Normalising birth for women with a disability: The challenges facing practitioners

Previous research on pregnant women with a disability and their experience of maternity care demonstrated that these mothers perceived themselves to be the 'perennial outsiders' with midwives automatically categorising them as 'high risk' because of their disability. They also felt that their ability to make choices, stay in control and have continuity of care was not considered to be part of the mainstream maternity care for them because they did not fit the 'normal' category. Objective: this research was undertaken to explore the perceptions of two multiprofessional teams in Irish hospitals as to how maternity services to these mothers can be improved. Participants: nineteen health-care professionals from midwifery, social work and public health nursing were recruited. Setting: two from two major maternity hospitals, one in the North and one in the South of Ireland. were featured. Design: the method chosen was a qualitative approach, using focus group interviews in which case studies depicting a range and breadth of women's birthing experiences were presented and discussed. Newell and Burnard's (2006) six stage approach to thematic content analysis was used. Findings: the professionals found the disabled women's stories believable, upsetting and challenging. Key conclusions: Staff acknowledged their 'lack of competence, knowledge and skill' regarding disability and felt that, on reflection, their failure to consult and collaborate with disabled women contributed to their failing to provide individualised woman centred care to women with a disability. Implications of practice: A series of recommendations for improved practice was agreed. (C) 2011 Elsevier Ltd. All rights reserved.