Blog: Caring for women with learning disabilities

As part of Disability History Month Elizabeth Maushe, a registered Learning Disability Nurse, writes about some of the challenges that women with learning disabilities can face when being cared for in maternity services and what the NMC's new midwifery standards say about their care.

During my undergraduate programme I was upset to learn of the extent to which women with learning disabilities were not expected to become mothers. Or, if they did have a baby, that they may be stereotyped as being not good enough mothers.

I quickly learned that these negative perceptions could make women with learning disabilities feel devalued. It's also no coincidence that the same women are particularly vulnerable when pregnant, giving birth, or in the early postnatal period.

It's these challenges faced by disabled women that made me want to know more about what support was available in maternity services and what needed to be improved.

During my final placement as a student at Milton Keynes University Hospital, I was fortunate enough to link up with midwives working on safeguarding issues. What really struck me was the limited specialised resources they had to support mothers with learning disabilities in their care.

The NMC's Standards of Proficiency for Midwives emphasise:

"6.69 recognise, assess, plan and respond to pre-existing and emerging complication and additional care needs for women and newborn infant, collaborating with, consulting and referring to the interdisciplinary and multiagency teams as appropriate"

I thought midwives would really welcome a tool to help them in caring for women with learning disabilities and that the women themselves would really benefit too. So, after carrying out the research for my dissertation I came up with a simple mnemonic - VALUE ME - to explain the main things midwives should consider when caring for women with learning disabilities:

V = Value family – listen to them and involve them in care

A = Avoid assumptions - make sure you ask women and families what they need

L = Look for support - if you need help, make sure you ask

U = Understand emotions - childbirth can be particularly stressful for women with a learning disability

E = Establish reasonable adjustments – how should you do things differently?

M = Mental capacity - have you established consent for the care and treatment?

E = Efficient discharge - do the woman and her family have the support they need?

I believe that considering these key things will support the maternity to team to treat everyone as an individual and avoid making assumptions about what women might need.

It's a tool that can also help the team to consider which other health and social care professionals may need to be involved in care. And to ensure that any changes to a woman's care that might be needed are properly considered, that consent for care is properly obtained and that women are properly supported when the time comes for them and their baby to go home.

Above all, I hope VALUE ME builds awareness about supporting people with learning disabilities and enables women with learning disabilities to build good therapeutic relationships with midwives.

There is still more work to do to validate this tool. So I'm now liaising with a research team who will develop it further and look to implement it into midwifery practice. In the future it would be great to think that midwives who are caring for women with learning disabilities think VALUE ME.

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