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Midwives’ knowledge of, attitudes towards and experiences of caring for women with intellectual disability during pregnancy and childbirth: a cross-sectional study in Sweden
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
2013 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 29, no 8, 950-955 p.Article in journal (Refereed) Published
Abstract [en]

Objective: to investigate midwives' knowledge of, attitudes towards andexperiences of caring for women with intellectual disability (ID) during pregnancy andchildbirth. Design/setting: a cross-sectional study among six hundred midwives working at antenatal care and labour wards in Sweden. Results: more than four out of five (81.5%) midwives had experience of caring for womenwith ID. Almost all midwives (97.1%) reported that caring for women with ID is different fromcaring for women without ID. Almost one-half (47.3%) had not received any education aboutpregnancy and delivery of women with ID, and a majority of the midwives (95.4%) requested evidence-based knowledge of women with ID in relation to childbirth. High proportion (69.7%) of the midwives were of the opinion that women with ID cannot satisfactorily manage the mother role, and more than one-third (35.7%) of the midwives considered that womenwith ID should not be pregnant and give birth at all. Most midwives partly/totally agreed that children of women with ID should grow up with their parents supported by the social authorities, but nearly one-fifth (19.1%) partly/totally agreed that the children should grow up in foster care. Conclusions: even if the majority of midwives had experience of caring for women with ID, they were uncertain about how to adapt and give advice and they needed more knowledgeabout these women. Some midwives had negative attitudes towards childbearing amongwomen with ID. Health Service providers should encourage midwives to update theirknowledge and provide supportive supervision in midwifery care for women with ID. 

Place, publisher, year, edition, pages
2013. Vol. 29, no 8, 950-955 p.
National Category
Other Medical Sciences
Identifiers
URN: urn:nbn:se:uu:diva-183018DOI: 10.1016/j.midw.2012.12.002ISI: 000321431200019OAI: oai:DiVA.org:uu-183018DiVA: diva2:561704
Projects
Berit Höglund
Available from: 2012-10-20 Created: 2012-10-20 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Pregnancy, Childbirth and Midwifery Care among Women with Intellectual Disability in Sweden: Epidemiological and Descriptive Studies
Open this publication in new window or tab >>Pregnancy, Childbirth and Midwifery Care among Women with Intellectual Disability in Sweden: Epidemiological and Descriptive Studies
2012 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to investigate pregnancy and childbirth in women with intellectual disability (ID), in Sweden, the health of their newborns and midwifery care for these women. Two register studies and two descriptive studies are included. Pregnancy and birth outcomes as well as data on the newborns’ health were examined by linking data from the National Patient Register and the Medical Birth Register (I-II). The women’s experience of pregnancy and delivery was investigated with repeated interviews (III). Midwives’ knowledge of, experience of and attitudes towards pregnancy and childbirth in women with ID were evaluated with questionnaires (IV). Mothers with ID were more often teenagers, smoked more during pregnancy and had more Caesarean Sections. Their children had a higher proportion of pre-term births, were small-for-gestational-age, stillborn or died in the perinatal period. The women with ID struggled to attain motherhood and feared to lose custody of the child. The pregnancy was seen as a happy event, even though relatives did not always approve. Parent education was considered important, but not adequately adapted to their needs. The birth process was overwhelming and difficult to understand, but the child was welcomed with warm feelings, and breastfeeding was natural. Midwives stated it was different to care for women with ID and requested additional knowledge. The majority of midwives affirmed that women with ID could not manage the mother role satisfactorily, and one-third expressed that women with ID should refrain from having children. A majority of the midwives considered that the children should grow up with the parents with support from family and society, but one out of five stated that the children should grow up in foster care.

Conclusion: Women with ID and their children should be considered as risk groups in pregnancy and childbirth. Professionals in maternity services need to elucidate their knowledge and skills for counselling and supporting this particular group of pregnant women in pre-, intra- and post-partum care.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 61 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 832
Keyword
pregnancy, delivery, women, intellectual disability, newborn health, experience, knowledge, attitudes, education
National Category
Clinical Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:uu:diva-183388 (URN)978-91-554-8515-3 (ISBN)
Public defence
2012-12-07, Auditorium Minus, Akademigatan 3, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2012-11-16 Created: 2012-10-25 Last updated: 2013-01-23

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Höglund, BeritLindgren, PeterLarsson, Margareta

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