Research

Access to Reproductive Health Care

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Content

Women with disabilities are significantly less likely to receive information on contraceptive options or screening for sexually transmitted diseases than non-disabled women.

Studies indicate that gynecologists are significantly less likely to ask women with three or more functional limitations or obvious physical deformity than women with no limitations about use of contraceptives. Very few of the women who used contraception in one study believed that their physicians considered their disabilities when recommending a contraceptive method. Doctors who assume women with disabilities are not sexually active may fail to screen for STDs or educate them about safe sex practices.

Women with disabilities are oftentimes discouraged from getting screened for STDs by inaccessible doctors' offices, difficulty getting onto the examination table, or previous experience with doctors not knowing how to handle disability-related symptoms during the exam such as spasticity, imbalance, and autonomic dysreflexia. Women with disabilities are frequently told that a pelvic exam is unnecessary because it would be too difficult to perform.

Content

Women with disabilities may be less likely to receive breast and cervical cancer screening, are diagnosed at later stages, and experience limitations in treatment options compared to non-disabled women.

Women with extensive functional limitations are less likely to receive breast and cervical cancer screening according to recommended guidelines than non-disabled women.

A national interview survey found that women with major long-term mobility impairments were less likely to have Pap smears and mammograms. The most common reason women with disabilities give for avoiding screenings is difficulty getting onto, or staying on, the exam table, or inability to assume the position required for a mammogram.

  • Women who are non-compliant with mammography or cervical cancer screening are much more likely than women who are screened regularly to have no health care plan or coverage of preventive services, or experience other cost barriers to accessing services.
  • Women with disabilities are more likely to be diagnosed at later stages of breast cancer.
  • Treatment is likely to be less successful when begun at a late stage, resulting in increased mortality rates.
  • There is some evidence that women with disabilities are less likely to receive breast conserving surgery or neoadjuvant therapy than non-disabled women.
  • Having certain chronic conditions and mobility impairments may limit options for treating cancer, such as adverse outcomes from radiation or interactions of cancer drugs with drugs taken for the chronic conditions.