Differences in contraceptive methods used by women with physical disabilities compared to women without disabilities

Women with physical disabilities face unique challenges often not addressed by gynecologists regarding choices of contraceptive method. Interactions between some hormonal methods of contraception and disability-related medications, inability to use barrier methods because of limitations in manual dexterity, potentially elevated risk for DVT, and need for menstrual management are factors that complicate decisions about contraceptive methods for this growing population. Objective: This study assessed similarities and differences in the use of and satisfaction with different methods of birth control between women with disabilities and women without disabilities, while controlling for age at onset and severity of disability. Methods: As part of a national survey, 616 women of childbearing age (315 with a variety of physical disabilities, 301 without disabilities) reported their use of and satisfaction with various forms of contraception. Results: Women with physical disabilities were significantly less likely than women without disabilities to use hormonal (11.7%/19.6%) or barrier methods (11.1%/17.6). They were significantly more likely to have had a hysterectomy (8.9%/4.3%) or use no method (41.9%/33.4%). There were no significant differences in the use of surgical methods (22.9%/22.6%) or natural methods (3.5%/2.7%). Women with more severe disabilities were significantly more likely to have had hysterectomies or use surgical or no method of contraception. Women with disabilities were least satisfied with barrier methods. Conclusion: Women with disabilities are more likely to use permanent methods or no method of contraception. Further research is needed to understand the impact of functional limitations and other disability-related factors on the use of other contraceptive methods in this population.