Planning for Child Care

Planning for confident and safe child care begins before the birth of your baby.

Parenting presents challenges for everyone. Parents with disabilities have had much pleasure and success raising children. Sometimes you may experience negative attitudes, questions and stares, which originate from fear of disability and self-doubt. Expect that sometimes you will be overwhelmed and will question your own decisions and abilities. However, you can and will be able to nurture and care for your child.

Explore your physical caregiving ability and identify any needs for instruction, practice, and adaptive devices. Do not hesitate to ask for assistance from the local community health nurses, occupational therapists, or physiotherapists. Try to find a knowledgeable childbirth educator and an accessible prenatal and parenting class in your community for information and preparation for childbirth and child care.

Insist that your questions are answered by your doctor and other health professionals on topics such as:
possible effects of pregnancy on your disability;
possible effects of your condition on the development of the baby;
possible effects of any medication on the baby;
possible complications during pregnancy, delivery and postpartum;
medical procedures that may be used during delivery (e.g. caesarean), their potential complications, and your options.

If you are able to breastfeed, gather information early from doctors, nurses and midwives as well as from family and friends. Breastfeeding provides optimum nutrition for your baby, involves less expenditure of energy than bottle feeding, is cost effective and, most importantly, gives you tremendous feelings of closeness with your baby.

Visit the hospital, if possible, and attend an orientation tour for expectant parents. Inquire about the hospital’s policy and procedures regarding labour, birth and postpartum care. Make an appointment with the head nurse of the maternity unit. Convey to the hospital staff and your doctor, in advance, your special needs and preferences for care, such as:
presence of your partner, birthing coach, and/or interpreter in the delivery room;
transfer or mobility needs (many obstetrical ward beds and room facilities are not suitable for wheelchair users);
toileting needs;
special physical, sensory or social considerations;
testing of the newborn for a specific condition (e.g. of vision or hearing)

Ask the hospital if your care can be provided by a consistent nursing team. The same nursing team might be able to care for you throughout your prenatal (should hospitalization be required), labour, delivery and postpartum periods.

Read about "postpartum blues" or ask your childbirth educator. Plan for possible periods of irritability, extreme fatigue or stress. Form a support network before the baby’s arrival and learn to nurture yourself. Seek to meet other parents to obtain guidance and support.

If you plan to use a child care helper, select the individual in advance, if possible. Consider the following with respect to the shared caregiving responsibility:
Your helper must understand and respect that you are the baby’s mother and therefore have full responsibility for the direction of child care.
When the helper is providing care, you should be nearby, if possible, and in charge.
Ensure that you and the helper are in agreement and clear about the limits you wish to set for the child.
Use the helper primarily for performing those tasks that are difficult for you (e.g. washing, shopping, cleaning).
Use the "free time" for cuddling your baby. If, due to pain or disability, you cannot hold the baby, arrange for others to help with cuddling and holding.

Plan for child-proofing your house before the baby’s arrival. You will have little time or energy once the baby arrives. Familiarize yourself with safety.

Remember there is no such thing as perfect parenting. Anticipating, planning and seeking information are ways of minimizing stress and avoiding dangerous situations.

There are many excellent books on parenting in libraries and bookstores. Choose one that suits your philosophy of childrearing. The following suggestions are found in many books:

Spend time with your child. Have a daily schedule which accommodates your own needs. Consistency provides children with a sense of security, and makes them more cooperative since they know what to expect. This is especially true for toddlers and preschoolers.

Teach your child how to make informed choices in areas where it is appropriate, so that the child develops a sense of responsibility. Positive comments are the strongest teaching tool. Praise your child as often as you can. Make explanations simple and straightforward.

Be honest with your child and keep the lines of communication open. Let the child know that adults can make mistakes, and admit when you are wrong. Be conscious of the example you set. Children reproduce the behaviours that they see.

Have a "bag of tricks" available so that you can keep the child occupied as the need arises (play dough, crayons, paint sets, Lego). Play with your child. Don’t worry if you are unable to move onto the floor to play with your child, as many parenting books suggest; play can occur in any place, at any time.

Establish a bedtime routine. Once your child is settled for the night, you may wish to read aloud to your child, as this is a soothing way to end the day. Reading helps children develop their imaginations and instills an interest in learning to read. If you have a visual disability, play taped children’s stories and cuddle with your child as you listen together.

(This information is excerpted from: "Parenting with a Disability: Assistive Devices and Adaptations for Child Care," by Elaine Carty, Tali Conine, Leah Dobell, Angela Holbrook and Chris Seminuck. For more information, contact: Elaine Carty, Professor, the Childbearing and Parenting Program for Women with Disabilities/Chronic Illnesses, c/o School of Nursing, University of B.C, at: (604) 822-7444; fax: (604) 822-7466; e-mail: carty@nursing.ubc.ca.)