Lack of post-natal services for mothers with disability criticised

THE lack of post-natal community services for new mothers who have a disability is a “key deficit” within health care services, a major study has found.

The report — The Strengths and Weaknesses of Publicly-funded Irish Health Services Provided to Women with Disabilities in Relation to Pregnancy, Childbirth and Early Motherhood — maintains poorly resourced community services cannot cope with new mothers who have a disability and who have been promised post-natal support. For example, mothers with disabilities were advised by hospital staff that support would be provided on discharge from hospital through the public health nurse. In reality, this promise was not delivered, the report says.

Commissioned by the National Disability Authority and carried out by Trinity College Dublin, the study found women with disabilities frequently fall between two stools when trying to access services. Some even reported having to leave the country to get the services they required — or pay for private care.

Also, services for families who need support with early child care vary significantly across the country.

Often the focus of community support is on children in need rather than on families who require interventions and support, and this is provided by voluntary agencies, each of which has its own specific agenda and client group.

Maternity services should implement and develop further inter-organisational communication to underpin service development if women with disabilities are to receive care that meets their needs.

The report, which was researched over a three-year period, says there is no publicly-funded community midwifery service in Ireland.

“Currently, the s0tate makes provision for one statutory visit to the mother and baby in the community by the Public Health Nurse (PHN).

This single visit usually takes place in the first week following birth, and the number and timing of further visits, and/or referral to other services, are at the discretion of the PHN. Regulations related to the education and training of a PHN no longer require a midwifery qualification. . . there is no requirement for a children’s nursing or mental health qualification, which may have consequences on the care delivered in the medium-to long-term.”

The study said there is a focus on “medicalisation” within maternity care services and the perceived impact of the woman’s disability limited choices and, for some expectant women and mothers, this meant that their choice of birth was overridden by the professionals’ decisions, thus reducing maternal autonomy.