Experiences of Women With Disabilities in Accessing and Receiving Contraceptive Care

Abstract

Objective: To conduct an initial exploration of the experiences of women with different types of disability when they attempt to obtain contraceptive care.

Design: Multiple-category focus group design.

Setting: Multiple community sites.

Participants: Seventeen women with disabilities of reproductive age.

Methods: We purposively sampled women with different types of disability and conducted four focus groups organized by disability type: physical disability, intellectual and developmental disability, blind or low vision, and deaf or hard of hearing. We used a semistructured focus group guide to elicit participants' positive and negative experiences with contraceptive care. We analyzed focus group transcripts using content analysis.

Results: Participants identified challenges to obtaining high-quality contraceptive care in three main thematic areas: Accessibility and Accommodations, Clinician Attitudes, and Health Insurance. Participants with physical disabilities encountered inaccessible clinic rooms and examination tables, and those with sensory disabilities or intellectual and developmental disability described inaccessible clinic forms and information. Participants from multiple disability groups described negative attitudes of health care providers and health insurance limitations.

Conclusion: As described by our participants, the processes and infrastructure of contraceptive care were based on an assumption of an able-bodied norm. Reliance on such a norm, for example, offering a paper pamphlet to a blind woman, is not helpful and can be harmful to women with disabilities. Increased attention to the reproductive health care needs of women with disabilities is important for improving health care equity and quality.

Keywords: communication barriers; disabled persons; family planning services; female contraception; focus groups; physical barriers; qualitative.