Disability and women's health
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Women with disabilities have the same health issues as any other women, such as the need for routine breast and cervical cancer screening.[1] However, women with impaired mobility are often not given basic tests, such as weight monitoring, due to the lack of accessible equipment.[2]
Article 12 of the
Because traditionally, men have been used to model and test health treatments, the approaches to health services, such as physical therapy, were not properly aligned with disabled women's needs.[6] It wasn't until after the 1990s that women's health issues were studied in-depth in the United States.[7] In addition, researching the health issues of women with disabilities is also understudied.[8] Starting in the early 2000s, health issues for people with disabilities began to be studied in the United States.[9] The first long-term study involving the experiences of women with disabilities and gynecological services was not published until 2001.[10]
Women with physical and or intellectual disabilities often face a medical bias within their communities. Factors can include unconscious bias, symptoms, negative perceptions, and even harsh assessments that can contribute to such discrimination.
Women with disabilities, especially individuals who belong to minority groups or who live in rural settings, are often underserved in their healthcare needs.
When disabled women need routine services for anything other than their main impairment(s), they can be perceived as "problematic patients" by healthcare providers.[17] Women with disabilities have reported that they are seen through the lens of their disability first and as a person second by healthcare providers.[18] Conversely, a 2003 report found that not only did healthcare providers, in general, have positive attitudes toward people with physical disabilities in Saudi Arabia, regardless of gender, which cited that most healthcare professionals worldwide have positive attitudes.[19]
In countries with strict gender segregation, such as in Saudi Arabia, women must use women-only clinics, many of which do not have access for people with physical disabilities.[20]
Sexual health and contraception
Contraceptives are used by women with intellectual disabilities for various reasons, including pregnancy prevention, menstrual suppression, and management of teratogenic medications.[21] Women with intellectual disabilities are more likely to use contraceptives or request a hysterectomy to manage menstruation.[22][23] Different types of contraception are available to women with disabilities, but the prescription of a specific type of birth control is based on the type of disability and the associated side-effects.[23]
Menstrual cycles are sometimes affected by different types of disabilities, such as rheumatoid arthritis.[23] In addition, women who become disabled later in life sometimes experience transient menstrual disorders.[23]
Healthcare professionals are less likely to refer women with disabilities for various gynecological screenings.[24] This could be due to the healthcare provider's unfamiliarity with disability or the assumption that women with disabilities are asexual in nature.[25] Women who have a spinal cord injury above the T6 vertebra can have autonomic dysreflexia during a pelvic exam which can be life-threatening.[26] Women with intellectual disabilities are less likely to receive Pap smears because the process may be upsetting to the patient.[27][28]
In the case that the
A study conducted in 1989 found that 19% of women with physical disabilities had been counseled on sexuality in a medical setting and were rarely offered information about contraceptives.[6] Women with intellectual disabilities often lack both education about sexual health and the ability to learn about it informally.[33] In addition, their medical providers are less likely to discuss contraception with them.[22] Women with intellectual disabilities can use supported decision-making with family members or other support persons to determine their preferred contraceptive option.[34]
In Zimbabwe, people with disabilities are often treated as second-class citizens. Women in Zimbabwe face increased barriers when accessing services for sexual health.[35] The National Reproductive Health Policy implemented in 2006 did not address the needs of women with disabilities.[36] Zimbabwean women with disabilities faced negative attitudes about their reproductive health, such as those of female nurses who expressed the idea that "sex was not meant for the disabled."[37]
Women with intellectual disabilities have been advised to become sterilized to possibly prevent sexual assault or because doctors may consider them unfit to become mothers.[38][39] In the United States, a 1927 Supreme Court case, Buck v. Bell, allowed the forced sterilization of women with intellectual disabilities.[40] In Singapore, the Voluntary Sterlisation Act (VSA) was passed in 1970 and which allowed any spouse, parent or guardian of persons who are "afflicted with any hereditary form of illness that is recurrent, mental illness, mental deficiency or epilepsy" to consent to the sterilization on their behalf.[41] In Brazil, many healthcare providers and individuals with disabilities both see sterilization as the only option for contraception.[24]
Maternity care
Some studies have highlighted potential obstacles for pregnant women with disability. For example, a 1996 study discovered that over 50% of United States hospitals lacked the necessary infrastructure to cater to the needs of physically disabled pregnant women, which rendered their facilities inaccessible.[42] These barriers may include lack of adjustable examination tables, wheelchair compatible features, and accessible weight scales.[43]
A study published in the Journal of Applied Research in Intellectual Disabilities demonstrated that pregnant women and mothers with intellectual disabilities benefit from the inclusion of a doula both before and after they gave birth.[44] This approach contrasts with "crisis driven" services that are more often given to parents who have intellectual disabilities.[45] Participants in one small study felt that they gained a trusting relationship with their doulas and that helped them stay calm both during labor and after.[46] Additionally, the women felt that they were able to make better, more informed choices about their own care because of the information and support they received from their doulas.[46]
Expectant mothers with intellectual disabilities may need more specialized training and guidance in regards to childcare after they give birth.[47] Important themes in training may include consistent formal obstetric training and education for both providers and mothers.[47]
Breast health
Many women with a disability do not regularly receive or are not regularly referred for breast cancer screenings.[48] Women with some physical disabilities may need to be referred to special mammography centers because most equipment is not designed to accommodate women who are unable to stand.[23][49] Some women with disabilities may be unable to receive breast cancer screening due to financial concerns.[49] Clinical depression is also a complication involved in whether or not women with disabilities get annual mammograms.[50] There is also potential concern that ionizing radiation applied to the spine too early on in life may cause an increased risk of developing breast cancer.[23] This is of particular concern for those women and girls who experienced disabilities relating to the spine from a young age.[23]
Later life
Standards of
Women with physical disabilities are at a greater risk of having lower bone mass and are at risk for osteoporosis.[54] Women with ID and Down syndrome often go through menopause at an earlier age than other women.[55] Women with various disabilities sometimes show different symptoms from decreased estrogen levels during menopause.[23]
Loss of estrogen after menopause can also lead to a greater likelihood of urinary incontinence[23] Treatment and therapy interventions for incontinence have not been tested or modified for women with disabilities.[56]
See also
References
Citations
- ^ "Women's Health". UCP. 2015-07-31. Archived from the original on 2017-06-28. Retrieved 2017-07-29.
- ^ Lehman 2009, p. 191.
- ^ Convention on the Elimination of All Forms of Discrimination against Women. New York: United Nations. 1979.
- ^ "Article 25 - Health | United Nations Enable". www.un.org. Retrieved 20 October 2017.
- PMID 21968028.
- ^ a b Nosek & Hughes 2003, p. 225.
- ^ a b Parish & Ellison-Martin 2007, p. 109.
- ^ Parish & Ellison-Martin 2007, p. 110-111.
- ^ Wisdom et al. 2010, p. 369.
- ^ Kaplan 2006, p. 450-451.
- ^ https://caccl-glendale.primo.exlibrisgroup.com/permalink/01CACCL_GLENDALE/fomh76/cdi_proquest_journals_2504562174
- PMID 31124165.
- ^ Lin et al. 2011, p. 149.
- ^ Nosek & Hughes 2003, p. 228.
- ^ Nosek & Hughes 2003, p. 228-229.
- ^ Carvalho, Brito & Medeiros 2014, p. 115.
- ^ Thomas 2001, p. 247.
- ^ Thomas 2001, p. 252.
- ^ Al-Abdulwahab & Al-Gain 2003, p. 67.
- ^ Aldosari 2017, p. 11.
- PMID 25266430.
- ^ a b Greenwood & Wilkinson 2013, p. 3.
- ^ .
- ^ a b Carvalho, Brito & Medeiros 2014, p. 116.
- ^ Kaplan 2006, p. 450.
- ^ Kaplan 2006, p. 453.
- ^ Greenwood & Wilkinson 2013, p. 5.
- ^ Drew & Short 2010, p. 262.
- ^ a b Kaplan 2006, p. 451.
- ^ Kaplan 2006, p. 452.
- ^ Waldman, Hilary (1998-03-03). "New Equipment, New Outlook". Hartford Courant.
- ISBN 978-0781735322.
- ^ Greenwood & Wilkinson 2013, p. 2.
- PMID 27432358.
- ^ Rugoho & Maphosa 2017, p. 2.
- ^ Rugoho & Maphosa 2017, p. 3.
- ^ Rugoho & Maphosa 2017, p. 4.
- S2CID 144316686.
- ^ Thomas 2001, p. 255.
- ^ Wills, Matthew (2017-08-03). "When Forced Sterilization was Legal in the U.S." JSTOR Daily. Retrieved 2017-08-03.
- ISBN 9781315527406.
- ^ Lehman 2009, p. 186.
- PMID 26484689.
- ^ McGarry, Kroese & Cox 2016, p. 32.
- ^ McGarry, Kroese & Cox 2016, p. 31.
- ^ a b McGarry, Kroese & Cox 2016, p. 29.
- ^ PMID 35031269.
- ^ Todd & Stuifbergen 2012, p. 74.
- ^ a b Todd & Stuifbergen 2012, p. 75.
- ^ Todd & Stuifbergen 2012, p. 76.
- PMID 27702838.
- ^ Mohamed 2013, p. 408.
- ^ Mohamed 2013, p. 414.
- ^ Dormire & Becker 2007, p. 98.
- ^ Chou, Lu & Pu 2013, p. 114-115.
- ^ Dormire & Becker 2007, p. 100.
Sources
- Al-Abdulwahab, Sami S.; Al-Gain, Salah I. (2003). "Attitudes of Saudi Arabian Health Care Professionals Towards People with Physical Disabilities" (PDF). Asia Pacific Disability and Rehabilitation Journal. 14 (1): 63–70. Archived from the original (PDF) on 2017-08-09. Retrieved 2017-09-10.
- Aldosari, Hara (2 May 2017). "The Effect of Gender Norms on Women's Health in Saudi Arabia". The Arab Gulf States Institute in Washington.
- Carvalho, Camila Fernandes da Silva; Brito, Rosineide Santana de; Medeiros, Soraya Maria de (December 2014). "Contextual analysis of gynaecological care provided to women with physical disability". Revista Gaúcha de Enfermagem. 35 (4): 114–117. PMID 25842789.
- Chou, Yueh-Ching; Lu, Zxy-Yann Jane; Pu, Cheng-Yun (1 June 2013). "Menopause experiences and attitudes in women with intellectual disability and in their family carers". Journal of Intellectual & Developmental Disability. 38 (2): 114–123. S2CID 7819715.
- Dormire, Sharon; Becker, Heather (January 2007). "Menopause Health Decision Support for Women With Physical Disabilities". Journal of Obstetric, Gynecologic, & Neonatal Nursing. 36 (1): 97–104. PMID 17238954.
- Drew, Julia A. Rivera; Short, Susan E. (December 2010). "Disability and Pap smear receipt among U.S. Women, 2000 and 2005". Perspectives on Sexual and Reproductive Health. 42 (4): 258–266. PMID 21126302.
- Greenwood, Nechama W.; Wilkinson, Joanne (2013). "Sexual and Reproductive Health Care for Women with Intellectual Disabilities: A Primary Care Perspective". International Journal of Family Medicine. 2013: 642472. PMID 24455249.
- Kaplan, Clair (November 2006). "Special Issues in Contraception: Caring for Women With Disabilities". Journal of Midwifery & Women's Health. 51 (6): 450–456. PMID 17081935.
- Lehman, Cheryl A. (2009). "APN Knowledge, Self-Efficacy, and Practices in Providing Women's Healthcare Services to Women with Disabilities". Rehabilitation Nursing. 34 (5): 186–194. S2CID 21455440.
- Lin, Lan-Ping; Lin, Jin-Ding; Chu, Cordia M.; Chen, Li-Mei (2011-09-01). "Caregiver attitudes to gynaecological health of women with intellectual disability". Journal of Intellectual & Developmental Disability. 36 (3): 149–155. S2CID 23541045.
- McGarry, Alison; Kroese, Biza; Cox, Rachel (2016-01-01). "How Do Women with an Intellectual Disability Experience the Support of a Doula During Their Pregnancy, Childbirth and After the Birth of Their Child?". Journal of Applied Research in Intellectual Disabilities. 29 (1): 21–33. PMID 25953324.
- Mohamed, Nadia Abdalla (2013). "The Relation Between Environmental Factors and Health Related Mobility Disability of Elderly Women with Osteoarthritis in Southern Egypt" (PDF). Journal of American Science. 9 (5): 408–416.
- Nosek, Margaret; Hughes, Rosemary B. (Summer 2003). "Psychosocial Issues of Women with Physical Disabilities: The Continuing Gender Debate". Rehabilitation Counseling Bulletin. 46 (4): 224–233. S2CID 144282612.
- Parish, Susan L.; Ellison-Martin, M. Jennifer (Fall 2007). "Health-Care Access of Women Medicaid Recipients". Journal of Disability Policy Studies. 18 (2): 109–116. S2CID 72441519.
- Rugoho, Tafadzwa; Maphosa, France (2017-05-26). "Challenges faced by women with disabilities in accessing sexual and reproductive health in Zimbabwe: The case of Chitungwiza town". African Journal of Disability. 6 (1): 252. PMID 28730062.
- Thomas, Carol (April 2001). "Medicine, Gender, and Disability: Disabled Women's Health Care Encounters". Health Care for Women International. 22 (3): 245–262. S2CID 40276648.
- Todd, Ana; Stuifbergen, Alexa (2012). "Breast Cancer Screening Barriers and Disability". Rehabilitation Nursing. 37 (2): 74–79. PMID 22434617.
- Wisdom, Jennifer P.; McGee, Marjorie G.; Horner-Johnson, Willi; Michael, Yvonne L.; Adams, Elizabeth; Berlin, Michelle (2010). "Health Disparities Between Women With and Without Disabilities: A Review of the Research". Social Work in Public Health. 25 (3): 368–386. PMID 20446182.