Justine P Wu1, Kimberly S McKee2, Michael M McKee3, Michelle A Meade4, Melissa A Plegue5, Ananda Sen6. 1. Assistant professor, Departments of Family Medicine and Obstetrics and Gynecology, The University of Michigan, Ann Arbor. 2. Research fellow, Department of Family Medicine, The University of Michigan, Ann Arbor. 3. Assistant professor, Department of Family Medicine, The University of Michigan, Ann Arbor. 4. Associate professor, Department of Physical Medicine and Rehabilitation, The University of Michigan, Ann Arbor. 5. Lead statistician Department of Family Medicine, The University of Michigan, Ann Arbor. 6. Professor, Department of Family Medicine, The University of Michigan, Ann Arbor.
Abstract
CONTEXT: Women with disabilities experience a higher rate of adverse pregnancy outcomes than women without disabilities. Preventing or delaying pregnancy when that is the best choice for a woman is a critical strategy to reducing pregnancy-related disparities, yet little is known about current contraceptive use among women with disabilities. METHODS: A cohort of 545 reproductive-age women with physical disabilities (i.e., difficulty walking, climbing, dressing or bathing) or sensory disabilities (i.e., difficulty with vision or hearing) was identified from among participants in the 2011-2013 National Survey of Family Growth. Those at risk for unplanned pregnancy were categorized by whether they were using highly effective reversible contraceptive methods (IUD, implant), moderately effective ones (pill, patch, ring, injectable), less effective ones (condoms, withdrawal, spermicides, diaphragm, natural family planning) or no method. Multinomial regression was conducted to examine the association between disability and type of contraceptive used. RESULTS: Some 39% of women with disabilities were at risk of unplanned pregnancy, and 27% of those at risk were not using contraceptives. The presence of disability was associated with decreased odds of using highly effective methods or moderately effective methods, rather than less effective ones (odds ratio, 0.6 for each), but had no association with using no method. CONCLUSION: There is a significant need to reduce contraceptive disparities related to physical or sensory disabilities. Future research should explore the extent to which contraceptive use differs by type and severity of disability, as well as identify contextual factors that contribute to any identified differences.
CONTEXT: Women with disabilities experience a higher rate of adverse pregnancy outcomes than women without disabilities. Preventing or delaying pregnancy when that is the best choice for a woman is a critical strategy to reducing pregnancy-related disparities, yet little is known about current contraceptive use among women with disabilities. METHODS: A cohort of 545 reproductive-age women with physical disabilities (i.e., difficulty walking, climbing, dressing or bathing) or sensory disabilities (i.e., difficulty with vision or hearing) was identified from among participants in the 2011-2013 National Survey of Family Growth. Those at risk for unplanned pregnancy were categorized by whether they were using highly effective reversible contraceptive methods (IUD, implant), moderately effective ones (pill, patch, ring, injectable), less effective ones (condoms, withdrawal, spermicides, diaphragm, natural family planning) or no method. Multinomial regression was conducted to examine the association between disability and type of contraceptive used. RESULTS: Some 39% of women with disabilities were at risk of unplanned pregnancy, and 27% of those at risk were not using contraceptives. The presence of disability was associated with decreased odds of using highly effective methods or moderately effective methods, rather than less effective ones (odds ratio, 0.6 for each), but had no association with using no method. CONCLUSION: There is a significant need to reduce contraceptive disparities related to physical or sensory disabilities. Future research should explore the extent to which contraceptive use differs by type and severity of disability, as well as identify contextual factors that contribute to any identified differences.
Authors: Renee Monique Haynes; Sheree L Boulet; Michael H Fox; Dianna D Carroll; Elizabeth Courtney-Long; Lee Warner Journal: Contraception Date: 2017-12-15 Impact factor: 3.375
Authors: Lesley A Tarasoff; Yona Lunsky; Simon Chen; Astrid Guttmann; Susan M Havercamp; Susan L Parish; Simone N Vigod; Adele Carty; Hilary K Brown Journal: J Womens Health (Larchmt) Date: 2020-07-14 Impact factor: 2.681