William Mosher1, Rosemary B Hughes2, Tina Bloom3, Leah Horton4, Ramin Mojtabai4, Jeanne L Alhusen5. 1. Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, USA 21205. Electronic address: wmosher@jhu.edu. 2. University of Montana Rural Institute for Inclusive Communities, 52 Corbin Hall, Missoula, MT, USA 59812. Electronic address: rosemary.hughes@mso.umt.edu. 3. University of Missouri Sinclair School of Nursing, S421 Sinclair School of Nursing, Columbia, MO, USA 65211. Electronic address: bloomt@missouri.edu. 4. Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, USA 21205. 5. University of Virginia School of Nursing, Post Office Box 800782, Charlottesville, Virginia, USA 22908.
Abstract
OBJECTIVE: The objective was to determine population-based estimates of use of contraception among women 15-44 years of age in the United States by disability status. STUDY DESIGN: We examined the relationship between disability status and use of contraception among 7505 women at risk of unintended pregnancy using data from the 2011-2015 National Survey of Family Growth. RESULTS: After examining the full distribution of contraceptive method use by disability status, we found that disability status was significantly associated with differences in three categories of use: female sterilization, the oral contraceptive pill and nonuse of contraception. Multivariate analysis shows that use of female sterilization was higher among women with cognitive disabilities (aOR=1.54, 95% CI=1.12-2.12) and physical disabilities (aOR=1.59, CI=1.08-2.35) than for those without disabilities after controlling for age, parity, race, insurance coverage and experience of unintended births. Use of the pill was less common among women with physical disabilities than for those without disabilities (aOR=0.57, CI=0.40-0.82). Finally, not using a method was more common among women with cognitive disabilities (aOR=1.90, CI=1.36-2.66). CONCLUSIONS: Self-reported cognitive disabilities ("serious difficulty concentrating, remembering or making decisions"), as well as physical disabilities, are significant predictors of contraceptive choices after controlling for several known predictors of use. IMPLICATIONS: The patterns found here suggest that screening for self-reported cognitive and physical disabilities may allow health care providers to tailor counseling and sex education to help women with disabilities prevent unintended pregnancy and reach their family size goals.
OBJECTIVE: The objective was to determine population-based estimates of use of contraception among women 15-44 years of age in the United States by disability status. STUDY DESIGN: We examined the relationship between disability status and use of contraception among 7505 women at risk of unintended pregnancy using data from the 2011-2015 National Survey of Family Growth. RESULTS: After examining the full distribution of contraceptive method use by disability status, we found that disability status was significantly associated with differences in three categories of use: female sterilization, the oral contraceptive pill and nonuse of contraception. Multivariate analysis shows that use of female sterilization was higher among women with cognitive disabilities (aOR=1.54, 95% CI=1.12-2.12) and physical disabilities (aOR=1.59, CI=1.08-2.35) than for those without disabilities after controlling for age, parity, race, insurance coverage and experience of unintended births. Use of the pill was less common among women with physical disabilities than for those without disabilities (aOR=0.57, CI=0.40-0.82). Finally, not using a method was more common among women with cognitive disabilities (aOR=1.90, CI=1.36-2.66). CONCLUSIONS: Self-reported cognitive disabilities ("serious difficulty concentrating, remembering or making decisions"), as well as physical disabilities, are significant predictors of contraceptive choices after controlling for several known predictors of use. IMPLICATIONS: The patterns found here suggest that screening for self-reported cognitive and physical disabilities may allow health care providers to tailor counseling and sex education to help women with disabilities prevent unintended pregnancy and reach their family size goals.
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: Monika Mitra; Linda M Long-Bellil; Lisa I Iezzoni; Suzanne C Smeltzer; Lauren D Smith Journal: Disabil Health J Date: 2016-01-02 Impact factor: 2.554