Accessible miscarriage resources

Trudi Collier, deaf mother, native BSL user, counsellor and Vice Chair of Deaf Parenting UK, from Aberdeenshire, UK, reviews a leaflet for D/deaf women. Katie Rowan, independent consultant from London, UK, reviews a leaflet for women with learning difficulties.

 

The Miscarriage Association has produced two new accessible versions of its introductory leaflet, We are sorry that you have had a miscarriage - one for D/deaf women and one for women with learning disabilities. This project was supported by the Department of Health.

Accessible leaflet for D/deaf women

The leaflet is structured in two columns using different colours - the left-hand page (in green) is in clear, condensed language and the right-hand page (in blue) contains more detail - to meet the needs of a wide range of D/deaf people with different levels of reading/English skills.

The leaflet covers every aspect of emotions that you may feel after miscarriage - for example, how others may react, remembering your baby, your health - with questions you may want to ask, information on the causes of miscarriage, what happens next, and so on.

I liked the use of different colours (green/blue) for each column as they make it easier for the reader to choose which side to read - simple explanation or in more detail.

I found the leaflet clear and informative and felt that it would reassure the reader. There is plenty of information if needed, plus it encourages the reader to talk to someone (whether it is a partner, a relative or a professional, such as a midwife or counsellor) if they need to discuss their miscarriage or health in general.

My only concern is that someone who may find it easier to read the green column (with brief information) may ignore the blue column (with more detail) and therefore miss out some important information.

For example, in the section on 'Your feelings', the blue column lists various emotions that someone may feel after a miscarriage such as shock, feeling empty, sadness, crying, not being interested in everyday life, constant tiredness, no interest in sex, anger, and so on, whereas the green column just says that you might feel sad and therefore misses out important information.

I thought perhaps it would have been helpful to add a paragraph in the front of the leaflet stating that it would be useful to try to look at both columns.

Overall, I find the leaflet very informative and a good starting point for people going through a big loss from miscarriage, especially in the way it reassures people that it is normal to go through various emotions and that there is more help available if they need it.

Trudi Collier

Accessible leaflet for women with learning difficulties

No one knows the actual number of parents with learning difficulties in the UK. Studies and estimates have foundered on the varying definitions of learning difficulties. It is, however, recognised that they represent a sizeable population whose special needs have so far not been adequately addressed by health and social services.

They are now top of the government agenda as part of an Independent Living Review under the remit of the Office of Disabilities work on equality. There is however some mismatch between intention and reality.

The challenge for all community health services is responding to those people in their population who do not have unusual health needs but require different approaches in service provision. Lack of appropriate information and support is a major obstacle faced by parents with learning difficulties.

This free leaflet is extremely welcome and meets a clear information gap both for parents and professionals. The information given is extremely comprehensive. The language used is simple and supportive and text is illustrated by line drawings supplied by CHANGE, an organisation for people with learning difficulties. Women with learning difficulties were also involved in the consultation.

Information is broken down into sections that encompass emotional feelings, health issues, causes of miscarriage, what happens next and where to get help.

The challenge for any leaflet such as this is the sheer range of abilities, understanding and aspirations covered by the generic term of learning difficulties. Many women who become pregnant may not have a partner. They will have varying degrees of literacy. Their life experiences, perceptions and expectations can be different to the rest of the population. Local authorities are implementing stricter service eligibility criteria. Unless they have a family support network, women with learning difficulties can be isolated in the community with limited or no services. If their learning difficulty has not been diagnosed, they may only be known to services when they become pregnant or miscarry.

It is not an easy task to encompass different levels of understanding in a leaflet such as this, however sensitively done. The extent of the information given may be difficult to absorb especially at a time of considerable stress. There is a risk of the amount of text on some pages overwhelming readers, particularly the section on feelings and relationships. This would need to be 'interpreted' as appropriate to individual circumstances.

Information could perhaps have been condensed and focused by the use of a slightly different layout, for example a 'box' format that linked text to picture with larger font, making it more accessible. It could also be improved by including space to insert specific local contacts in the check list under 'Where can I get help?'

However, the leaflet will be an extremely useful information tool for frontline health staff. The sections provide a framework that can support joint working, as one midwife put it "get us singing from the same hymn sheet". It is of great value as an adaptable teaching aid that can be used by professionals in their individual work with often very vulnerable women and families.

Katie Rowan

We are sorry that you have had a miscarriage by The Miscarriage Association, published in 2007, is available in standard English, bi-lingual English (with Polish, Urdu, Bangla, Gujerati, Punjabi, Arabic and Turkish), a version specially designed for D/deaf women, and a shorter illustrated version aimed at women with learning difficulties. Individual copies are available free. A charge is made to professionals ordering multiple copies.

Available from:

The Miscarriage Association

c/o Clayton Hospital

Northgate

Wakefield

WF1 3JS

Tel: 01924 200799

www.miscarriageassociation.org.uk

First published in Disability, Pregnancy & Parenthood, issue 62, Summer 2008.

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