Academic journal article International Journal of Child Health and Human Development

Women with Disabilities: Reproductive Care and Women's Health

Academic journal article International Journal of Child Health and Human Development

Women with Disabilities: Reproductive Care and Women's Health

Article excerpt

Introduction

All women have a right to reproductive care regardless of intellectual or developmental disability. Unfortunately, this right has traditionally been overlooked or neglected by many health care providers. Often, women with disabilities are considered to be 'asexual.' We have found, however, that women with disabilities are just as likely to be sexually active as women without disabilities. Sex is an innate human desire regardless of mental or physical capabilities. It is a basic human need involving feeling valued and attractive. Giving and receiving affection and sharing are needs that are met through sexual behavior (1). All people have a desire to love and to be loved. The initial coital act is called sexarche. In most cultures of the world sexarche occurs sometime during adolescence (2). A number of factors influence sexual behavior. These factors include society, one's physical body, one's cognitive functioning, and one's emotions.

Access to care

All women, especially those with an intellectual or developmental disability should have access to reproductive health care. A disability may be physical, developmental, or due to mental illness. The World Health Organization (WHO) breaks down the term "disability" into three domains. The first is impairments or deviations from the "norm" in the population. This includes losses of body structure or function. The second is activity. This is a person's ability to perform a task. The third domain is participation or involvement in life situations. Whether someone is disabled is partially caused by contextual factors. Contextual factors include the roles that society imposes as opposed to looking at an individual and their own strengths (3). Approximately 27 million women in the United States have a disability and the number is growing. Of women over 65 years of age, 50% report living with a disability (4). Women with disabilities need the same general medical care that all women require but may additionally require specialty care.

There are a number of barriers to providing women with disabilities access to care. However, all humans deserve optimal quality of life and those with disabilities should not be excluded. Women with disabilities need reproductive healthcare and deserve to have aspects of sexuality, contraception, childbearing, and menopause discussed and evaluated by healthcare professionals. Barriers to care may include lack of time by the health care professional as there may be other medical, physical, and functional needs that need to be addressed during the office visit (1). Other barriers include difficulty navigating wheelchairs or special equipment through tight office hallways, waiting rooms or small exam rooms. There may be a lack of knowledge in the health care provider or lack of the patient being able to communicate a concern. In addition, there may be poor reimbursement for a health care provider's services. There are also myths and misinformation among health care providers regarding the sexuality of women with disabilities (5).

Studies have shown that adolescents with physical disabilities are as sexually experienced as their peers without physical disabilities (1). A study of adult women with chronic physical disabilities in the United States found that across all women, 3.5% report being currently pregnant. Of these currently pregnant women, 3.8% did not have chronic physical disability whereas 2.0% of women did report a chronic physical disability. The study concluded that women with chronic physical disability do become pregnant and that the numbers will likely continue to increase (6).

Historical background

Since the 1970s the professional approach to care for women with disabilities has undergone significant changes. Women who were previously residents in chronic care institutions and hospitals are now integrated into the community setting. Instead of having care provided within the institution or hospital, individuals and their caregivers must now seek care on their own (7). …

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