title: Access and utilisation of maternity care for disabled women who experience domestic abuse: a systematic review.
abstract: BACKGROUND
  Although disabled women are significantly more likely to experience domestic abuse during pregnancy than non-disabled women, very little is known about how maternity care access and utilisation is affected by the co-existence of disability and domestic abuse. This systematic review of the literature explored how domestic abuse impacts upon disabled women's access to maternity services.
  
  
  METHODS
  Eleven articles were identified through a search of six electronic databases and data were analysed to identify: the factors that facilitate or compromise access to care; the consequences of inadequate care for pregnant women's health and wellbeing; and the effectiveness of existing strategies for improvement.
  
  
  RESULTS
  Findings indicate that a mental health diagnosis, poor relationships with health professionals and environmental barriers can compromise women's utilisation of maternity services. Domestic abuse can both compromise, and catalyse, access to services and social support is a positive factor when accessing care. Delayed and inadequate care has adverse effects on women's physical and psychological health, however further research is required to fully explore the nature and extent of these consequences. Only one study identified strategies currently being used to improve access to services for disabled women experiencing abuse.
  
  
  CONCLUSIONS
  Based upon the barriers and facilitators identified within the review, we suggest that future strategies for improvement should focus on: understanding women's reasons for accessing care; fostering positive relationships; being women-centred; promoting environmental accessibility; and improving the strength of the evidence base.
authors.affiliation: Social Dimensions of Health Institute, University of Dundee, Dundee, UK. j.breckenridge@dundee.ac.uk.
authors.forename: Jenna P
authors.initials: JP
authors.lastname: Breckenridge
authors.forename: John
authors.initials: J
authors.lastname: Devaney
authors.forename: Thilo
authors.initials: T
authors.lastname: Kroll
authors.forename: Anne
authors.initials: A
authors.lastname: Lazenbatt
authors.forename: Julie
authors.initials: J
authors.lastname: Taylor
authors.forename: Caroline
authors.initials: C
authors.lastname: Bradbury-Jones
mesh_terms: D006233:Persons with Disabilities; D017579:Domestic Violence; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000175:diagnosis; D011247:Pregnancy; D011369:Professional-Patient Relations; D012944:Social Support