Lesley Weatherson: More research is needed into deaf women’s maternity services

The study of deaf women and maternity services it seems has had little academic research.

Midwives do a fabulous job of looking after all women and their partners through their pregnancies, deliveries and after the baby is born.

Communication is key to this; establishing a rapport with women and building up trust.

But what if communication is a barrier? If the woman is deaf? Perhaps English isn’t their first language but British Sign Language (BSL) is?

Having spent 6 hours this week with a deaf lady and her partner who had been ‘let down’ by the ‘system’, it inspired me to question just how the needs of deaf women are being met, who is measuring success and what does ‘success’ look like?

A healthy mother and baby? The mother may remember every detail of her pregnancy and birth long after the midwife has discharged her from her care.

As student midwife, Touhey (1) in 2013 published this in Midirs:

The journey of one deaf woman’s experience in the maternity service was relayed to us and opened my eyes to the lack of deaf awareness within the maternity services and the health care system as a whole. As woman-centered care is pivotal to all our midwifery teaching and practice, it baffled me to hear that any mother could feel she was forgotten about during her labour, recalling that ‘in all the panic, no one thought of me’.

Sporek (2014) (2) spoke about ‘providing a voice.’ In spite of hearing loss affecting more than 10 million people in the UK (Action on Hearing Loss, 2011), there is little guidance available on the provision of maternity care to deaf women and their families (Bramwell et al, 2000) (3). Deafness and pregnancy are two concepts rarely considered together.

Do deaf women really have the same access to services as hearing women? How many appointments were missed in the antenatal period because the phone call to change a booking was missed? How many times did the deaf person not understand her midwife as no interpreter or lipspeaker had been booked? How many deaf women truly feel as though they made informed choices and had their wishes and needs considered?

We are all aware of times when a BSL interpreter can’t be found, especially out of hours or for an unknown duration when the woman is in labour. We know about families being asked to interpret for relatives but we need careful consideration whether the labour ward is truly appropriate. Sometimes difficult messages need to be conveyed to the parents to be; the role of the interpreter is invaluable.

What if the midwife could sign? There have been some excellent initiatives in various hospital trusts to encourage midwifes to learn BSL. Students training to become midwives at De Montfort University (DMU) in Leicester for example but should they be used in place of a qualified sign language interpreter? Each has a job to do and British sign language needs two hands!

I am a qualified midwife and qualified BSL interpreter (RSLI) and specialise in supporting deaf women and their partners through pregnancy, birth and post-natal care. It is important for me to remember which professional hat I’m wearing.

When the pregnant women asks a question about her progress that clearly I know the answer to, I always interpret it to the midwife and convey her response. What does help is the jargon used- a Bishops score, Dilatation, Station and APGAR, for example, are all terms that need a true interpretation.

The delivery suite saw myself and the mother to be practising haptic techniques (the branch of psychology that investigates sensory data and sensation derived from the sense of touch and localized on the skin) that I would use when the midwife gave instructions to stop pushing the baby out and to start panting as the very nature of intensive pushing can mean ones eyes close.

We agreed PUSH- my gentle squeezing of her arm, STOP- a double tap on the arm and PANT- a continues gentle fluttering of fingers on the arm. It worked a treat despite the woman being under the influence of prescribed analgesic medication including Entonox.

By planning for possible interventions with a calm mum, calm environment and interpreter…. we were able to prepare for the delivery, agree tactics and all matters regarding communications and the midwife was able to explain procedures, ascertain the ongoing and changing wishes of the deaf lady and her partner and establish that important rapport and mutual trust with her patient. Truly the meaning of Midwife; with woman.

A healthy baby boy was born and suffice it to say, emotions were charged and there wasn’t a dry eye in the room- including mine!

Pictured with permission of the parents is Cooper Lee, born 5th March 2019.

1. https://www.midirs.org/i-think-it-was-forgotten-that-i-am-deaf/
2. Sporek PE. (2014) Deaf Nest: Time for change! The British Journal of Midwifery. 22 (5): 302.
3. Bramwell R, Harrington F, Harris J (2000) Deaf women: informed choice, policy and legislation. BJM8(9): 545–8 

Lesley is the Chair of the Association of Lipspeakers with Additional Sign having formally been Chair of the Association of Lipspeakers. She helped write the National Occupational Standards for lipspeaking as well as the Signature Level 3 lipspeaker training course. She is a qualified assessor, studying level 2 Deafblind communication and guiding and is a regular contributor to discussions and proposals by deaf led groups and publications.