Amy J. Wint, Diane L. Smith, Lisa I. Iezzoni; Mothers With Physical Disability: Child Care Adaptations at Home. Am J Occup Ther 2016;70(6):7006220060. https://doi.org/10.5014/ajot.2016.021477
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OBJECTIVE. This study describes how women with physical disability experience caregiving for a new infant and how they adapt their home environment and care tasks.
METHOD. In 2013, we conducted 2-hr telephone interviews with 22 women with significant physical disability who had delivered babies within the previous 10 yr. The semistructured, open-ended interview protocol addressed wide-ranging pregnancy-related topics. NVivo was used to sort the texts for content analysis.
RESULTS. Night care, bathing, and carrying the baby were identified as the biggest challenges. Typical adaptations (with and without occupational therapy consultation) included use of a wrap for carrying the infant, furniture adaptations for mothers using wheelchairs, and assistance from caregivers.
CONCLUSION. Women with physical disability can be fully capable of caring for an infant and can find ways to adapt their environment. Further research may determine the role of occupation therapy.
We were doing cosleeping, and so she was in our bed, and so that was perfect. . . . I didn’t have to get up in the middle of the night and have to lift her out of the crib. I could just turn over, lift her out of her little cosleeper, and, you know, latch her on, and that was wonderful. So I felt a lot more safe that way. The same with changing her diaper. I set up a changing station on our little night table, and, you know, I could do everything I needed to there.
I have never given any of my children a bath, ever, because I know that’s not my capability with my disability. Timothy [husband] gives them a bath . . . because water and slippery and kids, that just doesn’t mix any time with a disability, even when I am the most capable.
I know bath time was always a changing challenge because she got heavier, whether she could sit up or she couldn’t. So we just thought outside the box. There were several months where it was just the safest and best option for me to get in with her. So I would transfer her to a little bouncer seat beside the tub, [and] I would climb in. And then I would reach over, get her, [and] bathe her.
I had a Boppy® pillow, that I turned into . . . a belt, so I had a strap that went all the way around my waist, and the Boppy pillow sat on my legs. Deena [infant] just sat in the middle [and] we rolled around . . . like that. After that . . . a belly binder, that I’d wrap around her and me. She would sit in my lap, and we had the belly binder around us.
I can’t have him on my lap in my wheelchair because I only have one arm, and that arm needs to be operating the joystick. So, I don’t have a second arm to protect him from falling off my lap. Ethan got really used to perching on my left shoulder over my 6-in. arm. He seemed to just naturally feel comfortable there, curved on my left shoulder.
I got a crib that you can’t get anymore. . . . It was a drop down. . . . I could get up alongside it and drop it down. And the mattress starts up high, so I could reach her easily and then go down. As she was older, she was able to sort of help crawl over the rail. Then . . . all of the changing tables are really high, and they’re not really wheelchair friendly. So we just basically made a desk. We got two cabinets and a Formica countertop because the space was cut out, so I could get under it. And that was her changing table. It wasn’t complicated.
I think one of the best things I ever did at that point [was] I went for occupational therapy. Because I’m like I need to know how I’m going to get my kid in and out of this car, because I can’t, I can’t stay homebound. I need to figure out how I’m going to carry her when I can’t hold her. We had gotten a stroller, but you know what? It wasn't that easy for me to push. So, you know, I went to OT [occupational therapy] and I started working out some of these issues, and that was a really good thing for me to do. Now, my doctor at [Rehabilitation Institute of Chicago] at the time was like, “Well, do you want to go to OT?” This was before when I was pregnant. I’m like I don’t know what I need yet. I don’t know what I’d go for. And so, well, I know now, and I try and tell women when I do peer counseling or anything, you know, these are some of the things you might want to think about. And if you want, this is a good time to go and get it. But it’s hard to know sometimes until you’re there.
The occupational participation of mothers with a physical disability can be increased by providing adaptive strategies (e.g., for carrying the baby, getting the baby in and out of a car).
Mothers with a physical disability can benefit from referral to occupational therapy for assistance in adapting tasks and the environment to increase their independence in child care.
Additional research is necessary to examine the most effective strategies and adaptations to assist mothers with a physical disability in child care.
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