Written by Jillian MacLeod

Effective communication is essential for building trust with patients, supporting decision-making capacity, and providing quality medical care–including abortion care. For patients with disabilities that affect communication, it can be the difference between access to quality abortion care and complete denial of care. People with communication disabilities are much more likely to have experienced three or more barriers to accessing reproductive healthcare in the last three years than nondisabled people.¹ Providers may be familiar with the legal responsibility to provide language services to people with limited English proficiency, but may overlook the needs of people with disabilities that affect communication. 

People with many different disabilities may need communication aids and services to be able to receive, understand, and convey information. Some examples of disabilities that can affect communication are: deafness, hearing loss, blindness, low vision, intellectual and developmental disabilities, and disabilities that affect the physical act of producing speech. 

Disability rights laws require medical providers to ensure that communication with people with disabilities is as effective as communication with nondisabled people.^2-3 This is imperative in the context of abortion care in order to ensure people with disabilities can make informed decisions and provide informed consent. Effective communication may require adjusting communication styles to meet the disabled person’s needs, or providing communication aids and services like:

• Qualified sign language interpreters 
• Real-time captioning, particularly for video telemedicine
• Assistive listening devices and systems (e.g., pocket talker)
• Offering written materials in alternative formats such as Braille, large print, or plain language
• Plain language (e.g., fourth-grade English)
• The teach-back method
• Visual aids
• Facilitating supported decision-making 
• Providing written notes summarizing the information provided

Communication aids must be provided in a timely manner, free of charge, in accessible formats, and in a way that protects the privacy and independence of the disabled patient.⁴ Anyone who needs a communication aid should have access to it for the duration of their visit and during all staff interactions (e.g., registration, triage, exam, lab work, check-out, etc.). Services must be individualized to meet the patient’s needs, and providers that participate in federal programs like Medicaid or Medicare must give primary consideration to the request of the patient with a disability.⁵ To capture the needs of the patient and allow as much time as possible for arranging services because of the time-sensitive nature of abortion care, clinics should ask patients at the first point of contact: “Do you have any access needs or communication needs? Is there any way we can make this appointment more accessible to you?” Stated needs should be noted in their file, and the requested arrangements should be made as soon as possible. 

In the context of abortion care, timely, effective communication is imperative to ensure access for all patients. To reduce disability-related barriers to care, clinicians should consider ways their practice can better serve people with communication disabilities, and commit to improving communication access to ensure quality care.

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