Files/2060-Pregnancy-and-arthritis.pdf
Ricability: consumer reports for disabled parents
http://www.ricability.org.uk/consumer_reports/parenting/
References
This section draws on fully referenced publications from the Royal College of Nurses and Disability, Pregnancy and Parenthood International:
Pregnancy and disability RCN guidance for midwives and nurses (2007)
http://www.rcn.org.uk/__data/assets/pdf_file/0010/78733/003113.pdf
Pregnancy, birth and early parenthood: a guide for physically disabled parents (2010)
http://www.dppi.org.uk/publications/pdfs/dppit9.pdf