Poor Maternity Services and Discrimination Faced by Disabled Mothers
When I had my first child back in 1996 I was told that the major university hospital I gave birth at had *never* delivered a woman with cerebral palsy before. Their complete lack of disabled facilities reflected this.
At the time there were no flat access showers and no bath benches or seats so I couldn't use any of the baths. During my three days in hospital, I could only wash at a sink.
There were no tea trolleys and no assistance offered by staff to get meals, which were left for mothers to fetch for themselves. When you can't carry plates and have no trolley, this was impossible for me. I frequently went without meals or a midwife would bring one so late that it was cold by the time it arrived.
The baby's crib positioned next to my bed was high set, making it difficult to place her in and out of the crib, and that's without even considering the actual birth.
A deceleration in her heart rate meant they wanted to do a forceps delivery and got out the stirrups. I protested.
"I've got cerebral palsy! My legs can't move like that!"
Ignoring my protests, they attempted to force my legs onto the stirrups. As I have very limited muscle control, they just fell off the stirrups, not to mention causing me more pain than the contractions.
After several failed attempts at keeping my legs on the stirrups with me yelling that they were hurting me, they gave up and removed the stirrups. One midwife looked at me and said
"Well, how will you give birth, then?"
Hardly a comforting question from a medical professional who was trained to deliver babies. If I could have got up and ran out of the room, I would have. It was not only humiliating but also frightening that the people involved in my care had no idea how to deliver a disabled mother.
While access issues in maternity units have improved since the mid-90's (some units now have wheelchair access, bath lifts and lower set cribs), 'abled' medical providers still don't have much of an idea how to approach birth in mothers with physical impairment.
Fast forward to the pregnancy with my son in 2007, the director of midwives tried to persuade me to cancel my planned home birth by extolling the virtues of their new birth centre and the fact that if I came in to hospital I could use their birth ball for a 'natural' birth, or have a water birth there. I rolled my eyes at her
"I have cerebral palsy", I repeated again for what felt like the 100th time, "I don't have the balance to sit on a birth ball, I'd fall off!"
As for water births, getting into the water birth tub would be totally impossible. I could only manage to get into a bath at home with the use of a bath bench and could not step over the side. As far as I am aware, there are no disabled access birthing pools. In desperation to get me to agree to a hospital birth, she bribed me with diamorphine.
"No thanks", I said, "That's heroin and I won't need anything that strong."
I gave birth successfully in my perfectly accessible living room, to a 9lbs, 1oz boy.
Discrimination Affecting Maternity Care
This time around, despite it being 2019, times have sadly not changed all that much. A midwife conducting a home visit seemed completely taken aback when I answered the door. The first question out of her mouth was
"Do you need a social worker?"
I don't know why it is that 'abled' professionals and some lay people think that disabled people need social services. I told her as politely as I could muster that I didn't require any help and that in any case, social services are notorious for not offering any and for targeting disabled parents and that as I am expecting a baby, they would be the last people I would want in my home.
"Oh, but you have to be ready for baby!", she exclaimed.
"I am", I said, "I can take care of him."
I had recently passed the home birth inspection and had the crib set up in the living room temporarily. I have a stair lift, wheelchair ramp, bath seat, and all the baby stuff any little one could possibly want. Her attitude, while depressingly common, was insulting.
After trying to convince me to 'get help', she then began panicking about my foot swelling - an artefact of having flat feet that I had before pregnancy. She insisted that it could be pre-eclampsia, even when I explained they were always like that and I was having treatment with the orthotics department. I had no headache, no flashing lights, no puffy face or arms and most importantly, my urine sample was completely normal. No excess protein. Despite this, she phoned the hospital and insisted I be checked for pre-eclampsia and that I *must* go that day. Given her remarks about social services, I was worried she would call them if I didn't go in.
What followed was a horrendous hour strapped down to a hospital bed while they monitored the baby's heart beat, unable to move in case the sensors moved, both my hips hurting like mad from the arthritis I now have. I spent the whole hour in significant pain and there was nothing wrong with the baby. I was there only because a midwife panicked about my disabilities. Lying there in pain made me feel grateful that I have booked another home birth as I still don't think that hospital staff know much about how to accommodate parents with mobility restrictions or have any idea how to help them stay comfortable.
When my regular midwife returned a few days later, I expressed my fear that discrimination against me would affect the outcome of my home birth. After all, I said, I won't know who is going to attend the birth and if I get midwives I've never met, they might similarly panic at my disability and transfer me to hospital unnecessarily. My named midwife said she would try hard to be on duty during the next few weeks so that she would be the one to deliver my baby. I can only hope that this is true.
My Baby Bump (Ignore the wrong date stamp on the photo, this was taken May 2019!)