Literature Review on Provision of Appropriate and Accessible ...

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be perceived as a risk factor for unwanted pregnancy, causing greater
use of surgical methods to prevent pregnancy.
4.2.3 Self-esteem
Women with intellectual disability face challenges with issues of selfesteem,
self-concept and body image, for instance as the result of the
physical characteristics of syndromes (McCarron & Kathryn Pekala
Service, 2002). In order to provide appropriate education and counselling
for the woman and her support network, nurses and other healthcare
providers need to have knowledge about the health needs and factors
that affect coping (Kagan-Krieger, 2001).
Support to People with an Intellectual Disability who are
Accessible
and Appropriate of Provision on <strong>Review</strong> <strong>Literature</strong>
Experiencing Crisis Pregnancy
4.2.4 Offsetting negative attitudes
Dixon (1996) notes that because of negative attitudes to women with
intellectual disability becoming pregnant and taking on the role of
mother, it is important that women with intellectual disability feel valued
and that their self-esteem is maintained throughout their interactions
with services, so as to optimise their ability to embrace motherhood.
4.3 Sex education for people with intellectual disability
It is now generally accepted that appropriate education with regard to
issues of sexuality, tailored to the individual’s unique learning style, can
be effectively utilised in the management of fertility and menstruation
difficulties (Sulpizi, 1996; Prevatt, 1998). McCarthy (1999) asserts that
the aim of sexuality policies and guidelines should always be to support
people with learning disabilities in their sexual lives, and not to dissuade
them from having sex. The only justification, she contends, for dissuading
people from having sex is if the risks they pose to themselves or others
are very serious and cannot be lessened in any other way. McCarthy
has emphasised the following points in relation to the provision of sex
education for women with learning disabilities:
• Emphasis needs to be placed on self-esteem and assertiveness
work for women with learning disabilities; this is not just in
relation to sexual matters but also more generally in their lives.
(This point stems from research she conducted demonstrating
that 49 per cent of women (n=65) had had sex with a man or men
without really wanting or enjoying it in its own right, i.e. they