• DOI:10.1097/AOG.0000000000002814
• Corpus ID: 51954776

Contraception for Women With Intellectual and Developmental Disabilities: Reproductive Justice.

@article{Hillard2018ContraceptionFW,
  title={Contraception for Women With Intellectual and Developmental Disabilities: Reproductive Justice.},
  author={Paula J. Adams Hillard},
  journal={Obstetrics \& Gynecology},
  year={2018}
}

• P. Hillard
• Published 1 September 2018
• Medicine, Psychology, Philosophy
• Obstetrics & Gynecology

A s individuals, we each have inherent worth and dignity as well as differing abilities. Medically we may speak of a range of disabilities, from cognitive disabilities to developmental, mental, physical, sensory, or other impairments. Historically, various disability communities have taken issue with the term disability, with its emphasis on medical defects, as opposed to individuals’ strengths and abilities. The medical model of disability tends to address impairments that a person may have that they themselves need to address, whereas a social model of disability suggests that it is society and the limits that it places on individuals that need to be remedied. In 1995, the First Lady of the United States, Hillary Clinton, stated at the 4th World Conference on Women in Beijing that women’s rights are human rights. At this conference, international recognition of reproductive health and rights was asserted, with the statement that, “reproductive health.implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so.”1 The same report of the program of action from this meeting affirmed the objectives of realizing the rights of all persons with disabilities.1 In this issue of Obstetrics & Gynecology, two articles address reproductive concerns of women with disabilities (see pages 559 and 565).2,3 Henan Li and colleagues address female sterilization and cognitive disability in the United States, using data from the National Survey of Family Growth from 2011 to 2015.2 These authors conducted a secondary data analysis in which women with self-reported difficulties with hearing, vision, cognition, ambulation, self-care, and independent living were compared with women without these disabilities. They found that rates of female sterilization were higher among women with either cognitive or noncognitive disabilities than among women without disabilities and that, after adjusting for sociodemographic covariates, women with cognitive disabilities were more likely to have undergone female sterilization or hysterectomy than were women without cognitive disabilities. They also found that these procedures were performed at younger ages in those with cognitive disabilities than in those without such disabilities. Cognitive disabilities included self-reported difficulties in processing information or making decisions. The data excluded institutionalized women as well as, presumably, individuals who were unable to respond to the survey personally. The authors cite the history of forced sterilizations among poor women, minorities, immigrants, prisoners, and those with disabilities. They raise appropriate questions as to whether nonmedical factors, such as prejudice and discrimination, may still be resulting in the disparities demonstrated in the current study. See related articles on pages 559 and 565.