Literature Review on Provision of Appropriate and Accessible ...

PAGE 39
is placed on their health and future fertility than on other women’s
(McCarthy, 1999: 224).
Another reason proposed for prescribing contraception to women
with intellectual disability is that such women, particularly those with
severe intellectual disabilities, would be unable to practically manage
their periods and/or that they would be very distressed by the sight
of blood (Taylor & Carlson, 1993). McCarthy contends that there is
actually very little evidence to support this point (1998). To protect a
woman with intellectual disability from the sexually active men around
her has also been used as a justification for prescribing contraception.
Taylor and Carlson (1993) point out that prescribing contraception to a
woman with learning disabilities thought to be at risk of sexual abuse
in fact increases her vulnerability to abuse. As research has shown that
perpetrators of abuse are more likely to be known to a woman with
intellectual disability, the knowledge that a woman is using contraception
provides protection in itself for a potential abuser, as he will know that
pregnancy will not occur and therefore that there are fewer chances of
his being caught and identified.
Support to People with an Intellectual Disability who are
Accessible
and Appropriate of Provision on <strong>Review</strong> <strong>Literature</strong>
Experiencing Crisis Pregnancy
2.3 Research on use of contraception
Most research concerning the contraception of intellectually disabled
women refers to the population attending a particular gynaecologist
(Grover, 2002) or a clinic (Elkins, Gafford, Wilks, Muram and Golden,
1986; Chamberlain, Rauh and Passer, 1984). Mail surveys have also
been conducted where directors in institutions have been asked to
estimate how often the different contraceptive methods are used in their
institutions (Gust et al., 2003).
2.3.1 Type of contraception used
The pattern of contraceptive use amongst women with
intellectual disability differs widely from that of the non-disabled
population. Longstanding research confirms that the Pill, Depot
Medroxyprogesterone Acetate and IUDs are the only methods used
by most women with learning disabilities, with barrier methods being
reported as unheard of (Chamberlain et al., 1984: 449; McCarthy, 1998;
Van der Merwe & Roux, 1987; Shet & Malpani, 1991). More recently,