Implementing and evaluating resources to support good maternity care for parents with learning disabilities: A qualitative feasibility study in England

Abstract

Problem: Parents with learning disabilities are often disadvantaged and their needs not well understood in maternity services. Background: Despite a global vision to improve maternity care, current evidence confirms poor pre- and postnatal care for parents with learning disabilities and their families. Midwives have expressed a need for support in the delivery of good care to this population of parents. Aim: To test the feasibility of implementing and evaluating two evidence-based and values-based resources – the Together Toolkit and Maternity Passport - to support good maternity care for people with learning disabilities. Methods: A qualitative feasibility study employing semi-structured interviews with 17 midwives and 6 parents who had used the resources in practice in four NHS Trusts in the south of England. Findings: Midwives and parents described how the resources positively impacted maternity care by enabling midwives, connecting networks and empowering parents. Factors affecting effective implementation of the resources were reported at an individual and setting level. Discussion: Staff training to raise awareness and confidence in supporting parents with learning disabilities, and improved systems for recording parent’s individual needs are required to enable the delivery of personalised care. Conclusion: Reasonable adjustments need to be prioritised to facilitate implementation of resources to support personalised maternity care and to address inequity for parents with learning disabilities. Aspirations for equity suggested commitment from midwives to challenge and overcome barriers to implementation. Recommendations were made to improve the resources and their implementation. These resources are free and accessible for use [www.surrey.ac.uk/togetherproject].