Midwives’ comprehension of care for women with intellectual disability during pregnancy and childbirth: An open-ended questionnaire study in Sweden |
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| Institution: | 1. Women''s College Research Institute, Women''s College Hospital, Toronto, Ontario;2. Institute for Clinical Evaluative Sciences, Toronto, Ontario;3. Department of Psychiatry, University of Toronto, Toronto, Ontario;4. Centre for Addiction and Mental Health, Toronto, Ontario;5. School of Psychology, University of Ottawa, Ottawa, Ontario;1. Department of Family Medicine and Community Health;2. Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury;3. Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, Waltham;4. Bureau of Family Health and Nutrition, Massachusetts Department of Public Health, Boston, Massachusetts;1. Institute on Development and Disability, Oregon Health & Science University, Portland, OR, USA;2. Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA;3. National Institute of Public Health, Center for Health Systems Research, Cuernavaca, Mexico;1. Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon;2. National Institute of Public Health, Center for Health Systems Research, Cuernavaca, Mexico;3. Institute on Development and Disability, Oregon Health & Science University, Portland, Oregon;1. Institute for Global Health, University College London, 30 Guildford Street, London WC1N 1EH, UK;2. MIRA, PO Box 921, Thapathali, Kathmandu, Nepal;3. Leonard Cheshire Disability and Inclusive Development Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK |
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| Abstract: | BackgroundFew studies have investigated midwifery care for women with intellectual disability (ID).AimTo gain a deeper understanding of midwives’ comprehension of care for women with ID during pregnancy and childbirth.MethodsA cross-sectional study among 375 midwives at antenatal clinics and delivery wards in Sweden. Findings 2476 quotations were sorted into six categories: information; communication and approach; the role of the midwife; preparing for and performing interventions and examinations; methods and assessments; and organisation of care. The midwives affirmed that individual, clear and repeated information together with practical and emotional support was important for women with ID. The midwives planned the care as to strengthen the capacity of the women, open doors for the unborn child and reinforce the process of becoming a mother. Extra time could be needed. They tried to minimise interventions. The midwives felt a dual responsibility, to support the mother–child contact but also to assess and identify any deficits in the caring capacity of the mother and to involve other professionals if needed.ConclusionsThe midwives described specially adapted organisation of care, models of information, practical education and emotional support to facilitate the transition to motherhood for women with ID. They have a dual role and responsibility in supporting the woman, while making sure the child is properly cared for. Healthcare services should offer a safe and trusted environment to enable such midwifery care. When foster care is planned, the society should inform and co-operate with midwives in the care of these women. |
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| Keywords: | Midwifery care Comprehension Pregnancy Childbirth Intellectual disability |
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