Disparities in receipt of family planning services by disability status: New estimates from the National Survey of Family Growth

Abstract

Background A substantial and increasing population of US women of childbearing age live with disability. Disability-based disparities in access to family planning services have been previously documented, but few studies have used population-based data sources or evidence-based measures of disability. Objective To determine population-based estimates of use of family planning services among women 15 – 44 years of age in the United States, and to examine differences by disability status. Methods This is a secondary analysis of a cross-sectional survey, the 2011-2015 National Survey of Family Growth. These analyses include 11,300 female respondents between the ages of 15 and 44 who completed in-person interviews in respondents' homes. Results Approximately 17.8% of respondents reported at least one disability in at least one domain. Women with disabilities were less likely than those without disabilities to receive services; the largest differences by disability status were seen among women with low education, low income, and those who were not working. Logistic regression analysis suggests that women with physical disabilities and those with poorer general health are less likely to receive services. Conclusions Women living with disabilities reported lower receipt of family planning services compared to women without disabilities, but the differences were small in some subgroups and larger among disadvantaged women. Physical disabilities and poor health may be among the factors underlying these patterns. Further research is needed on other factors that affect the ability of women with disabilities to obtain the services they need to prevent unintended pregnancy.

Challenges in Accessing Health Care for People with Disability in the South Asian Context: A Review

“…The WHO Report also emphasizes that part of the problem with the poorer health outcomes also rests with the barriers to access to health care services, which discriminate against PWD [ 1 ]. Across all continents from the Americas to Australia, studies have documented barriers in accessing health care among PWD compared to those without disabilities, across the life spectrum [ 8 , 13 , 14 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. Though the socio-economic milieu may be different, PWD have faced significantly more barriers than those without a disability in all contexts.…”

“…This they believe results in reduced health care access, as well as quality of health care [ 28 ]. Studies also show that women with disabilities report lower receipt of family planning services [ 22 ]. Evidence also documents that among PWD, the differentials in access is adverse for women, the poor, and those lacking health insurance cover [ 21 ].…”

From words to actions: systematic review of interventions to promote sexual and reproductive health of persons with disabilities in low- and middle-income countries

“…Although unintended pregnancy has long since been identified as a serious concern for women with disabilities (eg, 8 ), estimates from the USA indicate that they were far less likely than women without disabilities to access family planning services. 9 A similar US study showed that 30.2% of women with disabilities used female sterilisation compared with 18.8% of non-disabled women, 10 highlighting the need to investigate issues of consent and knowledge gaps related to use of permanent methods for contraception. In a recent study in Nepal, women with severe impairment reported higher levels of physical and/or sexual, emotional, economic and in-law violence than women without a disability.…”

Contraceptive use by disability status: new national estimates from the National Survey of Family Growth

“…[15,16] Research has identified disparities between U.S. women with and without disabilities in accessing and receiving recommended clinical preventive services such as routine physical examinations, cervical cancer screenings, and family planning services. [17, 18] Women with disabilities report multiple barriers to achieving pregnancy. For example, they report difficulties finding accessible facilities and medical equipment as well as obstetrical practitioners and other providers who are knowledgeable about the potential interactions between their disability and pregnancy, and a lack of health insurance to cover the services [8-14].…”