Professionals Helping vulnerable families Parents with disabilities There are around 1.7 million disabled parents in the UK, mostly with physical and sensory impairments.Health and social services have a legal duty under the Disability Discrimination Act 2005 to make reasonable adjustments to ensure their services and any information are accessible to disabled people. Issues in pregnancy Some disabled parents face negative attitudes to their decision to have a child. Physical access to buildings, and familiarisation with the layout for people with a visual impairment. Accessible equipment such as examination tables, beds and maternity cribs. Use of side room if extra equipment e.g. wheelchair too large for postnatal ward. Flexible appointment times (for people with chronic fatigue or pain). Communication difficulties - people with sensory impairments may need an advocate or interpreter. Questions about safety of medication. Being classified automatically high risk, with the assumption that a caesarean will be necessary or that home birth will be impossible. Pregnancy exacerbating (or sometimes alleviating) symptoms. Finding suitable birth positions. Advance consultation with anaesthetist on epidural positioning. Accessibility of antenatal classes. May need occupational therapist support to plan adaptive strategies or support. May need a social care needs assessment for support needs. Issues in parenting A social care needs assessment can identify support required in the new parenting role. Where a disabled parent receives support from a personal assistant, s/he has to adjust to having an outside person involved in family life and to cope with his/her feelings about not being able to care for his/her child without help. There is a lot of information available from specialist organisations and other disabled parents on how to meet the challenges of parenting with a physical disability for example www.dppi.org.uk May be able to access volunteer support e.g. Home Start. Key points for health professionals Understand the social model of disability (that impairment is the functional limitation of the body but disability is caused by the barriers to participation created by society). Ask the individual what words are acceptable to him/her to describe the condition. Work with the individual, who is the expert on his/her condition, to identify his/her abilities and needs. Liaise with the disability specialist. Address complex needs by networking with the multi-disciplinary team. Develop a maternity care plan with the pregnant woman, without imposing stereotyped assumptions e.g. that a caesarean section is automatically necessary Identify appropriate sources of equipment, aids and parent-to-parent support. Key organisations and publications Disability, Pregnancy and Parenthood & National Centre for Disabled ParentsMany useful publications including guides for disabled parents on practical issues.Information service: 0800 018 4730http://disabledparent.org.uk/ Epilepsy Action UK: Mothers in mind project Information for mothers and professionalshttp://www.epilepsy.org.uk/mothersinmind NHS Choices Help for Disabled Parents References This section draws on fully referenced publications from the Royal College of Nurses and Disability, Pregnancy and Parenthood International: Royal College of Nurses (2007). Pregnancy and disability RCN guidance for midwives and nurses http://www.rcn.org.uk/__data/assets/pdf_file/0010/78733/003113.pdf Disability, Pregnancy and Parenthood international (2010) Pregnancy, birth and early parenthood: a guide for physically disabled parents.