Pregnancy Intendedness by Maternal Disability Status and Type in the United States

Abstract

CONTEXT Societal views about sexuality and parenting among people with disabilities may limit these individuals’ access to sex education and the full range of reproductive health services, and put them at increased risk for ­unintended pregnancies. To date, however, no national population‐based studies have examined pregnancy ­intendedness among U.S. women with disabilities. METHODS Cross‐sectional analyses of data from the 2011–2013 and 2013–2015 waves of the National Survey of Family Growth were conducted; the sample included 5,861 pregnancies reported by 3,089 women. The proportion of pregnancies described as unintended was calculated for women with any type of disability, women with each of five types of disabilities and women with no disabilities. Multivariate logistic regression analyses were conducted to examine the relationship of disability status and type with pregnancy intendedness while adjusting for covariates. RESULTS A higher proportion of pregnancies were unintended among women with disabilities than among women without disabilities (53% vs. 36%). Women with independent living disability had the highest proportion of unintended pregnancies (62%). In regression analyses, the odds that a pregnancy was unintended were greater among women with any type of disability than among women without disabilities (odds ratio, 1.4), and were also elevated among women with hearing disability, cognitive disability or independent living disability (1.5–1.9). CONCLUSIONS Further research is needed to understand differences in unintended pregnancy by type and extent of disability. People with disabilities should be fully included in sex education, and their routine care should incorporate discussion of reproductive planning.

Factors affecting utilization of sexual and reproductive health services among women with disabilities- a mixed-method cross-sectional study from Ilam district, Nepal

“…Access to SRH services is essential for people with disabilities. Growing evidence in North America, Europe and Australia indicate that women with disabilities have poor pre-conception health status (diabetes, frequent mental distress, obesity, asthma, lack of emotional support) [ 6 ]; and have a greater risk for unplanned or unintended pregnancies [ 7 ]. They also can have perinatal and postnatal complications (gestational diabetes, hypertension, urinary tract infection, preterm rupture of membranes, cesarean delivery, and postpartum depression) [ 7 – 9 ] and adverse pregnancy outcomes (small for gestation, preterm birth, with smaller numbers of studies revealing elevated risk for other adverse neonatal and infant outcomes) [ 10 ].…”

The Use of Self-Reported Functional Limitation to Examine Pregnancy and Reproductive Health Experiences in a National Sample of Women

“…Importantly, women may manifest more than one type of functional limitation (80% of women who reported a self-care limitation also reported a mobility limitation), signaling that utilized disability definitions and subgroups may not be mutually exclusive. 9 …”

Prevalence of Hysterectomy by Self-Reported Disability Among Canadian Women: Findings from a National Cross-Sectional Survey

“…Disability is umbrella term for functional impairments and activity limitations related to an individual's health condition and their environment, 10 and is emerging as an important determinant of women's health. Women with disability less often use long-acting reversible contraceptive methods, 11 more frequently experience unintended pregnancy, 12 have heightened risk of maternal morbidity, 13 and less often have up-to-date breast and cervical cancer screening. 14 These differences are not fully explained by comorbidities or socioeconomic factors.…”