Contraception and Women with Intellectual Disabilities

Abstract

Background Contraception is widely prescribed to women with intellectual disabilities, yet little is known about what the women think and feel about this. One of the aims of the study was to explore what women understood and to what extent they were able to exercise choice and control. Method Twenty-three women with mild and moderate intellectual disabilities in South East England were interviewed about their current and past use of contraception, their knowledge of contraception more broadly, the process of being prescribed contraception and sources of information and support. Results Knowledge of how contraception works was very limited and approximately half the women also lacked basic knowledge about reproduction. Few women attended medical appointments alone and none had been given any accessible information about contraception. Conclusions There is a role for increased education, support and advocacy for women with intellectual disabilities when they are prescribed contraception. This would help to ensure women are prescribed methods which are best for them as individuals and to help maximize their participation in the process.

Contraceptive choices for women with learning disabilities

“…28 per cent of respondents said that contraception was required because the women concerned were sexually active, in 15 per cent of cases there was an expectation that that the women would become sexually active, whilst a fear of pregnancy and the need to manage menstruation were cited in 31 and 17 per cent of cases respectively. These figures from third parties appear to confirm McCarthy's (2009aMcCarthy's ( , 2009bMcCarthy's ( , 2010 earlier findings that contraception is frequently used 'just in case' without a clear clinical or social rationale for the benefits . 21 responses from the online survey were from third parties with involvement in contraceptive decision-making with women with high support needs.…”

“…This applies to starting contraceptive use, duration of use and deciding to discontinue (McCarthy, 2009a;2009b). Instead they report that decisions are imposed on them (Rowlands, 2011).…”

“…Although there has been considerable research into issues concerning parents with learning disabilities (see Llewellyn et al, 2010 for a comprehensive overview of this literature), in the UK, aside from the work of a few (see for example McCarthy, 2009a;2009b;2010a;2010b;Stansfield, 2007;Stansfield et al, 2007;Rowlands, 2011) far less attention has been paid to the question of how learning disabled women's reproductive capacity is managed , and the associated processes of contraceptive decision-making. Contraceptive decision-making with women who have high support needs remains particularly under-researched (McCarthy, 2010: 294).…”

Identifying Effective Methods for Teaching Sex Education to Individuals With Intellectual Disabilities: A Systematic Review

“…This negatively influences attainability of knowledge and skills that are beneficial for good sexual health. It is therefore not surprising that individuals with intellectual disabilities show low levels of knowledge regarding sexuality-related topics such as masturbation, pregnancy, safe sex, reproduction, and same-sex relationships (Healy, McGuire, Evans, & Carley, 2009;Kelly et al, 2009;Lesseliers, 1999;Leutar & Mihokovic, 2007;McCabe, 1999;McCarthy, 2009;Murphy & O'Callaghan, 2004) as compared to nondisabled individuals (McCabe, Cummins, & Deeks, 1999). Individuals with intellectual disabilities may also show impaired social, behavioral, and decisionmaking skills (Egemo-Helm et al, 2007;Hayashi, Arakida, & Ohashi, 2011;Khemka, Hickson, & Reynolds, 2005;Miltenberger et al, 1999).…”

Relaties en seksualiteit

“…Weinigen zochten hiervoor medische hulp of kregen toegankelijke informatie. 9 Met andere woorden: de voorlichting is vrij technisch en geeft geen antwoord aan mensen met een verstandelijke beperking op vragen zoals: is mijn verstandelijke beperking erfelijk? Is een orgasme gevaarlijk als je epilepsie hebt?…”