Sexuality and Reproductive Health--Contraception
Sexuality and Reproductive Health Table of Contents
Very little information is available on the risks and benefits of various forms of contraception for women with disabilities.
- A mistaken belief that few women with disabilities are sexually active and, therefore, do not need birth control, may underlie the lack of research about safe and effective birth control for this group.
- Gynecologists typically have not offered information about birth control to women with very severe, visible disabilities.
- When doctors do give information about birth control to women with disabilities, they may not take women's disabilities into consideration.
- In a national study of nearly 1,000 women with and without disabilities, 30 percent of women with disabilities believed that their doctors had given them wrong information about birth control, compared to only 9 percent of women without disabilities.
- When making decisions about birth control, women with disabilities and their doctors should consider other medications they are taking, limits in using their hands to insert a diaphragm or other barrier methods, increased risk of blood clots, and the additional urge to use hormones to manage menstrual periods.
- Success in using hormone methods, such as the Pill or Depo Provera, has been mixed depending on type of disability. Hormones in the Pill can improve some chronic conditions but make others worse.
- Natural family planning methods that rely on taking body temperature to know when to avoid sexual activity during ovulation are likely to fail for any woman with spinal cord injury or other disabilities that produce irregular body temperature.
- Women with spinal cord injury or chronic conditions, such as lupus and scleroderma, should avoid using IUDs because of increased risk of severe bleeding, undetected movement of the device away from its appropriate location in the uterus, and autonomic dysreflexia.
- The perception that they have few safe options, along with difficulties they experienced when they tried to use various methods, seems to have led many women with disabilities to prefer surgical methods of birth control or none at all.
- In the national study referenced above, women were significantly more likely to use no birth control, have their "tubes tied," have a hysterectomy, or use natural family planning methods, than were women without disabilities.
- Overall, women with disabilities in that study were most satisfied with surgical methods of birth control, such as tubal ligation or hysterectomy, and least satisfied with barrier methods, such as the diaphragm.
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