Reference--Nosek, Young, Rintala, et al., 1995
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.
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.