Literature Review on Provision of Appropriate and Accessible ...

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PAGE 4 <strong>Literature</strong> <strong>Review</strong> on Provision of Appropriate and Accessible Support to People with an Intellectual Disability who are Experiencing Crisis Pregnancy
PAGE 5 Foreword by the HSE Crisis Pregnancy Programme On behalf of the HSE Crisis Pregnancy Programme (formerly the Crisis Pregnancy Agency), I welcome the findings of this literature review relating to intellectual disability, pregnancy, counselling, and crisis pregnancy. Support to People with an Intellectual Disability who are Accessible and Appropriate of Provision on <strong>Review</strong> <strong>Literature</strong> Experiencing Crisis Pregnancy The study, which was jointly commissioned by the National Disability Authority and the Crisis Pregnancy Agency, aimed to describe the key challenges faced by women with intellectual disabilities in accessing health and social work services during crisis pregnancy. The study also aimed to identify international models of good practice regarding crisis pregnancy counselling and support services for women with intellectual disabilities experiencing a crisis pregnancy. The comprehensive examination of Irish and international literature presented in the report reveals that there is very little research investigating crisis pregnancy among women with intellectual disability. However, the review does reveal specific challenges in relation to preventing crisis pregnancy for women with intellectual disability, such as lack of knowledge surrounding sexual relationships, increased vulnerability to sexual exploitation and lack of appropriate support services. The review also demonstrates that sexual health care and relationships for women with intellectual disability are complicated by legal and technical issues surrounding her capacity to consent, both to medical treatment (including contraception) and to sexual intercourse. Negative attitudes to sexual activity among people with disabilities, a desire to protect women from exploitation and lack of specialised care to enable women to participate in healthcare and reproductive decision-making can compromise the level of care a woman with an intellectual disability receives. While the review identifies many challenges and barriers faced by women with intellectual disability it also demonstrates that providing appropriate education and support services, supported by an effective legal framework, can improve such women’s participation in decisions
Page 1 and 2: Literature <strong
Page 3: Literature <strong
Page 7 and 8: PAGE 7 Foreword by the National Dis
Page 9 and 10: PAGE 9 About the author Joan O’Co
Page 11 and 12: PAGE 11 2.5.4 Codes of practice 52
Page 13 and 14: PAGE 13 4.5.1 Challenges in support
Page 15 and 16: PAGE 15 Glossary of terms Enduring
Page 17 and 18: PAGE 17 • The pattern of contrace
Page 19 and 20: PAGE 19 • The review considers th
Page 21 and 22: PAGE 21 • To describe the challen
Page 23 and 24: PAGE 23 on how impairments affect f
Page 25 and 26: PAGE 25 • Searches by publication
Page 27 and 28: PAGE 27 • Differences in definiti
Page 29 and 30: PAGE 29 • 32 per cent (8,262 indi
Page 31 and 32: PAGE 31 1.7 Heterogeneity People wi
Page 33 and 34: PAGE 33 McCarthy (1999: 44) notes t
Page 35 and 36: PAGE 35 partner was the same age, a
Page 37 and 38: PAGE 37 1.10 Structure of the revie
Page 39 and 40: PAGE 39 is placed on their health a
Page 41 and 42: PAGE 41 McCarthy (1999: 221), who c
Page 43 and 44: PAGE 43 • Contraception in women
Page 45 and 46: PAGE 45 Wehmeyer and Bolding’s re
Page 47 and 48: PAGE 47 persons who lack decision-m
Page 49 and 50: PAGE 49 • Consent and capacity in
Page 51 and 52: PAGE 51 2. When doing the act, reas
Page 53 and 54: PAGE 53 2.6 Critique of the Law Ref
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PAGE 55 or she is unable to make a
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PAGE 57 Good practice provisions of
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PAGE 59 reasonably can to work out
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PAGE 61 has reasonable grounds to b
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PAGE 63 They point out that evaluat
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PAGE 65 2.8.2 Assessment of capacit
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PAGE 67 In the absence of explicit
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PAGE 69 4. Physical disabilities, n
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PAGE 71 The British Medical Associa
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PAGE 73 legislation in this area an
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PAGE 75 • Consideration of whethe
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PAGE 77 perceive sexual activity as
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PAGE 79 The right to have children
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PAGE 81 • In relation to capacity
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PAGE 83 more serious the decision,
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PAGE 85 - The requirement that the
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PAGE 87 3.0 Capacity to consent to
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PAGE 89 The following rights, oblig
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PAGE 91 relationships of various ki
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PAGE 93 Studies consistently show t
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PAGE 95 Functional approach is base
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PAGE 97 • There needs to be a rea
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PAGE 99 of capacity to consent to s
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PAGE 101 Meanwhile, the authors fou
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PAGE 103 3.8 Situational aspect of
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PAGE 105 3.11 Laws that prohibit se
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PAGE 107 autonomy and fulfilment. I
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PAGE 109 laws generally require tha
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PAGE 111 • Offences where the def
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PAGE 113 2002; McCabe, 1999). Grayd
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PAGE 115 higher prosecution rates.
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PAGE 117 Section 17 of the Crimes (
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PAGE 119 relationships. The study i
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PAGE 121 Table 3: Comparative legis
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PAGE 123 Legal aspect Ireland Unite
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PAGE 125 Legal aspect Relevant legi
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PAGE 127 any formal contract or tes
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PAGE 129 Laws that prohibit sex wit
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PAGE 131 and the particular pressur
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PAGE 133 relationships, marriage, a
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PAGE 135 • 44 per cent knew that
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PAGE 137 be perceived as a risk fac
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PAGE 139 4.3.1 Components of sex ed
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PAGE 141 introduced students not on
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PAGE 143 to have a significant impa
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PAGE 145 about pregnancy and childb
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PAGE 147 Eastgate (2008), writing i
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PAGE 149 • Considered themselves
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PAGE 151 4.7 Pregnancy outcomes in
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PAGE 153 The authors suggested that
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PAGE 155 Research indicates that le
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PAGE 157 Klaar (1999) notes that so
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PAGE 159 Workers might also need to
Page 161 and 162:
PAGE 161 • Possible components of
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PAGE 163 Accessing services • The
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PAGE 165 5.0 Parenting 5.1 Introduc
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PAGE 167 5.2 Approaches to understa
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PAGE 169 fulfilling three condition
Page 171 and 172:
PAGE 171 Tarleton et al.’s study
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PAGE 173 vulnerable if a breakdown
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PAGE 175 More recent research on mo
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PAGE 177 while training programmes
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PAGE 179 5.8 Adequacy of training a
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PAGE 181 5.10 Key findings Key find
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PAGE 183 Professional and training
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Support to People with an Intellect
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PAGE 187 The review examined nation
Page 189 and 190:
PAGE 189 A number of issues have be
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PAGE 191 6.5 Capacity to consent to
Page 193 and 194:
PAGE 193 • A number of commentato
Page 195 and 196:
PAGE 195 • During the early stage
Page 197 and 198:
PAGE 197 Bibliography Affleck, F. (
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PAGE 199 Bartlett, P. (2008) Blacks
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PAGE 201 Booth, T. & Booth, W. (200
Page 203 and 204:
PAGE 203 Burgen, B. (2008a) ‘Stra
Page 205 and 206:
PAGE 205 Cuskelly, M. & Bryde, R. (
Page 207 and 208:
PAGE 207 Issues in Sexuality and Le
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PAGE 209 The Mental Health Foundati
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PAGE 211 Gust, D.A., Wang, S.A., Gr
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PAGE 213 Kaplan C. & Richman S. (20
Page 215 and 216:
PAGE 215 Leutar, Z. & Mihokovic, M
Page 217 and 218:
PAGE 217 Mayes, R., Llewellyn, G. &
Page 219 and 220:
PAGE 219 McConnell, D., Llewellyn,
Page 221 and 222:
PAGE 221 Murphy, G.H. & Clare, I.C.
Page 223 and 224:
PAGE 223 O’Hara, J. & Sperlinger,
Page 225 and 226:
PAGE 225 Rogers, J. (1997) Birthcoa
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PAGE 227 period 1988 to 1999. Journ
Page 229 and 230:
PAGE 229 Traustadottir, R. (1997) W
Page 231 and 232:
PAGE 231 Watson, G. & Rogers, R. (1
Page 233 and 234:
PAGE 233 Appendices Appendix A - Co
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PAGE 235 Form 4 D Involvement of th
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PAGE 237 Guidance to health profess
Page 239 and 240:
PAGE 239 involve people close to th
Page 241 and 242:
Experiencing Crisis Pregnancy <stro
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