To explore reproductive health issues of women with physical disabilities, these Texas researchers interviewed 10 women with a variety of physical disabilities. The tape-recorded interviews were computer coded to reveal these themes: barriers, facilitators, birth control issues, pregnancy, STDs, menopause and aging, sexuality, and suggestions.

About barriers, women said some were structural, for example, inaccessible examining tables. But the most common barriers involved interactions with health care providers. The women said the health care providers were insensitive and lacked awareness off disability issues regarding reproductive health.

Lack of good communication led the women to avoid asking questions. Said one woman: "It's pretty difficult to continue to ask questions when you get looked at like you're coming from Mars." Perceived as being asexual, too, was cited as a barrier.

What would make the visits better, the women said, would be providers who ask questions, are willing to learn, and respect women as decision makers in their own health. About physical access, one woman told of a chair that converts into an examination table, which makes transferring easier from a wheelchair.

Women said they were concerned about birth control methods that might interact with medications they already were taking. One woman who worked at Planned Parenthood said some women with physical disabilities can't physically take the pills.

Individuals related their pregnancy experiences. One said others expressed concerns about a woman with disabilities having children. Another said people had commented about possible birth defects from faulty genes. Medicinal effects on the fetus were another expressed concern.

Most said they didn't know how much of a problem STDs would be for women with disabilities. Indicated problems included lack of sensation in the genital area to detect infection, inability to use barrier conception methods, and low esteem that might lead to promiscuity and increased infection risk.

Older women expressed concern about menopause and its interaction with disability. Several said there was a reluctance to discuss sexuality with women who had disabilities. Positioning problems, partner rejection, and low self-esteem were also brought up by the women.

Educating providers and women with disabilities were both offered as ways to improve reproductive issues of women with disabilities.

EndNotes

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Becker, H., Stuifbergen, A., & Tinkle, M. (1997). Reproductive health care experiences of women with physical disabilities: A qualitative study. Archives of Physical Medicine and Rehabilitation 78, S3-S10.