
Barriers to Reproductive
Health Maintenance Among Women with Physical Disabilities
Nosek MA, Young ME, Rintala DH, Howland CA, Foley CC,
Bennett JL. Barriers to reproductive health maintenance among women with
physical disabilities. Journal of Women's Health 1995;4(5):505-18.
ABSTRACT
This study examined barriers to reproductive health maintenance among women
with physical disabilities. A qualitative interview methodology was used.
All interviews were recorded on audio cassette, transcribed, and analyzed
using constant comparison and analytic induction. Thirty-one women with
disabilities that resulted in functional impairments were interviewed.
Theoretical sampling was used to assure that the individuals selected represented
key variables thought to affect sexuality, such as type of disability,
age at onset of disability, ethnicity, and marital status. Identified themes
coalesced into two major domains: participants' experiences, including
childhood interactions with medical settings, opportunities to learn about
reproductive health, abuse experienced in medical settings, and disability
as a risk factor for reproductive health problems; and characteristics
of medical systems and practitioners, including problems with health insurance,
medical systems' policies, attitudes of practitioners, architectural barriers
in medical facilities, the need for direct communication, and contradictory
information about contraception. Results of this study indicate a strong
influence of characteristics of medical systems and practitioners on the
knowledge, beliefs, and experiences of women with physical disabilities
as they strive to maintain their reproductive health. An analytic model
is proposed that presents disability status as having a strong influence
on the internal factors that lead to reproductive health maintenance behaviors,
such as knowledge, beliefs, psychological factors, and medical experiences.
While disability itself does not have a direct effect on environmental
factors, such as medical systems and professionals, it conditions the way
in which medical systems and professionals respond to women. Environmental
factors influence internal factors. Both, in turn, affect reproductive
health maintenance.
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