Reproductive health care experiences of women with physical disabilities: A qualitative study

Objective: To explore the reproductive health care experiences of women with physical disabilities and how reproductive health care experiences could be improved. Design: A qualitative interview study was conducted. Participants: Ten women, ages 28 to 47 years, with physical disabilities, including multiple sclerosis, cerebral palsy, and paralysis, were recruited through the investigators' contacts with local disability groups. Results: Interviewees encountered numerous barriers to quality reproductive health care services, including inaccessible equipment and facilities, limited contraceptive options, health care providers' insensitivity and lack of knowledge about disabilities, and limited information tailored to their needs. Providers sometimes appeared surprised that they would be sexually active, and did not ask about contraceptive use or assess for sexually transmitted diseases. Although most interviewees had private health insurance, some had problems seeing preferred providers. Accessing reproductive health care services is so difficult that some women avoid regular gynecologic visits. Suggestions for improving services included involving women with disabilities in teaching health care providers about their special needs and self-advocacy training to help disabled women become more knowledgeable partners in their own health care. Conclusions: Additional research should address the gaps in knowledge about the reproductive health care needs of women with disabilities. (C) 1997 by the American Congress of Rehabilitation Medicine.