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Research

Reproductive Health

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Optimal reproductive health demands equal access to inclusive, competent, and medically appropriate reproductive health services and information. Three important aspects of women’s reproductive health are:

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Contraception

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The reproductive health of women with disabilities relies on the freedom to exercise their rights to decide whether to become pregnant and give birth, as well as the number, spacing, and timing of their children. It also involves the right to prevent unplanned pregnancies by having access to effective, affordable, and accessible methods of contraception. Research suggests that women with disabilities may receive sterilization at higher rates and certain types of birth control at lower rates than other women.1 Women with disabilities also report experiencing both negative attitudes and misguided assumptions from clinicians when seeking contraceptive information, and inaccessible facilities and exam tables.2,3 To learn more, visit our page on Contraception.

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Pregnancy and Childbirth

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Women with disabilities are increasingly choosing pregnancy and childbirth.4 The abilities to conceive, carry a pregnancy to term, and have favorable pregnancy outcomes are generally not affected by physical disability5 although some women with disabilities experience more pregnancy and delivery complications than women in general.5-8 However, with knowledgeable health care providers who focus more on the woman’s ability than her disability, most women with disabilities can give birth to healthy babies.9 To learn about pregnancy and childbirth risks related to specific disability types as well as  experiences of women with disabilities related to changes in body and mobility during pregnancy, pregnancy care, labor and delivery, breastfeeding, and maternal and infant health outcomes, visit our page on Pregnancy and Childbirth. We also offer information on LGBTQ Women and Pregnancy and Assisted Reproduction options for women who cannot or decide not to become pregnant.

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Well Woman Exam

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A well woman exam, or annual visit to an obstetrician/gynecologist (OBGYN) or other healthcare provider for examination of the reproductive system, is central to maintaining reproductive health, identifying risk factors for disease, promoting prevention practices, and detecting problems requiring medical treatment or self-management. This exam usually includes an updated health history, an assessment of overall health, a pelvic exam, a clinical breast exam, orders for laboratory and other tests, and a discussion on ways to improve and maintain overall health. To learn more, visit our page on the Well Woman Exam.

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Additional Information

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Reproductive health is essential to the overall health and well-being of women with disabilities. Until recently, their reproductive health was a taboo topic because sexuality, conception, and parenting capabilities were not as well recognized in women with disabilities. Now, we see in the media, policy decisions, and the literature that there is growing respect and calls-to-action for women with disabilities’ reproductive health. There is recognition that women with disabilities are sexual beings with the same reproductive rights,10 desires11 and needs for services as other women.5 Women with disabilities have the right to equitable access to reproductive health services including family planning/birth control, well woman exams, and pregnancy and maternal health services.

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Barriers to Services

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When women with disabilities seek reproductive health services, they often face many complex barriers. Physically, many facilities and equipment are often inaccessible. Additionally, providers may lack information about a woman’s specific disability and the knowledge needed to accurately inform her about reproductive health issues and decisions. 3,12

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Attitudes and Assumptions

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Families, medical providers, and the public often hold negative, paternalistic attitudes and judgments regarding the rights and abilities of a disabled woman to become pregnant and parent children.13-15 People often falsely assume that women with disabilities are not sexually active and, therefore, not in need of the same reproductive health services as other women.

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Disparities 

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Despite the fact that decades have passed since the ADA was signed into law, women with disabilities continue to lack access to equitable reproductive health care, including prenatal care, preventive services, treatment, accurate information, and family planning services.16-20 For more information, visit our page Pregnancy Disparities.

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Lack of Information

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A woman with a disability is the best source of information about her own body and its functioning. Nevertheless, women with disabilities need and deserve up-to-date and accurate reproductive health support and information throughout their lifetime — whether they are dealing with issues related to cancer screenings, menstruation, contraception, sexuality, sexually transmitted infections, pregnancy, breastfeeding, or menopause.13, 21-22

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References

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21 - Smeltzer 2018

Smeltzer, S. C., Mitra, M., Long-Bellil, L., Iezzoni, L. I., & Smith, L. D. (2018). Obstetric clinicians' experiences and educational preparation for caring for pregnant women with physical disabilities: A qualitative study. Disability and health journal, 11(1), 8-13. https://doi.org/10.1016/j.dhjo.2017.07.004

22 - Nosek, Hughes 2004

Nosek, M. A., Hughes, R. B., Howland, C. A., Young, M. E., Mullen, P. D., & Shelton, M. L. (2004). The meaning of health for women with physical disabilities: A qualitative analysis. Family & Community Health, 27, 6-21.