Clients with Disabilities

Midwives can provide care to clients with disabilities and/or complex health issues, either as primary care providers or as part of a multidisciplinary team designed to meet the individual clients' needs.

In 2021, the SOGC published Guideline No. 416: Labour, delivery, and postpartum care for people with physical disabilities.

The Provincial Council for Maternal and Child Health (PCMCH) Accessible Pregnancy Care Planning Toolkit supports health-care providers in addressing the unique challenges faced by pregnant individuals with physical disabilities and their families. The resources aim to drive high-quality care, reduce barriers to access and promote inclusivity. The toolkit is designed as a guide for providers to initiate conversations and create a tailored plan for pregnancy care reflective of the needs of each pregnant individual with a physical disability.

All organizations in Ontario, including midwifery clinics, are required to comply with the Accessibility for Ontarians with Disabilities Act (AODA) standard on customer service. This regulation requires practices to establish policies, practices and procedures on providing services to people with disabilities. Midwifery practice groups could go one step further and articulate your commitment to working with clients with disabilities. For an example of this type of statement, see the AOM’s Statement on Diversity, Equity and Inclusion.

Things you and your practice can do to provide accessible care for clients with disabilities:

• Be mindful of the words you use when discussing disabilities with your clients. Always ask your clients for their preferred terminology to describe their disability.
• If the client finds it helpful, include support attendants or family members in informed choice discussions and care plans.
• Educate yourself on using adaptive equipment for labour, birth, breastfeeding and parenting.
• Be aware of what resources are available for people with disabilities in your community.
• Be proactive about coordinating interpretative services for deaf clients by booking an interpreter at the same time you are booking your client’s next appointment.
• Taking into account the nature of the disability, and potential barriers to coming to the clinic, it may be worthwhile considering more home visits when working with clients with disabilities.
• Birth may increase the individual’s mobility and fatigue issues, making it more difficult to seek services outside the home. Consider scheduling more at-home postpartum appointments and offering additional supports in the early weeks.
• Be aware that parents with disabilities may be apprehensive about accessing community support that non-disabled parents utilize because of societal scrutiny and discrimination. Parents with disabilities (particularly those with intellectual disabilities) are significantly overrepresented in statutory child protection proceedings. If your client is being investigated by CAS, knowing the organization's philosophy around working with families from diverse backgrounds may be helpful in advocating for your client or supporting your client with self-advocacy.

Community Resources

Local Community Care Access Centres (CCAC) may be able to provide in-home care for the postpartum period.

Adult Protective Services provides advocacy to disabled parents in the Greater Toronto Area involved in legal/social cases.

Adult Protective Service Association of Ontario supports adults with developmental disabilities living on their own in the community to live as independently, safely and securely as possible.

Parenting with a Disability Network is a resource/support network for disabled parents, offering books, support and workshops.

ARCH Disability Law Centre provides free support and advocacy for disabled people in Ontario.

Additional Resources