title: Midwives' comprehension of care for women with intellectual disability during pregnancy and childbirth: An open-ended questionnaire study in Sweden.
abstract: BACKGROUND
  Few studies have investigated midwifery care for women with intellectual disability (ID).
  
  
  OBJECTIVE
  To gain a deeper understanding of midwives' comprehension of care for women with ID during pregnancy and childbirth.
  
  
  METHODS
  A cross-sectional study among 375 midwives at antenatal clinics and delivery wards in Sweden. Findings 2476 quotations were sorted into six categories: information; communication and approach; the role of the midwife; preparing for and performing interventions and examinations; methods and assessments; and organisation of care. The midwives affirmed that individual, clear and repeated information together with practical and emotional support was important for women with ID. The midwives planned the care as to strengthen the capacity of the women, open doors for the unborn child and reinforce the process of becoming a mother. Extra time could be needed. They tried to minimise interventions. The midwives felt a dual responsibility, to support the mother-child contact but also to assess and identify any deficits in the caring capacity of the mother and to involve other professionals if needed.
  
  
  CONCLUSIONS
  The midwives described specially adapted organisation of care, models of information, practical education and emotional support to facilitate the transition to motherhood for women with ID. They have a dual role and responsibility in supporting the woman, while making sure the child is properly cared for. Healthcare services should offer a safe and trusted environment to enable such midwifery care. When foster care is planned, the society should inform and co-operate with midwives in the care of these women.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. Electronic address: berit.hoglund@kbh.uu.se.
authors.forename: Berit
authors.initials: B
authors.lastname: Höglund
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Margareta
authors.initials: M
authors.lastname: Larsson
mesh_terms: D000328:Adult; D002648:Child; D032882:Comprehension; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000451:nursing* / Q000523:psychology; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000451:nursing* / Q000517:prevention & control; D000068097:Maternal Health / Q000706:statistics & numerical data*; D008880:Midwifery / Q000379:methods*; D009723:Nurse-Patient Relations; D036801:Parturition / Q000523:psychology; D011247:Pregnancy; D011795:Surveys and Questionnaires; D013548:Sweden; D035502:Trust
keywords: Childbirth; Comprehension; Intellectual disability; Midwifery care; Pregnancy