Contraceptive Pearl: Reproductive Health Care for People with Physical Disabilities
People with physical disabilities often lack basic reproductive health care. This occurs for many reasons, including office inaccessibility, clinician biases, and lack of provider training. Providers should go beyond compliance with the Americans with Disabilities Act towards full accessibility for patients with impaired mobility.
Making the exam room more accessible:
Ideally, health centers should have at least one accessible exam table. The best table lowers to around 20 inches for easy transfers, has side rails for extra security, and has adjustable padded boots in place of traditional stirrups. If you lack an accessible exam table, you should help a patient transfer safely and comfortably from a wheelchair or other mobility device in whatever way she needs. Train staff in transfer techniques and make a plan with the patient for her preferred transfer method. Each patient knows what works best for her.
Check your biases:
People with disabilities are often considered asexual and assumed not to have the ability, desire, or right to express their sexuality or to have children and function as parents. Always take a sexual history. In prenatal genetic and structural screening, never assume that any particular abnormality warrants pregnancy termination. Recognize that people with disabilities can make their own medical decisions, give informed consent, and parent a child.
Always ask! By asking a physically disabled patient about her abilities, preferences, and accommodation needs, you can avoid making false assumptions and ensure that she receives the best possible care.
We appreciate your feedback! Please write to us at pearls@reproductiveaccess.org with any questions, comments, or additional resources to add to our list.
Helpful Resources
ACOG Interactive Site for Clinicians Serving Women with Disabilities
Take Charge Reproductive Health Guide for Women with Disabilities
Sources
Pharma-free
The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.
