Are disabled women getting the best deal when it comes to enjoying sex without risking pregnancy if they don’t want to or are unable to parent a child? According to Dr. Maida Taylor of the University of California, low dose birth control is manageable for lots of disabled women, as are many other types of birth control including the IUD so long as regular monitoring is carried out with adjustments made as necessary.
It DOES depend on the type of impairment a woman experiences, including a mental disability, as to which type of low dose birth control is suitable but the Depo injection or implants are not the only method of birth control that can be considered. Even the low dose birth control pill, in some circumstances, is quite OK.
The Depo-Provera shot [medroxyprogesterone acetate] is popular because it lasts for 3 months, it does not contain estrogen and is highly effective in preventing pregnancy. The injection is given into the woman’s buttocks or the arm muscle. The ‘shot’ does not suit all women as it can cause headaches, bloating/weight gain and irregular bleeding which is tough enough for anyone to manage and I would imagine, the last thing you need if you’re disabled.
Dr. Taylor reviewed several disabilities and diseases and below are her recommendations for which contraceptives are suitable for affected women:
Visual impairment and blindness. – if caused by a form of thrombosis, any birth control containing estrogen may be unsuitable. Dr. Taylor explains “but there is no evidence that hormonal contraception accelerates microvascular disease in diabetics. Since pregnancy has a high probability of accelerating retinal disease, effective contraception is essential for susceptible insulin-requiring diabetics”
Stroke, cerebrovascular accident and head injury – male and female condoms, caps, diaphragms and pessaries are fine. IUDs are good also. Again, Dr. Taylor warns that if cause of the disorder is thrombotic, then a contraceptive that does NOT contain estrogen should be used. As with any form of visual impairment, if a woman has suffered a head injury she should be very cautious about using oral contraceptives (OCs) so as not to cause further damage, even though the risk is small. “Contraceptive implant and progestin injectable might be considered with consultation,” Dr. Taylor said.
Cerebral palsy, polio, and muscular dystrophy -low dose birth control pills and other methods of birth control containing estrogen need to be used with care and preferably only if a woman is fairly active. If a woman is immobile she is at greater risk from blood clots/thrombosis. Diaphragms are good but may not be suitable if a woman’s bladder is not working properly as they can contribute to urine being held back and a subsequent urinary tract infection developing.
Mental retardation – condoms, caps, diaphragms and other barrier methods are not suitable for women who are severely retarded so for maximum effectiveness and convenience of use, Depo injections and implants are provided for these women. Dr. Taylor emphasises “With any and all contraception in this population, consent issues with parents, conservators, or courts may be raised. And there is a need to work with patients so they can comprehend, as much as possible, pregnancy, sexuality, and childbearing.”
Loss of an arm, hand – this disability allows for several types of low dose birth control to be used if desired and barrier methods may be especially convenient and hassle free for the disabled woman but all this needs to be worked out with a partner, who must be willing to assist with a method of birth control that suits them both – so honest chats beforehand are the go here.
Partial loss of movement or impaired movement, paralysis or amputation of a leg – this often means that a woman is confined to a chair or bed and is not active in moving around so her risk of thrombosis is increased. Low dose birth control methods WITHOUT estrogen would not be suitable.
A woman’s ‘contraception career’ lasts decades but does not need to be a burden for disabled women – if low dose birth control pills are used, constant monitoring of the combination with other medications taken and changing levels of hormones should be carried out. The type of low dose birth control that served you well at 29 may not be satisfactory when you’re 35. If debilitation occurs or the progression of a disease brings on immobility or affects the immune system, the method of birth control should be reviewed.
A disabled woman has the right to have a variety of birth control methods ‘designed’ for her throughout her ‘contraception career’. If she is unable to make a choice for herself, surely we have a duty of care to honour and acknowledge her sexuality by making that decision for her so that she can celebrate her womanhood with safety?