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Access and quality of maternity care for disabled women during pregnancy, birth and the postnatal period in England: data from a national survey
  1. Reem Malouf,
  2. Jane Henderson,
  3. Maggie Redshaw
  1. Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
  1. Correspondence to Dr Maggie Redshaw; maggie.redshaw{at}npeu.ox.ac.uk

Abstract

Objectives More disabled women are becoming mothers, and yet, their care is rarely the focus of quantitative research. This study aimed to investigate access and quality of maternity care for women with differing disabilities.

Design Secondary analysis was conducted on data from a 2015 national survey of women's experience of maternity care. Descriptive and adjusted analyses were undertaken for five disability groups: physical disability, sensory impairment, mental health disability, learning disability and multiple disability, and comparisons were made with the responses of non-disabled women.

Setting Survey data were collected on women's experience of primary and secondary care in all trusts providing maternity care in England.

Participants Women who had given birth three months previously, among whom were groups self-identifying with different types of disability. Exclusions were limited to women whose baby had died and those who were younger than 16 years at the time of the recent birth.

Results Overall, 20,094 women completed and returned the survey; 1958 women (9.5%) self-identified as having a disability. The findings indicate some gaps in maternity care provision for these women relating to interpersonal aspects of care: communication, feeling listened to and supported, involvement in decision making, having a trusted and respected relationship with clinical staff. Women from all disability groups wanted more postnatal contacts and help with infant feeding.

Conclusion While access to care was generally satisfactory for disabled women, women's emotional well-being and support during pregnancy and beyond is an area that is in need of improvement. Specific areas identified included disseminating information effectively, ensuring appropriate communication and understanding, and supporting women's sense of control to build trusting relationships with healthcare providers.

  • maternity care
  • maternity services
  • disability
  • pregnancy
  • labour
  • postnatal

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors All three listed authors have contributed to this paper: MR designed the analysis plan, JH and RM carried out the analyses, RM drafted the main manuscript and all authors contributed to the interpretation of the findings and refining the manuscript. All three authors read and approved the final version of the manuscript.

  • Funding This study was funded by the Policy Research Programme in the Department of Health (DH) in the UK.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The women's trust-based data used in this study were accessed from CQC that was responsible for the survey.