Momina Khan, Hilary K Brown, Yona Lunsky, Lesley A Tarasoff
Many societal, structural, interpersonal, and individual factors shaped participants' reproductive life planning experiences. External perceptions of disability and parenthood, silence and stigma about sexuality from parents, barriers to accessible reproductive healthcare, and socioeconomic challenges were important factors. Partner dynamics, including experiences of sexual violence, perceived vulnerability in reproductive life plans, management of co-occurring health conditions and safety, and apprehensions related to pregnancy and childbirth also influenced participants' experiences. Participants' reproductive aspirations were positively shaped by self-advocacy and their support networks, with resilience prominently shaping their reproductive life planning experiences.
INTRODUCTION: Reproductive life planning can be a valuable component of reproductive health promotion. However, little is known about attitudes, desires, and intentions regarding pregnancy among people with disabilities. This exploratory qualitative study aimed to understand the reproductive life planning experiences of women and gender-diverse people with physical, intellectual, and developmental disabilities.
METHODS: We used purposeful sampling to recruit 29 reproductive-aged individuals with physical, intellectual, and/or developmental disabilities living in Ontario, Canada. We conducted semi-structured interviews virtually in 2020-2021. We audio-recorded the interviews and used thematic analysis to synthesize the data.
RESULTS: Many societal, structural, interpersonal, and individual factors shaped participants' reproductive life planning experiences. External perceptions of disability and parenthood, silence and stigma about sexuality from parents, barriers to accessible reproductive healthcare, and socioeconomic challenges were important factors. Partner dynamics, including experiences of sexual violence, perceived vulnerability in reproductive life plans, management of co-occurring health conditions and safety, and apprehensions related to pregnancy and childbirth also influenced participants' experiences. Participants' reproductive aspirations were positively shaped by self-advocacy and their support networks, with resilience prominently shaping their reproductive life planning experiences.
DISCUSSION: The persistence of societal biases and structural barriers, including ableism and disability microaggressions, experienced by participants highlights a need for inclusive social and healthcare environments that support the reproductive rights of women and gender-diverse people with disabilities. Training for healthcare providers, tailored reproductive health resources for people with disabilities, and enhanced support networks are needed to foster positive reproductive life planning experiences for this population.