Deafness, blindness, and pregnancy. How to accommodate patients well? 11
Disability is a very wide issue, but it is common. Dr. Anton Titov, MD. So what should a woman consider and how to manage pregnancy in women with disabilities? Medical second opinion. And maybe you could group it by different types of disabilities? Yeah, it’s a very, it’s a very important question. Dr. Marc Dommergues. Medical second opinion. And the world of disability is an incredibly complex world with very different situations. If you start with deaf people who speak using sign language, is it a disability? Is it a specific culture? Are they different from let’s say, Chinese people coming to France? Interesting question. Should they be taken care of by doctors who speak the language? This means kind of triage and going to special places. Or should they be able to go to any place? I’ve no definite answer to that. Dr. Marc Dommergues. Medical second opinion. And it’s a philosophical question. As far as our center is concerned. Dr. Marc Dommergues. We and our hospital, we have developed for years or the hospital has developed for years a system of a welcoming system for people who use sign language. They can go to any place in the hospital and have a translator. Dr. Marc Dommergues. Medical second opinion. And in different departments, there is medical staff who speak the language. For example, in our department, there’s a midwife who is rather good at speaking with sign language. She is the one who follows the ladies who use sign language. She taught us a lot to us about the culture of deaf people. For example, one is not always aware that there were victims of the Nazi Holocaust. Dr. Marc Dommergues. Medical second opinion. And this makes them very sensitive to any genetic discussion. Dr. Marc Dommergues. Medical second opinion. And this is something you have to bear in mind. Another issue is that when you’re deaf, it’s sometimes difficult to get access as a kid to information on reproductive issues, etc. Dr. Marc Dommergues. Medical second opinion. And it’s also important that in a hospital, one knows that if people are deaf, the answer is not to shout at them. This is something you see occasionally. You can just take your phone and type things or dictate things on your phone and have discussions. At the level of the organization or the hospital, the system of text messages or video conversations, etc., is possible to implement. Also, it’s possible to employ people who themselves are deaf and who are bilingual the other way around. This is something we do here. Dr. Anton Titov, MD. So probably for deaf people who are using the sign language, the most important thing is just to recognize that they’re speaking a different language and to adapt ourselves. Dr. Marc Dommergues. Medical second opinion. And ideally, of course, to have someone who speaks the language and who can follow the pregnancy or have a translator. This is a straightforward thing. It’s not that easy to implement everywhere. Dr. Anton Titov, MD. There are questions about the best approach. Should people be triaged to a specific hospital? If we consider visual impairment. Again, it is probably important that as a team, we understand what type of visual impairment we are dealing with. What will be the impact of the light? How to organize the rooms? How to manage dogs? I mean a dog helper, how do we manage the dog? Right? How do we manage with this animal in the Labor ward, etc? Medical second opinion. And these are little things you have to find solutions for. Usually, it’s rather easy to get those solutions. Dr. Anton Titov, MD. There’s also the genetic question. For example, just on thinking of a patient, blindness may be the consequence of the treatment of bilateral retinoblastoma, which is an inherited disease. Dr. Marc Dommergues. Medical second opinion. And then, if you discuss the pregnancy beforehand. The question of the inheritance of the genetic diagnosis will be raised. It is a difficult issue, of course. But this needs to be discussed. This is an example where disability and genetics meet together.
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