Disabilty in Pregnancy and Childbirth

As a basic textbook about the needs of disabled women during pregnancy and childbirth ‘Disability in Pregnancy and Childbirth’ is suitable read for everyone. The advice ranges from basic care of the woman and her family, to assessing ward suitability and scoping the necessary improvements. I felt that much of the advice given in this text book should be standard practice with all clients; those who are disabled and those who are not. However, as the mechanisms of pregnancy and childbirth are in many ways the same for both, this should be regarded as a bonus of this volume rather than a detriment. The information is applicable and suitable for ward managers, the woman and her family and everyone in between.

I particularly liked how the authors made reference to the fact that a woman with a recognised disability, for example Achondroplasia, may not consider herself to be disabled in any way while someone with a chronic illness such as Diabetes may be significantly disabled by their condition. This is a concept which all health professionals should keep foremost in their mind when caring for someone who is ‘differently abled’.

This book touches on most aspects of motherhood from screening to postnatal care. The screening advice offered is slightly out of date, for example the triple test is discussed but not nuchal fold measurements. As with other non screening specific textbooks, it is best to refer to the more specialised publications to benefit from the most up to date information on these subjects.

The following chapters contained information of particular distinction:

The appendix to chapter 3 has an interesting set of questions with which a woman could use to evaluate the care she received. The information obtained in this way would be a useful resource for health care professionals to use as a platform from which to reflect upon their practice and develop their skills in caring for this group of women.

In chapter 8, ‘The interaction between specific conditions and the childbirth continuum’, the author has taken the brave step of referring to specific disabilities. This chapter included many that are not usually mentioned in volumes such as this like Dyspraxia and Fibroymalgia but neglected to include the more ‘hidden disabilities’ such as Obsessive Compulsive Disorders and High Functioning Autism/Asperger’s Syndrome. Although this chapter at first glance appears to be quite comprehensive, the dyscogniton that occurs with Fibromyalgia, also known as ‘fibrofog’ and its importance in relation to making informed choices is not highlighted. This leads me to surmise that important factors with the other listed disabilities may be also be missing.

Chapter 9 lists resources suitable for disabled women and the health care professionals who participate in facilitating their experience of pregnancy and childbirth. There are links to many UK organisations but also included are several links to international organisations. Two very useful links are missing but I will include them here:

The National Autistic Society
Aim to champion the rights and interests of all people with autism and aim to provide individuals with autism and their families with help, support and services that they can access, trust and rely upon and which can make a positive difference to their lives.
Contact details:
0845 070 4004
http://www.nas.org.uk/

The UK Fibromyalgia Association
Raising awareness of Fibromyalgia in the United Kingdom. This website is endorsed by the Arthritis Research Campaign (ARC) leaflet on Fibromyalgia
Contact details:
Helpline: 0845 345 2322
http://www.fibromyalgia-associationuk.org/

Both of these sites will be able to provide local support group contact information. Additionally Mencap (listed on page 194), offers ‘Parent Partnership’, a system which provides support in many forms not the least of which is attending meetings and appointments with disabled and differently abled people.

‘Disability in Pregnancy and Childbirth’ has evenly, appropriately weighted chapters with some interesting and useful resources. The handouts at the end of the book are intended as a resource to back up the information given by health care professionals and aimed specifically at disabled women and their partners. The average Crystal Mark reading age for information leaflets in England is 9 years and these handouts are pitched at a higher level than this. Therefore they would need a bit of tweaking before being widely circulated. Overall this book aids and encourages the establishment of evidence based practice in relation to caring for disabled and differently abled women.

I strongly recommend ‘Disability in Pregnancy and Childbirth’ as required reading for all those involved in the training of student midwives, nurses and doctors. This book should also be read and then kept as a reference book for any post registration healthcare professionals with a remit in providing care for disabled and differently abled women of childbearing age.

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