Learning disability and perinatal mental health « PATH

Toddler sitting on blanket surrounded by toys

A learning disability is defined by the Department of Health as a “significant reduced ability to understand new or complex information, to learn new skills (impaired intelligence), with a reduced ability to cope independently (impaired social functioning), which started before adulthood”.

This definition includes people with an IQ of less than 70 and also deficits in social functioning and communication skills.¹

In the UK 7% of adults with a learning disability were parents and most of them have a mild to borderline impairment, which may make it difficult to identify them as they will not have a formal diagnosis.²

The children of parents with a learning disability are more likely than any other group of children to be removed from their parents’ care.³

Parents with a learning disability are often affected by poverty, social isolation, stress, mental health problems, low literacy and communication difficulties.²

Women with intellectual and developmental disabilities (IDD) have high rates of adverse perinatal outcomes including premature birth and low birthweight. A third of pregnant woman with a learning disability report moderate to severe levels of stress, anxiety and depression.⁴

Supporting women with learning disabilities⁵–

In the antenatal period-

Offering good quality antenatal care that meets their requirements-

Extra time and support for appointments
The opportunity to have information repeated
Information about pregnancy and birth choices, and about parenting, that is presented in a form they can understand and is empowering
Involvement of family carers and advocates
Understanding the complexity of consent issues
Liaison with other agencies involved
Access to tailored and inclusive antenatal classes with focus on ensuring that each person has the opportunity to gain confidence, develop skills and make meaningful relationships
When a woman has complex needs such as learning disability or acquired cognitive impairment, consideration should be given to specialist assessment when developing a care plan.

In the postnatal period-

Avoid stereotype beliefs that people with learning disabilities cannot be good enough parents
Offer social support to parents living under conditions that could contribute to poorer parenting- poverty, domestic abuse, social isolation
It is essential to recognise that parents with a learning disability may be reluctant to ask for support with parenting issues because of fears that this will raise child protection concerns

References

1. DoH, Valuing People, a new strategy for learning disability for the 21st century. (2001)

2. Emerson E, Malam S, Davies I and Spencer K. Adults with learning difficulties in England 2003/4. (2005)

3. Booth T and Booth W and McConnell D. The prevalence and outcomes of care proceedings involving parents with a learning disability in the family courts. Journal of Applied Research in Intellectual Disabilities. (2005)

4. Redshaw, M., Malouf, R., Gao, H., Gray, R. Women with disability: the experience of maternity care during pregnancy, labour and birth and the postnatal period. BMC Pregnancy Childbirth. (2013)

5. MENCAP Inclusive support for parents with a learning disability. (2011)