Policy Research Unit for maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Old Road, Oxford OX3 7LF, UK.
BMC Pregnancy Childbirth. 2013 Sep 13;13:174. doi: 10.1186/1471-2393-13-174.
It has been estimated that 9.4% of women giving birth in the United Kingdom have one or more limiting longstanding illness which may cause disability, affecting pregnancy, birth and early parenting. No large scale studies on a nationally representative population have been carried out on the maternity experiences of disabled women to our knowledge.
Secondary analysis of data from a survey of women in 2010 by English National Health Service Trusts on behalf of the Care Quality Commission was undertaken. 144 trusts in England took part in the postal survey.Women self-identified with disability and were excluded if less than 16 years of age or if their baby had died. The 12 page structured questionnaire with sections on antenatal, labour and birth and postnatal care covered access, information, communication and choice. Descriptive and adjusted analyses compared disabled and non-disabled groups. Comparisons were made separately for five disability subgroups: physical disability, sensory impairment, mental health conditions, learning disability and women with more than one type of disability.
Disabled women comprised 6.14% (1,482) of the total sample (24,155) and appeared to use maternity services more than non-disabled women. Most were positive about their care and reported sufficient access and involvement, but were less likely to breastfeed. The experience of women with different types of disability varied: physically disabled women used antenatal and postnatal services more, but had less choice about labour and birth; the experience of those with a sensory impairment differed little from the non-disabled women, but they were more likely to have met staff before labour; women with mental health disabilities also used services more, but were more critical of communication and support; women with a learning disability and those with multiple disabilities were least likely to report a positive experience of maternity care.
This national study describes disabled women's experiences of pregnancy, child birth and postnatal care in comparison with non-disabled women. While in many areas there were no differences, there was evidence of specific groups appropriately receiving more care. Areas for improvement included infant feeding and better communication in the context of individualised care.
据估计，英国 9.4%的产妇患有一种或多种可能导致残疾的长期限制疾病，这会影响妊娠、分娩和育儿。据我们所知，尚无针对残疾妇女的全国代表性人群的大规模生育经历研究。
对代表护理质量委员会的英格兰国民保健署信托基金于 2010 年对妇女进行的调查数据进行二次分析。英格兰的 144 家信托机构参与了这项邮寄调查。如果妇女年龄不足 16 岁或其婴儿死亡，则自行确定残疾身份并将其排除在外。该 12 页的结构化问卷分为产前、分娩和产后护理部分，涵盖了获得服务、信息、沟通和选择。对残疾组和非残疾组进行了描述性和调整后的分析。对五个残疾亚组（身体残疾、感觉障碍、心理健康状况、学习障碍和多种残疾的妇女）分别进行了比较。
残疾妇女占总样本（24155 人）的 6.14%（1482 人），她们似乎比非残疾妇女更多地使用了产妇服务。大多数人对她们的护理表示满意，并报告说获得了足够的服务和参与，但母乳喂养的可能性较小。不同类型残疾妇女的经历有所不同：身体残疾妇女更多地使用了产前和产后服务，但在分娩和分娩方面选择较少；有感觉障碍的妇女与非残疾妇女的经历几乎没有不同，但她们在分娩前更有可能见过工作人员；心理健康障碍妇女也更多地使用服务，但对沟通和支持更具批判性；有学习障碍和多种残疾的妇女最不可能报告对产妇护理有积极的体验。
本项全国性研究描述了残疾妇女与非残疾妇女在妊娠、分娩和产后护理方面的经历。虽然在许多方面没有差异，但有证据表明，特定群体得到了更多的适当护理。需要改进的领域包括婴儿喂养和在个性化护理背景下改善沟通。
