User:Loisgriffinxcx/Disability and women's health

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Women use contraceptives for various reasons: prevention of pregnancy, menstrual suppression, or use of teratogenic medications.[1] Women with intellectual disabilities are more likely to use contraceptives or request a hysterectomy in order to manage menstruation.[2][3] Various types of contraception are available to women with disabilities, however, prescription of a specific type of birth control is determined by the kind of disability a woman has and the associated side-effects of the method of contraception.[3]

Menstrual cycles are sometimes affected by different types of disabilities, such as rheumatoid arthritis.[3] In addition, women who become disabled later in life sometimes experience transient menstrual disorders.[3]

Healthcare professionals are less likely to refer women with disabilities for various gynecological screenings.[4] This could be due to the healthcare provider's unfamiliarity with disability or the assumption that women with disabilities are asexual in nature.[5] Women with disabilities are less likely to receive recommended Pap smears than women without disabilities. Women who have a spinal cord injury above the T6 vertebra can have autonomic dysreflexia during a pelvic exam which can be life-threatening.[6] Women with intellectual disabilities are less likely to be given Pap smears because the process may be upsetting to the patient.[7][8]

Women with physical disabilities may be unable to get a Pap smear if the examination table cannot be lowered.[9] There are a number of alternative examination procedures that can be used, including knee-chest position, diamond-shaped position, M-shaped position and V-shaped position.[10]These alternative procedures can help accommodate women who have difficulty putting their feet into stirrups or who need greater body support.[10] In addition, OB stirrups can be used for additional comfort.[11] The Welner table, designed by American obstetrician-gynecologist and disability rights activist Sandra Welner, is an examination table designed with a wider range of adjustments and positions to facilitate accessibility for both patients and doctors with physical disabilities.[12] Welner also compiled the handbook, Welner's Guide to the care of women with disabilities.[13]

A study conducted in 1989 found that 19% of women with physical disabilities had been counseled on sexuality in a medical setting and were rarely offered information about contraceptives.[14] Women with intellectual disabilities often lack both education about sexual health and the ability to learn about it informally.[15] In addition, their medical providers are less likely to discuss contraception with them.[2]

In Zimbabwe, people with disabilities are often treated as second-class citizens. Women in Zimbabwe face increased barriers when accessing services for sexual health.[16] The National Reproductive Health Policy implemented in 2006 did not address the needs of women with disabilities.[17] Zimbabwean women with disabilities faced negative attitudes about their reproductive health, such as those of female nurses who expressed the idea that "sex was not meant for the disabled."[18]

Women with intellectual disabilities have been advised to become sterilized to possibly prevent sexual assault or because doctors may consider them unfit to become mothers.[19][20] In the United States, a 1927 Supreme Court case, Buck v. Bell, allowed the forced sterilization of women with intellectual disabilities.[21] In Singapore, the Voluntary Sterlisation Act (VSA) was passed in 1970 and which allowed any spouse, parent or guardian of persons who are "afflicted with any hereditary form of illness that is recurrent, mental illness, mental deficiency or epilepsy" to consent to the sterilization on their behalf.[22] In Brazil, many healthcare providers and individuals with disabilities both see sterilization as the only option for contraception.[4]


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References[edit]

  1. ^ Committee on Adolescence (29 September 2014). "Contraception for Adolescents". Pediatrics. 134 (4): e1244–e1256. doi:10.1542/peds.2014-2299. PMC 1070796. PMID 25266430.
  2. ^ a b Greenwood & Wilkinson 2013, p. 3.
  3. ^ a b c d Welner, Sandra L.; Hammond, Cassing (2009). "Gynecologic and Obstetric Issues Confronting Women with Disabilities". The Global Library of Women's Medicine. doi:10.3843/GLOWM.10076.
  4. ^ a b Carvalho, Brito & Medeiros 2014, p. 116.
  5. ^ Kaplan 2006, p. 450.
  6. ^ Kaplan 2006, p. 453.
  7. ^ Greenwood & Wilkinson 2013, p. 5.
  8. ^ Drew & Short 2010, p. 262.
  9. ^ Parish & Ellison-Martin 2007, p. 114.
  10. ^ a b Kaplan 2006, p. 451.
  11. ^ Kaplan 2006, p. 452.
  12. ^ Waldman, Hilary (1998-03-03). "New Equipment, New Outlook". Hartford Courant.
  13. ^ Sandra L. Welner; Florence Haseltine, eds. (2004). Welner's Guide to the care of women with disabilities. Philadelphia: Lippincott Williams & Wilkins. ISBN 978-0781735322.
  14. ^ Nosek & Hughes 2003, p. 225.
  15. ^ Greenwood & Wilkinson 2013, p. 2.
  16. ^ Rugoho & Maphosa 2017, p. 2.
  17. ^ Rugoho & Maphosa 2017, p. 3.
  18. ^ Rugoho & Maphosa 2017, p. 4.
  19. ^ Napier, Stephen (2010). "Contraception for the Mentally Disabled: A Contraceptive Act?". The Linacre Quarterly. 77 (3): 280–307. doi:10.1179/002436310803888745. ISSN 0024-3639.
  20. ^ Thomas 2001, p. 255.
  21. ^ Wills, Matthew (2017-08-03). "When Forced Sterilization was Legal in the U.S." JSTOR Daily. Retrieved 2017-08-03.
  22. ^ Wong, Meng Ee; Ng, Ian; Lor, Jean; Wong, Reuben (2017). "Navigating Through the 'Rules' of Civil Society: In Search of Disability Rights in Singapore". In Song, Jiyoung (ed.). A History of Human Rights Society in Singapore: 1965-2015. New York: Routledge. p. 173. ISBN 9781315527406.
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